Perceived stress reduction through an infertility coaching program: a randomized controlled clinical trial.

Infertility has been recognized as a distressing experience among couples worldwide, cutting across various cultures. This present study was conducted to assess the impact of a supportive stress management program led by an infertility coach for women undergoing fertility treatment. This randomized controlled clinical trial study was performed on 60 infertile women undergoing assisted reproductive techniques at Maryam Infertility Center located in Sari in 2018. After random allocation in two groups, 30 individuals were in the intervention group and 30 in the control group. The intervention program was implemented according to the infertility coach's counseling protocol in six stages. The control group received only routine ward counseling. In order to measure stress, the Newton Infertility Stress Questionnaire was used firstly before intervention and then after oocyte puncture, embryo transfer, and pregnancy testing. Data analysis was performed using SPSS statistical software version 18 and Shapiro-Wilk, Chi-square, Mann-Whitney, independent t-test, Friedman test, Wilcoxon test, GEE test, and Cohen's effect size. Our analysis approach has also been based on the analysis of (ITT). The significance level was 0.05. The mean ± SD scores of infertility perceived stress before the intervention in the control was 146.16 ± 16.90 and the intervention group was 156.53 ± 9.31, after intervention at the time of oocyte puncture in the controls was 165.36 ± 8.98 and the intervention group was 155.83 ± 10.70, at the day of embryo transfer in the control group was 156.35 ± 14.45 and in the intervention group was 123.58 ± 22.9 and in the pregnancy test day in the control group was 185.76 ± 26.56 and in the intervention group was 127.61 ± 21.57 (P < 0.001). According to Friedman test, the mean of stress in three situations after the intervention showed a significant difference in reduction of the mean of stress (P < 0.001). In the control group, the stress score of the samples had an increasing trend, which was significant during the measurement steps based on Friedman test results (P < 0.001). In the intervention group, paired t-test results showed no significant comparing mean score of Newton's infertility stress before and after oocyte puncture day (P = 0.711), comparing the mean of stress before and after pregnancy test day (P = 0.003) and also comparing of mean stress before and after pregnancy on the day of embryo transfer according to Wilcoxon test (P < 0.001). And comparing mean stress before and after pregnancy test day, paired t-test (P = 0.001) showed significant statistical differences. According to the results of the GEE test, changes in stress scores over time were significant between the two groups (P < 0.001), as well as the effect of stress on oocyte puncture day (0.41), embryo transfer day (1.69), pregnancy test day (P < 0.001) (2.46) had a significant effect on the day of embryo transfer and pregnancy test day. Based on the results of this study, the infertility coach program demonstrated the ability to decrease the perceived stress related to infertility. Additionally, it showed potential in enhancing treatment outcomes, such as oocyte count and positive pregnancy results, among infertile women undergoing assisted reproductive techniques.Trial registration: Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/33357 ). Registered 11-11-2018.

Evaluation of clinical competence and its related factors among ICU nurses in Kermanshah-Iran: A cross-sectional study.

OBJECTIVES: The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah, Iran. METHODS: In this cross-sectional study, 155 Iranian nurses were selected by stratified random sampling. The data collection tools included a personal information form and the "Nurse Competence Scale". Data were analyzed using descriptive and analytical statistics. RESULTS: The mean score of nurses' clinical competence was equal to 76.14 ±â€¯1.59 out of 100, which was at a "very good level". The mean score of using clinical competence in practice was equal to 70.38 ±â€¯15.25 out of 100, which was at a "good level". Among the subscales of clinical competence, the highest mean score was related to "managing situation". The mean score of "using clinical competence in practice" was related to the subscale of "therapeutic interventions". There was no statistically significant difference among the score of clinical competence of nurses varying with different gender, age, academic degree, and work experience. CONCLUSIONS: The clinical competence of critical care nurses in Kermanshah was at a "very good" level, and the use of clinical competence in practice was at a "good level." Given the importance of clinical competencies in practice, nurses' clinical competence should be evaluated objectively and positive measures should be taken to promote the application of their clinical competence.

Occupational stress and its related demographic factors among Iranian CCU nurses: a cross-sectional study.

OBJECTIVES: Occupational stress can have an adverse effect on mental and physical health and performance of nurses. The aim of this study was to investigate the occupational stress of Iranian critical care unit (CCU) nurses and its related demographic factors. RESULTS: In this cross-sectional study, 155 CCU nurses were randomly selected. The Osipow Occupational Stress Questionnaire was used as data collection tool. The mean of nurses' occupational stress was 210.13 ± 40.87 out of 300, which was at the "moderate-to-high" level. The highest mean of occupational stress was related to the subscale of "Role Overload" (36.30 ± 6.98) and the lowest mean was related to the subscale of "Physical Environment" (33.58 ± 9.76). There was no statistically significant difference between the mean occupational stress and variables of sex, age, academic degree and working experience.

Radioactivity levels in the mostly local foodstuff consumed by residents of the high level natural radiation areas of Ramsar, Iran.

Among High Level Natural Radiation Areas (HLNRAs) all over the world, the northern coastal city of Ramsar has been considered enormously important. Many studies have measured environmental radioactivity in Ramsar, however, no survey has been undertaken to measure concentrations in the diets of residents. This study determined the 226Ra activity concentration in the daily diet of people of Ramsar. The samples were chosen from both normal and high level natural radiation areas and based on the daily consumption patterns of residents. About 150 different samples, which all are local and have the highest consumption, were collected during the four seasons. In these samples, after washing and drying and pretreatment, the radionuclide was determined by α-spectrometry. The mean radioactivity concentration of 226Ra ranged between 5 ± 1 mBq kg-1 wet weight (chino and meat) to 725 ± 480 mBq kg-1 for tea dry leaves. The 226Ra activity concentrations compared with the reference values of UNSCEAR appear to be higher in leafy vegetables, milk and meat product. Of the total daily dietary 226Ra exposure for adults in Ramsar, the largest percentage was from eggs. The residents consuming eggs from household chickens may receive an elevated dose in the diet.