Effect of augmented reality-based rehabilitation of hand burns on hand function in children: A randomized controlled trial.

BACKGROUND: Despite the use of traditional rehabilitation methods, hand function may still remain impaired in children suffering from burn injuries. PURPOSE: This study aimed to assess the impact of implementing an augmented reality (AR) rehabilitation booklet designed for pediatric hand burn on their hand functionality. STUDY DESIGN: This was a randomized controlled trial. METHODS: Seventy-two children, aged 8-14 years with a hand burn, were randomly allocated into intervention (n = 36) and control (n = 36) groups. Children in the control group received routine rehabilitation program, while in the intervention group, children performed exercises using a printed booklet with related AR application. The Jebsen-Taylor Hand Function Test was completed before the intervention at the time of the patients' discharge and 1 month later. RESULTS: The results of analysis of covariance based on baseline- and fully-adjusted models showed significant intervention effect after discharge as well as after intervention for hand function (mean difference [95% confidence interval] for discharge: -8.2 [-15.0 to -1.4] and for after intervention: -74.0 [-88.8 to -59.1]) and the items (all p < 0.05), except for writing and lifting large light objects for both after discharge and after intervention measures (all p-value > 0.05). CONCLUSIONS: A significant decrease in the total time taking to complete the Jebsen-Taylor hand function test was observed in the intervention group compared to the control group 1 month after discharge. Rehabilitation of children with hand burns, using printed educational booklet with related AR application, improves their hand function.

Family-centred empowerment using telenursing on pressure injury incidence in post-discharge stroke patients.

OBJECTIVE: The aim of this study was to evaluate the effect of a family-centred empowerment intervention on the incidence, stage and status of pressure injury (PI) in patients diagnosed with stroke during the post-discharge period with a telenursing approach. METHOD: This randomised controlled clinical trial (RCT) was conducted with patients admitted to Ghaem Hospital in Mashhad and who were diagnosed with stroke. Patients were randomly assigned to one of two equal-sized groups: intervention and control. Family education and follow-up of the intervention group was performed using WhatsApp messenger for one month. Caregivers of patients in the control group received the routine training programme. The incidence, stage and status of PIs of both groups were measured at the beginning and at one month later using the Braden Scale, the EPUAP/NPUAP Classification System, and the Pressure Ulcer Scale for Healing (PUSH). RESULTS: A total of 60 patients took part in the RCT (30 patients allocated to each group). The incidence of PI in the control group was significantly higher than in the intervention group (p<0.001). The results showed significantly lower stages of PI in the intervention group than in the control group (p<0.001 and p<0.05 for univariable and multivariable models, respectively). The results showed a significantly lower PUSH score in the intervention group than in the control group (p<0.001 and p<0.05 for univariable and multivariable models, respectively). CONCLUSION: The findings of this RCT show that the empowerment and training of caregivers of patients diagnosed with stroke after discharge using telenursing can reduce the incidence and severity of PIs and improve their status in these patients.

The effect of threshold inspiratory muscle training on the duration of weaning in intensive care unit-admitted patients: A randomized clinical trial.

Background: The purpose of this study was to evaluate the effect of threshold inspiratory muscle training (IMT) on the duration of weaning in intensive care unit (ICU)-admitted patients. Materials and Methods: This randomized clinical trial enrolled 79 ICU-admitted, mechanically ventilated patients in 2020-2021 in Imam Reza Hospital, Mashhad. Patients were randomly divided into intervention (n = 40) and control (n = 39) groups. The intervention group received threshold IMT and conventional chest physiotherapy, while the control group only received conventional chest physiotherapy once a day. Before and after the end of the intervention, the strength of inspiratory muscles and the duration of weaning were measured in both the groups. Results: The duration of weaning was shorter in the intervention group (8.4 ± 1.1 days) versus the control group (11.2 ± 0.6 days) (P < 0.001). The rapid shallow breathing index decreased by 46.5% in the intervention group and by 27.3% in the control group after the intervention (both P < 0.001), and the between-group comparison showed a significantly higher reduction in the intervention group than control group (P < 0.001). The patients' compliance after the intervention compared to the 1st day increased to 16.2 ± 6.6 in the intervention group and 9.6 ± 6.8 in the control group (both P < 0.001), and the between-group comparison showed a significantly higher increase in the intervention group than control group. The maximum inspiratory pressure increased by 13.7 ± 6.1 in the intervention group and by 9.1 ± 6.0 in the control group (P < 0.001). Furthermore, the weaning success was 54% more probable in the intervention group than control group (P < 0.05). Conclusion: The results of this study showed the positive effect of IMT with threshold IMT trainer on increased strength of respiratory muscles and reduced weaning duration.

