Ethical Climate in the Delivery Wards of Educational Hospitals in Southeast Iran.

Ethical climate is one of the important factors in the working climate of the hospital. Considering the difference in the Ethical climate in different departments of the hospital and the importance of the ethical climate in the delivery ward, this study aimed to assess the characteristics of hospital ethical climate in delivery ward of educational hospitals in southeast Iran. This descriptive and multi-center study was conducted from 2020 to 2021 in educational hospitals in southeast Iran. Two hundred forty midwives working in delivery wards, midwifery instructors, and midwifery students were included in the study by census method. Data collection tools included a demographic information form, Olson's Hospital Ethical Climate Survey, completed using the self-report method. The mean ethical climate in the midwifery group (3.82 ± 0.63 out of 5) was higher than in the instructors' and students' groups. The lowest mean score obtained from the ethical climate questionnaire of participants was associated with the inability to use their experiences in the delivery ward. The lowest mean of ethical climate from the midwives' point of view is the Physicians' dimension and the patient's dimension from the instructors' point of view. The highest mean score belonged to the ethical climate of the supervisors. According to the results of the present study, it is suggested to implement protective laws to support the higher independence of midwives to improve the ethical climates by using their experiences in the delivery department.

Women's perception of continuity of team midwifery care in Iran: a qualitative content analysis.

BACKGROUND: Understanding the pregnant women's perception of continuity of team midwifery care is necessary for introducing and implementing this model of midwife-led care in the Iranian maternity services. This qualitative study aims to explore women's perception of continuity of team midwifery care in Iran. METHODS: This research is a qualitative study conducted in Iran to explore women's perception of continuity of team midwifery care during pregnancy, birth and postpartum from October 2019 to August 2020. Fifteen semi-structured interviews were conducted with women individually in private midwifery clinic through a purposive sampling method. Interviews were digitally recorded and transcribed verbatim in Persian and analyzed using conventional content analysis. RESULTS: From the data analysis, two themes, four main categories, and nine subcategories emerged. The themes were "Maternal empowerment" and "Mother's satisfaction during the transition from pregnancy to motherhood". The first theme included two categories of improving self-efficacy during antenatal education classes and the effective midwife-mother interaction. The second theme composed of two categories of satisfaction with the process of pregnancy, childbirth and postpartum as well as satisfaction with motherhood. CONCLUSION: Findings of this qualitative study highlight the effectiveness of continuity of team midwifery model of care for promoting empowerment and satisfaction in women during pregnancy, birth and postpartum. The results of this study could pave the way for developing, introducing and implementing the midwife-led continuity models of care in Iran.

The effect of evening primrose oil on cervical ripening and birth outcomes: A systematic review and meta-analysis.

Background and purpose: The results of various studies on the effect of evening primrose oil (EPO) on cervical ripening are controversial. The purpose of this systematic review and meta-analysis was to assess the effect of EPO on cervical ripening and birth outcomes. Materials and methods: The Cochrane Library, Embase, PubMed, Scopus, Web of Science and Persian databases were searched for studies published from the inception of the databases up to February 2021 (search updated in May 2022). Full-text articles published in English or other languages, randomized controlled trials, and quasi experimental studies with control group were included. Studies published in form of conference proceedings, and those whose full texts were not available, as well as studies with control groups receiving other treatments for cervical ripening, and those in which the intervention group received drugs besides EPO were all excluded. The Cochrane handbook was used to determine the risk of bias of the included studies. All data were analyzed using Review Manager 5.4 and reported in forest plots. Results: Seven trials involving 920 women were included in the meta-analysis. In five studies, including 652 participants, cervical ripening was evaluated using Bishop score. The use of EPO was found to significantly improved Bishop score (MD = 3.23; 95% CI: 3.17, 3.29). The meta-analysis showed no significant differences between two comparison groups in terms of 1-min Apgar score and length of the second stage of labor. However, the two groups were significantly different in terms of their 5-min Apgar score and the time interval between administration of EPO and birth. Based on subgroup analysis by route of administration, both vaginal and oral use of EPO increased Bishop score significantly in the intervention group compared to the placebo group. Conclusion: This study showed that using EPO in term and post-term pregnant women was clinically effective in improving their Bishop score.

Is the quality of life different in single and remarried elderly?

BACKGROUND: Due to increasing number of the world population, elderly individual's quality of life (QOL) is a matter of concern and marital status as one of the objective measures of QOL is of paramount importance. This study was done to compare the QOL between single and remarried elderly. MATERIALS AND METHODS: This case-control study was conducted on 200 elderly people in Qaen (Southern Khorasan province), Iran. The research sample consisted of two groups of single and remarried elderly, 100 in each group. A demographic and LEIPAD (an acronym deriving from the name of Leiden and Padua universities) QOL questionnaires were completed by the participants via interview. RESULTS: There was a significant difference between single and remarried elderly groups in the QOL (P < 0.001). Linear regression showed that marital status (P < 0.000), economic situation (P < 001), primary education (P < 0.0002), and diploma (P < 0.030) opposed to the illiterate were significantly related to the QOL. In other words, being married and higher economic situation and education increase the QOL. There was a significant negative correlation between the age (P < 0.000) and QOL. The strongest factor was age. CONCLUSIONS: Marital status, income, and education play an important role in all aspects of QOL in older adults. Thus, being married can be a protective factor against physical, psychological, and social problems in old age. Realizing this issue in consultation process of elderly peoples is recommended.

Use of Medicinal Plants and Synthetic Medicines by Pregnant Women in Kerman, Iran.

BACKGROUND: Pregnant women take medicinal plants for various reasons, supposing that these plants are completely safe for their fetus and their own health. This study aims to identify all types of medicinal plants and synthetic medicines used by pregnant women in Kerman and to study factors related to their use. METHODS: In this cross-sectional study, 150 women who had received prenatal care at 12 health centers in Kerman in 2017 were interviewed. Chi-square, t test and logistic regression were applied to investigate factors such as age, gestational age, mother's education, mother's occupation, perception of safety related to the use of medicinal plants and synthetic medicine during pregnancy. RESULTS: In this study, the rate of taking medicinal plants was 71.3% in pregnant women. The most common used medicinal plants and synthetic medicines were mint water (30%) and vitamins (47.3%), respectively. The most important mentioned reason for taking these medicinal plants during pregnancy was digestive problems. 52% of people believed that medicinal plants don't have any side effects. The chance of taking medicinal plants in housewives was 4.4 times more than employed women. Thinking that these medicines are safe to use increased the possibility of taking medicinal plants and synthetic medicines 4.5 and 3.1 times, respectively. CONCLUSION: Due to the potential side effects of medicinal plants, development and implementation of training programs to increase pregnant women's knowledge and a plan for specialized training for midwives and physicians employed in health centers seems necessary.