Exposure to Secondhand Smoke during Pregnancy and Neonatal-Related Outcomes

Background: Fetal and neonatal health is of particular importance in pregnant women. Secondhand smoke (SHS) can jeopardize the health of the mother, fetus, and neonate. The present study was conducted to determine the relationship between exposure to secondhand smoke during pregnancy and neonatal-related outcomes.Methods: This retrospective cohort study was conducted in 2022 on 270 mother-newborn pairs through convenience sampling in two equal groups (n=135), including exposure and non-exposure to SHS at  Rohani Hospital, Babol, Children's Hospital, Amirkola, and Imam Ali Hospital, Amol. In order to collect the data, a checklist including the demographic characteristics, medical variables, questions related to the exposure of mothers to cigarette smoke, the neonatal outcomes questionnaire, and the SNAPPE-II scale were used. Data analysis was performed using STATA statistical software (version 17), and the significance level of all tests was considered less than 0.05.Results: The mean age of mothers was 28.30±5.83 years, and 61% of births were by cesarean section. The SNAPPE-II score was 8.23​±5.29 in the non-exposure group and 20.68±13.53 in the exposure group (P=0.005). The prevalence of neonates with a birth weight of less than 2500gr was higher in mothers exposed to SHS (P=0.033).  Considering confounding variables, the neonates in the non-exposure group were, on average, 1.46 cm taller than those in the exposure group (P=0.005). Exposure to smoking increases the risk of premature birth by 1.65 times (P=0.032).  Conclusion: Exposure of pregnant mothers to SHS is associated with adverse neonatal outcomes. Therefore, it is recommended to train families to avoid exposure to cigarette smoke, especially during pregnancy, and also for health centers to pay special attention to this matter in the care of pregnant mothers

Lifelong learning strategies in nursing: A systematic review

Background: Lifelong learning is an expectation in the professional performance of nurses, which is directly related to the success of students in nursing schools. In spite of the considerable attention paid to this issue, lifelong learning strategies are not fully understood. Objective: The aim of this study was to clarify lifelong learning strategies of nursing students with respect to international experience. Methods: In this systematic review, an extensive investigation was carried out using Persian and English studies in Pub Med, ProQuest, Cochrane, Ovid, Scopus, Web of Science, SID, and Iran Doc using the following keywords: lifelong learning, self-directed learning, lifelong learning model, continuing education, nursing education, and lifelong program. Finally, 22 articles published from 1994 to 2016 were selected for the final analysis. Data extracted from the selected articles was summarized and classified based on the research questions. Results: In this study, 8 main themes, namely intellectual and practical independence, collaborative (cooperative) learning, researcher thinking, persistence in learning, need-based learning, learning management, suitable learning environment, and inclusive growth, were extracted from the article data. Conclusion: Having identified and clarified lifelong learning strategies in nursing, it is recommended to use the research findings in the programs and teaching systems of nursing schools. Use of strategies of lifelong learning will led to increased quality of education, development of nursing competency and finally, increased quality of patient car