Rehabilitation of Burn Victims: Improving Quality of Life in Victims With Face and Neck Burn Through an Augmented Reality Coupled Pamphlet.

The present study aimed to investigate the effect of implementing rehabilitation programs using an augmented reality (AR) coupled pamphlet on the quality of life (QOL) of patients with face/neck burns. This randomized clinical trial was conducted on 60 patients (intervention = 30, control = 30) admitted to the burn center of Imam Reza Hospital, Mashhad, Iran. Patients in the intervention group performed their rehabilitation program using AR coupled pamphlet during 6 weeks, while control patients used simple pamphlet. The Burn-Specific Health Scale for Face and Neck (BSHS-FN) was completed at the beginning, and 2 and 6 weeks after the intervention. The results for 2 weeks after intervention measures in model 1 ANCOVA showed significant raise of measures only for Hand function (P = .035). However, for the total QOL score and other domains the differences were not significant (All P > .05). Adjusting for confounders, model 2 ANCOVA showed similar results for 2 weeks after intervention. However, in both models, the results indicated significant intervention effect for 6 weeks after intervention in QOL score and all domains (All P < .05), so that the amount of increase in measures were significantly higher in the intervention group. According to the findings, implementing rehabilitation program for patients with face and neck burns using AR coupled pamphlet can improve their QOL.

Prevalence of Polycystic Ovary Syndrome in Iranian Adolescent Girls Based on Adults and Adolescents' Diagnostic Criteria in Mashhad City.

Background: PCOS is a common endocrine disorder of reproductive age with high morbidity that its prevalence ranging from 5.6% to 26%. The aim of this study was to evaluate the prevalence of PCOS in Iranian adolescent girls aged 14-19 years based on adults and adolescents' criteria. Methods: This cross-sectional study was carried out with 650 high school adolescent girls in Mashhad city, north-east of Iran. PCOS was defined as the presence of three or two of the three features including oligo/amenorrhea, clinical or biochemical hyperandrogenism, and polycystic ovaries. Descriptive statistics, chi-square, and t-test were used to analyze the data through SPSS vs 22 (SPSS Inc., USA) and the significance level was set at p≤0.05. Results: The mean age of adolescent girls was 16.73±3.4 years. The prevalence of PCOS using Rotterdam, National Institutes of Health (NIH), Androgen Excess-PCOS Society (AES), European Society of Human Reproduction and Embryology (ESHRE)/American Society for Reproductive Medicine (ASRM) (2012), and Endocrine Society Clinical Practice (2013) criteria was 4.2%, 3.6%, 3.6%, 0.7%, and 3.6%, respectively. Conclusion: The rate for prevalence of PCOS calculated based on Rotterdam, NIH, AES, and Endocrine Society (2013) criteria was higher in comparison to ESHRE/ASRM (2012) criteria. According to the results of our study, in order to prevent overestimation of this syndrome's prevalence in the adolescents due to its overlap with signs of pubertal development, all above-mentioned three criteria should be considered together, which is in line with the recommendations proposed by Carmina et al. and ESHRE/ASRM working group.

Acceptability, feasibility, and effectiveness of smartphone-based delivery of written educational materials in Iranian patients with coronary artery disease: A randomized control trial study.

Background and Aims: Providing education to patients with coronary artery disease (CAD) is one of the crucial roles of nurses and, there are various education methods for these patients. This study aimed to investigate the acceptability, feasibility, and effectiveness of smartphone-based delivery (SPBD) of written educational materials in Iranian patients with CAD. Methods: A total of 104 patients with CAD who were admitted to the cardiovascular unit of a large hospital in the northeast of Iran were randomly divided into control and intervention groups. When the standard educational content was provided, educational materials were delivered to the intervention group using a SPBD and to the control group using the routine print delivery (PD). The authors investigated the usability in the postintervention phase and information satisfaction and medication self-efficacy in the pre- and postintervention phases. Results: The mean age and the standard deviation of "patients" age in SPBD and PD groups was 51.8 ± 1.1 and 52.7 ± 1.3 years, respectively. No significant difference was observed between the two groups in terms of mean information satisfaction score (p = 0.726); however, the information satisfaction score was significantly higher in the SPBD group than PD group after the intervention (p = 0.012). The findings showed no statistically difference between two groups in terms of usability score (p > 0.05). The two groups were homogenous in terms of the mean medication self-efficacy score in the preintervention phase (p = 0.987); however, it was significantly higher in SPBD group than PD group in the postintervention phase (p = 0.045). Conclusion: The SPBD method had the same usability as the PD method and at the same time this method was more effective in promoting medication self-efficacy. Therefore, SPBD could be used to educate patients with CAD and their caregivers and have appropriate effectiveness and acceptability among the Iranian population.

The Effect of Peer Teaching on the Quality of Report Writing Based on the Nursing Process.

Background: Considering the importance of report writing and its problems, different teaching methods can be used to improve nurses' knowledge and performance, among which is peer teaching. This study aimed to determine the effect of peer teaching on the quality of report writing based on the nursing process. Materials and Methods: This quasi-experimental study examined 60 nurses working in the surgical and cardiac wards of Razavi Hospital in Mashhad during 2019. These wards randomly assigned to intervention (n = 30) and control (n = 30) groups. For 2 weeks, report writing teaching was implemented for the intervention group based on the nursing process through peer teaching. The control group routinely performed report writing. At the beginning and end of the study, we reviewed nursing reports of both groups using a valid and reliable checklist. Data were analyzed using two-way analysis of variance with repeated-measures analysis of variance. Results: Before the intervention, there was no significant difference between the two groups in terms of scores of report writing quality in structure, content dimensions, and the total scores (p > 0.05). After the intervention, the mean score changes were significantly higher in the structure (Mean Difference (MD) = 4.99, 95%CI: 1. 26-8.72, p < 0.010), content (MD = 8.11, 95%CI: 4.91-11.31, p < 0.001), and the total quality of report writing (MD = 7.54, CI: 4.56-10.53, p < 0.010) in the intervention group than the control group. Conclusions: Peer teaching improved the nurses' quality of report writing. The teaching planners are recommended to use this method to train nursing staff.

Improving respiratory muscle strength and health status in burn patients: a randomized controlled trial.

PURPOSE: Pulmonary complications are among the major disadvantages of burns. The present study aimed to determine the effect of inspiratory muscle training on respiratory muscle strength and health status in burned patients. METHODS: The current randomized clinical trial was conducted on 64 burned patients in Burn Center of Imam Reza Hospital, Mashhad, Iran. In the intervention group, a Powerbreathe device (KH1 digital model) was used twice a day for 10 days, accompanied by the routine procedures and in the control group, only chest physiotherapy and incentive spirometer were used. RESULTS: Before the intervention, the mean scores of respiratory muscle strength were 38.8 ± 10.1 and 35.8 ± 9.0 in the Powerbreathe group and control group, respectively (p = .206). After the intervention, the mean score of respiratory muscle strength of Powerbreathe group was 49.2 ± 11.8 and in the control group was 39.3 ± 8.5 (p < 0.001). Moreover, the mean scores of health status before the intervention in the burned patients were 66.3 ± 14.8 and 63.0 ± 17.3 in the Powerbreathe group and control group, respectively (p = 0.550). In the post-intervention phase, the mean health status score of the burned patients in the intervention and control groups were measured at 75.9 ± 14.1 and 66.7 ± 15.9, respectively (p = 0.019). CONCLUSION: It seems that inspiratory muscle training improves respiratory muscle strength and health status in the burned patients. Therefore, the use of Powerbreathe is recommended for the prevention and improvement of pulmonary complications in patients with chest burns.

The Effect of a Recreational Therapy Program on the Pain Anxiety and Quality of Life of Patients With Burn Injuries: A Randomized Clinical Trial.