خستگی از شفقت نسبت به والدین سالمند و بیمار در فرزندان بزرگسال: یک مطالعه مروری

Background and Aim: Adult children of elderly and sick parents face many challenges and may experience the compassion fatigue, which can affect the care process. The aim of this study was to investigate the dimensions and symptoms of compassion fatigue in children who take care of their elderly and sick parents. Materials and Methods: In this study, data bases including SID, Magiran, IranMedex, Google Scholar, Elsevier and PubMed were searched for studies published between 2000 and 2019 with the following keywords: Parent, Family Caregivers, Compassion Fatigue, Adult Children and Elderly. By this means, a number of 426 articles were acquired which were reviewed in two stages (first, the title and the abstract and then the whole article) based on the inclusion and exclusion criteria. In the end, 17 articles entered the present study. Findings: The type of articles used in this study were as follows: descriptive-analytical and correlational (7 articles), review (3 articles), qualitative (5 articles) and case study (2). The focus of the studies was on the different aspects of compassion fatigue. According to the reviewed studies, compassion fatigue is often accompanied by the symptoms of anxiety, helplessness, disappointment, insomnia, social isolation, reluctance as well as physical and mental fatigue. Ethical Considerations: Publication of the results is carried out honestly without bias and by citing the original reliable resources and references. Conclusion: Since fatigue compassion creates various physical, psychological and social dimensions in adult children of elderly and sick parents, Support centers, counselors, and nurses need to consider this in regard to the families of elderly patients in their support program.   Cite this article as: Zabihi A, Jafarian Amiri SR, Aziznejadroshan P, Qanbari Qalehsari M. Compassion Fatigue among Adult Children of Elderly and Sick Parents: A Review Study. Med Ethics J 2020; 14(45): e14.زمینه و هدف: فرزندان بالغ والدین سالمند و بیمار با چالش‌های زیادی رو به رو هستند و ممکن است خستگی ناشی از ابراز شفقت را تجربه کنند که می‌تواند فرآیند مراقبت را با اختلال مواجه کند. هدف از این مطالعه، بررسی ابعاد و علائم خستگی از شفقت در فرزندانی است که از والدین سالمند و بیمار خود مراقبت می‌کنند. مواد و روش‌ها: در این مطالعه مروری با استفاده از پایگاه‌های اطلاعاتی SID، PubMed، Elsevier، Magiran، IranMedex، Google Scholar، مطالعاتی که بین سال‌های 2000 تا 2019 با ترکیبی از واژگان کلیدی خستگی از شفقت، فرزندان بزرگسال، سالمند، والدین، مراقبان خانواده، Elderly Adult Children، Compassion Fatigue، Family Caregivers و Parent انتشار یافته‌اند، مورد بررسی قرار گرفتند. از 426 عنوان به  دست‌آمده طی دو مرحله بازبینی بر اساس معیارهای ورود و خروج که در مرحله اول عنوان و چکیده و در مرحله دوم کل مقاله بررسی گردید. نهایتاً 17 مقاله وارد مطالعه شد. یافته‌ها: مقالات مورد استفاده در این مطالعه از نظر نوع مطالعات به روش توصیفی ـ تحلیلی و همبستگی (7 مقاله)، مروری (3 مقاله)، مطالعه موردی (2)، کیفی (5 مقاله) بودند. تمرکز مطالعات بر روی جنبه های مختلف خستگی از شفقت بود. بر اساس مطالعات بررسی‌شده خستگی از شفقت غالباً با علائم اضطراب و نگرانی، درماندگی، ناامیدی، بیخوابی، انزوای اجتماعی، بی‌میلی و خستگی جسمی و ذهنی همراه است. ملاحظات اخلاقی: انتشار نتایج بدون سوگیری و استناد به منابع با صداقت و امانتداری و مراجعه به منابع اصلی انجام شده است. نتیجه‌گیری: با توجه به این‌که خستگی ناشی از شفقت ابعاد مختلف جسمی، روانی و اجتماعی را در فرزندان بزرگسال والدین سالمند و بیمار ایجاد می‌کند، لازم است تا مراکز حمایتی، مشاوره‌ای و پرستاران این موضوع را در ارتباط با خانواده‌های بیماران سالمند در برنامه حمایتی‌شان در نظر بگیرند

The effect of instructing mothers in attachment behaviors on short-term health outcomes of premature infants in NICU

BACKGROUND: The birth of a pre-mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short-term health outcomes of pre-mature infants admitted to neonatal intensive care units (NICUs). MATERIAL AND METHODS: In this quasi experimental study, 80 mothers of pre-mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother–infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant's Maternal Attachment Assessment Strategy. Moreover, infants' short-term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis. RESULTS: On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4–42/11) and 37 (31/85–42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05). CONCLUSION: Instructing mothers in attachment behaviors clinically improved short-term health-related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre-mature infants

The effect of oropharyngeal mother’s milk on nutritional outcomes in preterm infants: a randomized controlled trial

Abstract Background and objective Oropharyngeal interventions are an accepted method to improve the nutritional performance of premature infants. Considering the countless benefits of breast milk and the few studies on the use of breast milk as an oral-pharyngeal intervention, this study was conducted with the aim of determining the effect of oral-pharyngeal administration of breast milk on nutritional outcomes in premature infants. Materials and methods In this clinical trial, 80 premature infants hospitalized in the neonatal intensive care unit of Amir al-Mu’minin Hospital in Semnan (a city in Iran) were randomly assigned to intervention (n = 40) and control groups (n = 40). Infants in the intervention group were given breast milk, and infants in the control group were given sterile water as a placebo. The data collection tool included demographic and clinical questions checklist, including sex, gestational age, weight, milk administration time, lavage and its amount, vomiting, abdominal distension, and so on. Data analysis was performed using SPSS23. Results The mean volume of total milk received by infants (p = 0.047) and the mean volume of milk received by mouth (p < 0.000) at the time of discharge were higher in the intervention group. Moreover, the time to start enteral nutrition in the intervention group was lower than in the control group (P = 0.012). Administering mother’s milk through the oropharyngeal method led to a reduction in infants’ length of stay in the hospital (P = 0.022). Conclusion Based on the results of the present study, the oropharyngeal administration of breast milk in the first days after the birth of premature infants admitted to the hospital improves the outcomes related to their nutritional status. Therefore, it is suggested that this convenient, safe, and feasible method be used in hospitalized premature infants as soon as possible so that premature infants can benefit from the important advantages of breast milk