Pain anxiety and dysfunction are among the most prevalent complications of burns, impacting the quality of life (QOL) of patients with burn injuries. As a nonpharmaceutical approach, recreational therapy can be effective in reducing the complications of burns. This study aimed to examine the effect of a recreational therapy program on the pain anxiety and QOL of patients with burn injuries. This controlled randomized clinical trial was conducted on 58 patients admitted to the burn center of Imam Reza Hospital in Mashhad, Iran. These patients were randomly allocated to the intervention and control group. The intervention group received a recreational therapy program three sessions a week, for 2 weeks. The control group performed routine daily activities. As the main variable of the study, the Burn Specific Pain Anxiety Scale and Burn Specific Health Scale-Brief were completed for both groups before and 2 weeks after the intervention. After controlling confounders, the pain anxiety score in the intervention group was significantly lower than in the control group (P = .002). The total QOL score was significantly higher in the intervention group than the control group (P = .001). In addition, the intervention significantly increased the scores of QOL in the physical (P < .001), emotional (P = .009), and social (P < .001) dimensions. As it reduces pain anxiety and promotes the QOL of patients with burn injuries, this recreational therapy program is recommended for promoting the mental health and QOL of these patients.

The Effect of Inhalation Aromatherapy on Sedation Level, Analgesic Dosage, and Bispectral Index Values during Donor Site Dressing in Patients with Burns: A Randomized Clinical Trial.

OBJECTIVE: To determine the effect of inhalation aromatherapy on sedation level, analgesic dosage, and bispectral index (BIS) values during donor site dressing in patients with burns. METHODS: This trial was conducted on 62 patients with burns requiring donor site dressing who were admitted to the Burn Center of Imam Reza Hospital, Mashhad, Iran. In the intervention group, the patients inhaled damask rose 40% and lavender 10% essential oils during donor site dressing change, whereas in the control group, the site was dressed using routine protocol. Sedatives and analgesics were prescribed until the levels of brain activity achieved light sedation. The brain activity and sedation levels were measured before and after the donor site dressings using the BIS. Data were analyzed using the analysis of covariance and the two-way analysis of variance with repeated measures. RESULTS: All 62 patients completed the study. The required doses of ketamine (P < .001), fentanyl (P = .003), morphine (P < .001), and propofol (P < .001) were significantly lower in the intervention group. The BIS was also significantly lower in the intervention group (P < .001). Heart rate decreased significantly during the aromatherapy, as well as after analgesic and sedative consumption (P < .001). CONCLUSIONS: The inhalation of damask rose and lavender essential oils is an effective intervention to reduce the doses of sedative and analgesic drugs administered as well as BIS during donor site dressing change in patients with burns.

The Effects of Manual Lung Hyperinflation on Pulmonary Function after Weaning from Mechanical Ventilation among Patients with Abdominal Surgeries: Randomized Clinical Trial.

Introduction: After abdominal surgery, the patients who are separated from mechanical ventilation and provided with oxygen therapy via a T-piece are at risk for respiratory complications. Therefore, they need additional respiratory support. This study aimed to evaluate the effects of manual hyperinflation (MHI) on pulmonary function after weaning. Methods: This randomized clinical trial included 40 patients who had undergone abdominal surgery and were receiving oxygen via a T-piece. Patients were selected from the intensive care units (ICU) of two hospitals in Mashhad, Iran. The subjects were randomly allocated to intervention (MHI) and control groups. Patients in the MHI group were provided with three 20-minute MHI rounds using the Mapleson C, while the control group received routine cares. Tidal volume (Vt), Rapid Shallow Breathing Index (RSBI), and the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F ratio) were measured before the intervention, as well as 5 and 20 minutes after the intervention. Atelectasis prevalence was assessed before and 24 hours after the intervention. Data were analysed by SPSS software version 13. Results: At baseline, there were no significant differences between the groups regarding Vt, RSBI, P/F ratio, and atelectasis rate. No significant difference was also found between the groups regarding atelectasis rate 24 hours after the intervention. However, at both posttests, Vt, RSBI, and P/F ratio in the MHI group were significantly better than the control group. Conclusion: In patients with artificial airway and spontaneous breathing, MHI improves pulmonary function.

The effect of rehabilitation education through social media on the quality of life in burn patients: a randomized, controlled, clinical trial.

BACKGROUND: Burn is one of the most brutal harms to the human body and mind and its wide-ranging complications have many adverse effects on the patients' quality of life. The present study was conducted to investigate the effect of rehabilitation education through social media on burn patients' quality of life. METHODS: The present randomized, controlled, clinical trial was conducted on 60 patients admitted to Imam Reza Hospital Burn Center in the city of Mashhad, Iran, who were randomly assigned to either the intervention or control groups (n = 30 per group). The researcher then created a WhatsApp channel to provide educational content and a WhatsApp group for burns patients to join and get their questions answered. The intervention group patients pursued their post-discharge education through the social media for a month. The control group patients received their discharge education according to the ward's routine procedures through pamphlets and face-to-face training by the personnel. As the study's main variable, the Burn Specific Health Scale-Brief was completed by both groups before and 1 and 2 months after the intervention. Data were analyzed using the ANCOVA and repeated-measures ANOVA. RESULTS: There was no significant differences between the intervention and control groups in terms of the QOL score and any of the domains at baseline. The results indicated the significant effect of the intervention both 1 and 2 months post-intervention on the QOL score and all the domains (P < 0.05), except for body image (Pmodel1 = .550 and  Pmodel2 = .463) and skin sensitivity (Pmodel1 = .333 and Pmodel2 = .104). CONCLUSION: The post-discharge rehabilitation education of burns patients through social media improves their quality of life and can be used as an appropriate educational and follow-up method in different stages of the rehabilitation of burn patients. TRIAL REGISTRATION NO. : IRCT20190622043971N1, 05-10-2019.

Continuing nursing education: use of observational pain assessment tool for diagnosis and management of pain in critically ill patients following training through a social networking app versus lectures.

BACKGROUND: Nursing staff training in using observational pain assessment tools is highly important to improve the assessment of pain. The present study was conducted to examine the effect of two different training methods (lectures vs. a social networking app) on the diagnosis and management of pain in mechanically-ventilated patients. METHODS: This quasi-experimental study was conducted on 70 nurses working in two Intensive Care Units (ICU) in Mashhad, Iran. The nurses were trained in the application of observational pain assessment tools by lectures or through a social networking app. Before and after the intervention, the nurses' performance was evaluated in both groups using a checklist based on Critical-Care Pain Observation Tool (CPOT). RESULTS: In the pre-intervention phase, the nurses' performance scores in the domains of pain diagnosis and pain management were not significantly different between the two groups (P > 0.05). Following the intervention, the mean score of pain diagnosis was 82 ± 19 in the lecture group and 97 ± 8 in the social networking app group (P < 0.01), and the mean pain management scores were 30 ± 17 and 90 ± 18 (P < 0.01), respectively. CONCLUSION: This study showed that learning through a social networking app led to improved diagnosis and management of pain in mechanically-ventilated patients when compared with lectures. Training through social networking applications can therefore be considered as a feasible instructional method for developing nurses' pain management skills.

Uncovering psychobehavioural implications of SARS-CoV-2 infection in Iran.

Iran is the country in Western Asia most impacted by the COVID-19 outbreak. A survey was conducted among the general public in Iran aimed at investigating psychobehavioural issues related to the COVID-19 outbreak, namely (a) barriers to preventive measures against SARS-CoV-2 infection; (b) negative emotions towards SARS-CoV-2 infection; and (c) anxiety levels among the general public in Iran. A cross-sectional, web-based survey using an online questionnaire was carried out between 16 March and 1 April 2020. The six-item version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety levels. A total of 1,789 complete responses were received. Nearly 60% reported having difficulty in wearing a face mask to protect against SARS-CoV-2 infection. The mean and standard deviation (SD) for the total prevention barrier score was 35.8 (SD ± 7.1; range 18-68) out of a possible score of 72. Male respondents [odds ratio (OR) = 1.25; 95% confidence interval (CI) 1.03-1.51] and respondents who perceived their health status as poor/fair (OR = 1.49; 95% CI 1.31-1.82) were predictors of high prevention barriers. Negative emotions such as fear (74.6%) followed by depression (43.4%) and stigma (23.0%) associated with SARS-CoV-2 infection were reported. Respondents who perceived their health as poor/fair (OR = 2.19; 95% CI 1.57-3.04) reported a higher likelihood of having higher negative emotions. Findings on anxiety level revealed 68.0% (95% CI 65.8-70.1) reported moderate to severe anxiety. Respondents who perceived their health as poor/fair (OR = 3.46; 95% CI 12.22-5.40) and who were females (OR = 1.91; 95% CI 1.55-2.36) were predictors of moderate to severe anxiety. In conclusion, psychobehavioural interventions are needed to facilitate management and control of the COVID-19 outbreak.

Comparison of Using Cold Versus Regular Temperature Tube on Successful Nasogastric Intubation for Patients in Toxicology Emergency Department: a Randomized Clinical Trial.

Introduction: In view of the contradictory results for the use of cold tubes for the purpose of enhancing nasogastric tube insertion success there is a pressing need for further research in this area. This study aimed to determine the effect of using cold versus regular temperature nasogastric tube on successful nasogastric tube insertion for patients referring to toxicology emergency department. Methods: This study is a clinical trial with two groups design of 65 patients admitted to toxicology emergency department who were divided into two groups by random allocation. Nasogastric tubes used in the intervention group had been stored in a refrigerator at 2°-8° C while the ones employed in the control group had been maintained at the room temperature of 22-28° C. Nasogastric tube insertions in both groups were done by the investigator according to standard methods. The data were analyzed using SPSS ver. 13. Results: The placement of nasogastric tube was done in the first attempt with 27 (%84.4) of the subjects in the control group and 33 (%100.0) in the intervention group. The chi-square test results showed that the frequency of the number of attempts for gastric intubation in subjects between the two groups was statistically significant. Conclusion: Cooling gastric tubes reduces the time required for nasogastric intubation. Thus, it is suggested that the gastric tubes be cooled before the application of the procedure so as to reduce complications, increase patient comfort and save nurses time.

A quasi-experimental study of the effect of teaching Orem's self-care model on nursing students' clinical performance and patient satisfaction.

AIMS: This study aims to determine the effect of teaching Orem's self-care model on nursing students' clinical performance and patient satisfaction. DESIGN: The study was a quasi-experimental, non-randomized, two-group design with posttest. METHODS: In this quasi-experimental study, 66 nursing students were selected via convenience sampling method. The intervention group was trained based on Orem's self-care model and the control group based on the routine nursing process method. Both groups cared patients for a week. Students' performance was evaluated during the clinical course by performance observation checklist and patient satisfaction was assessed at the end of clinical course using patient satisfaction form. Data were analysed in SPSS software using chi-squared, Fisher Exact test, Mann-Whitney, t test and two-way ANOVA. RESULTS: Clinical performance evaluation mean score in the intervention group was significantly higher than that of the control group. However, patient satisfaction scores in both the control group and intervention group did not show statistically significant differences. Orem's self-care model showed a 23% improvement in students' performance. It is recommended to use Orem's self-care model for undergraduate courses, especially in clinical training.

The effect of educational package on sexual function in cold temperament women of reproductive age.

INTRODUCTION: Sexual health is one of the key factors to sustain marital life and having a good sexual function. On the other hand, temperament affects sexual function. Training is also one of the basic foundations for promoting sexual health. Therefore, the researcher has designed and implemented a study (2017) aimed "determining the study of educational package on sexual function in cold temperament women of reproductive age." METHODS: This randomized clinical trial study was performed on 80 women in two groups (40 in each group). This study was done, in available method, on no pregnant women aged 20-40 years old that referred to health centers in Mashhad. DASS 21 sexual function and determining temperament questionnaires were completed in two groups before intervention. At first, the sexual function training package was held by the researcher at 6 sessions (twice a week for 3 weeks) that was based on nutrition, sport, and lifestyle axes. The control group also received routine care. A week after intervention finished, all the units completed a sexual function questionnaire. The results were analyzed by these techniques as SPSS software (version 16) and statistical tests such as Independent t-test, T-pair, Mann-Whitney, Chi-square, and Fisher's exact test. RESULTS: At the beginning of the study, there was no statistically significant difference between the personal characteristics and the mean score of sexual function and all its dimensions in the two groups. The mean sexual performance score and all its dimensions after intervention were significantly different in intervention and control groups P < 0.001. Sexual function and all its dimensions were improved after intervention in the intervention group. CONCLUSION: Giving sexual function package has improved the sexual function of cold temperament women. So, for routine caring of cold temperament women, it is better that health center employees consider this training package as an effective, easy, available, nonpharmacological, and economic intervention.

Women's perceptions and experiences of the challenges in the process of male infertility treatment: A qualitative study.

BACKGROUND: Despite the fact that both men and women are equally subject to infertility, it is usually women who bear the burden of treatment and its consequences, even in cases of male infertility. Therefore, it is more necessary to recognize their health problems in order to help them. AIM: To explore women's perceptions and experiences of the challenges they face in the process of male infertility treatment. METHODS: This qualitative study was conducted during 2014-2015 using content analysis. Thirty semi-structured interviews were conducted with women whose husbands suffered from male infertility. Purposive sampling was conducted until data saturation was achieved. All interviews were recorded, transcribed and analyzed using conventional content analysis adopted by Graneheim and Lundman. RESULTS: From data analysis, the major category of "treatment-related stresses" and four subcategories of "high treatment expenses", "inefficiency of healthcare system", "being captive in the infertility treatment" and "treatment failure" emerged. CONCLUSION: Experiences of women who face male infertility indicate their various concerns in the process of treatment. Therefore, it is required to develop emotional and financial support for the clients and to promote their quality of healthcare services. In addition, awareness of treatment challenges of these women can assist proper planning to promote the quality of services they need.

Development of Islamic Spiritual Health Scale (ISHS).

OBJECTIVE: To develop and psychometrically assess spiritual health scale based on Islamic view in Iran. METHODS: The cross-sectional study was conducted at Imam Ali and Quem hospitals in Mashhad and Imam Ali and Imam Reza hospitals in Bojnurd, Iran, from 2015 to 2016 In the first stage, an 81-item Likert-type scale was developed using a qualitative approach. The second stage comprised quantitative component. The scale's impact factor, content validity ratio, content validity index, face validity and exploratory factor analysis were calculated. Test-retest and internal consistency was used to examine the reliability of the instrument. Data analysis was done using SPSS 11. RESULTS: Of 81 items in the scale, those with impact factor above 1.5, content validity ratio above 0.62, and content validity index above 0.79 were considered valid and the rest were discarded, resulting in a 61-item scale. Exploratory factor analysis reduced the list of items to 30, which were divided into seven groups with a minimum eigen value of 1 for each factor. But according to scatter plot, attributes of the concept of spiritual health included love to creator, duty-based life, religious rationality, psychological balance, and attention to afterlife. Internal reliability of the scale was calculated by alpha Cronbach coefficient as 0.91. CONCLUSIONS: There was solid evidence of the strength factor structure and reliability of the Islamic Spiritual Health Scale which provides a unique way for spiritual health assessment of Muslims.

Virtual reality and anxiety in primiparous women during episiotomy repair.

BACKGROUND: In recent studies, using virtual reality (VR) has been proposed as a nonpharmacological method for anxiety reduction, but until this time, its effects have not been assessed on anxiety during episiotomy repair. This study aimed to determine the effect of audiovisual distraction (VR) on anxiety in primiparous women during episiotomy repair. MATERIALS AND METHODS: This clinical trial was conducted on 30 primigravida from May to July 2012 in the maternity unit of the Omolbanin Hospital, Mashhad city, Iran. The samples were divided randomly into two groups with the toss of a coin. Anxiety were evaluated by the numeric 0-10 anxiety self-report, in the first and during labor. However, after delivery, anxiety was measured with the Spilberger scale. Mann-Whitney, Chi-square, Fisher tests, and repeated-measures analysis of variance were used to analyze data. RESULTS: Anxiety scores were not significantly different between the two groups (wearing video-glass and receiving routine care), but anxiety scores were lower in the intervention group during and after repair (P = 0.000). CONCLUSIONS: VR are safe, appropriate, and nonpharmacologic to decrease and manage the anxiety-associated episiotomy.