Mothers experiences on how care giverS break bad newS about their perinatal mortality

Background & Aims : Breaking bad news to parents in perinatal periods is an especially difficult and important part of maternal education and counseling. This qualitative study aimed to explore maternal experience of delivering bad news by caregiver in perinatal periods. Materials & Methods : This qualitative study were conducted in 2012 in Shahrekord, in –depth interviews with 38 mothers who had experienced a perinatal loss(abortion, miscarriage ,in-utero death, still birth, or death of a newborn within the 28 day of life) within the last 2 years. The data was collected through the use of open interviews and analyzed by content analysis method . Results: The data analysis resulted in emerging 5 themes of maternal preferences for how to deliver bad news. Methods of communication, who disclose bad news, supporting, environmental and facilitating items were important factors for mothers during breaking bad news in prenatal periods. Conclusion: Results of this study showed some light on what is important to women who face bad news in perinatal periods. Although more researches are needed in this field. We hope that our results assist health care provider in establishing guidelines for the effective communication during breaking bad news

The attitudes of health care providers toward breaking bad news in neonatal intensive care units and labor wards

Abstract Breaking bad news emotionally affects both health professionals and patients. Breaking bad news is a sensitive issue for both health care providers and patients. It is generally believed that the patient’s adjustment can be affected by either a positive or a negative experience in this respect. This study aims to determine health care providers’ attitudes toward breaking bad news to parents in NICU and labor wards. This cross-sectional study was conducted in Shahrecord in 2011 with a study sample of 70 health care providers drawn from neonatal intensive care units and labor wards and the department of nursing and midwifery who had had at least one year’s clinical experience. The sampling method was census. Data were collected through a self-administered questionnaire in two sections: demographic information and health care providers’ attitudes toward breaking bad news. Data were analyzed by SPSS software with descriptive and Chi-square and T-student test statistics. Most participants (63.2%) had a positive attitude toward disclosing bad news to parents. 77.6% of caregivers faced difficulties in delivering bad news to parents, 92.6% of them believed that training workshops in this field are necessary. There was a significant statistical relationship between the attitudes of the health care providers and their education level and work place (P < 0.0001). Health professionals with higher education levels and nursing and midwifery staff had more positive attitudes. There was no significant statistical relationship between the attitudes of the health care providers and their history of difficulties in transferring bad news, workshop trainings, work experience, gender, age and marital status (P > 0.05). The majority of health professionals had a negative attitude toward immediate disclosure of bad news to parents, mothers holding and seeing their deceased babies, dedicating a special room to perinatal loss mothers with similar problems, and preventing other patients and their families from contacting them. Based on the findings of this study, teaching bad news communication skills to personnel of NICU and labor wards should receive prioritization in future continuing medical education programs in order to best prepare the staff for disclosure of bad news to parents

Severity of Striae Gravidarum and its relationship with perineal trauma and vaginal lacerations during vaginal delivery of pregnant women referred to Hajar Hospital of Shahr-e-Kord in 2010-2011

Background and Objective: Striae Gravidarum found during pregnancy may be an indicative of poor skin elasticity and may prone to tearing perineal and vaginal tissues during vaginal delivery. The aim of this study was to determine relationship between striae gravidarum and perineal trauma and vaginal lacerations in women referred to Hajar Hospital Labor Ward in Shahr-e kord city. Materials and Methods: This cross-sectional study included 587 women who referred to Hajar Hospital Labor Ward for vaginal delivery in 2010-2011. The study was conducted within the first and second stages of labor. Data was collected by using interviews, hospital files and physical examinations. Descriptive statistics and chi square test, t- student test, one-way ANOVA and step-wise multivariate logistic regression were used to analyze the collected data. Results: 82.8 percent of the participants developed stretch marks.14.5 percent of the pregnant women in this study experienced vaginal and perineal tears. There was a significant association of vaginal and perineal tears with conduction anesthesia (P0.05). Conclusion: Patients with breast striae gravidarum are at a higher risk of vaginal and perineal lacerations at the time of vaginal delivery. This finding suggests that midwives and obstetricians consider beast striae gravidarum score as a simple and non- invasive tool for assessment of vaginal and perineal lacerations in management of women during vaginal delivery

Knowledge of midwives, from Chaharmahal and Bakhtiary province to ward midwifery legal and religious commandments and some of the relevant factors in 2006

چکیده: زمینه و هدف: ماماها در حیطه کاری خود با مسائل قانونی و شرعی مختلفی مواجه می‌باشند. با توجه به پیشرفت های مامایی در زمینه‌های مختلف از جمله: موارد سقط درمانی، روشهای پیشگیری و روشهای نوین درمان ناباروری، احکام شرعی و استفتائات جدیدی نیز از ناحیه فقها و مراجع تقلید صادر گردیده است، که این امر موجب ضرورت آگاهی ماماها از احکام شرعی و قانونی فوق می گردد. این تحقیق با هدف بررسی میزان آگاهی ماماهای استان چهارمحال و بختیاری نسبت به احکام شرعی و قانونی حیطه مامائی و برخی از عوامل مرتبط با آن صورت گرفته است. روش بررسی: در این مطالعه توصیفی تحلیلی 151 نفر مامای شاغل در مراکز بهداشتی درمانی شهرهای استان چهارمحال و بختیاری از طریق نمونه‌گیری آسان انتخاب شدند. اطلاعات توسط پرسشنامه ای که شامل مشخصات دموگرافیک و سؤالات مربوط به احکام قانونی و شرعی بود جمع‌آوری و سپس با استفاده از آزمون‌های آماری کای اسکوار و t تجزیه و تحلیل گردید. یافته ها: میانگین سنی نمونه‌ها 8/7±9/26 سال و بیشتر افراد تحصیلات فوق دیپلم داشتند (2/66). فقط 7/12 نسبت به کل احکام شرعی و قانونی آگاه بودند. آگاهی کافی نسبت به احکام قانونی در 3/15 و نسبت به احکام شرعی در 3/11 افراد دیده شد. 9/60 افراد طی خدمت خود به مسئله‌ای برخورد کرده بودند که حکم آن را نمی‌دانستند. 1/78 معتقد بودند که آموزش حین تحصیل نیازهای حرفه‌ای ماماها را در زمینه مسائل قانونی و شرعی تامین نمی‌کند. 1/88 گفته بودند که در صورت برگزاری برنامه بازآموزی در‌ آن شرکت می‌کنند. بین هیچکدام از مشخصات دموگرافیک با آگاهی ارتباط معنی داری دیده نشد. نتیجه‌گیری: با توجه به آگاهی کم، اعلام نیاز به بازآموزی و تمایل به شرکت در بازآموزی در اکثریت نمونه‌ها، تدوین برنامه‌های آموزشی مستمر در این زمینه ضروری است. همچنین توصیه می شود جهت پربارتر کردن محتوی درسی دانشجویان مامائی در زمینه مورد بحث در سر فصل دروس دانشگاهی تجدید نظر گردد

Prevalence of apparent major congenital malformations and some associated factors, in terminated pregnancies in Hajar hospital of Shahrekord, 2005-2006, Iran

Background and aim: Congenital malformations are a major cause of morbidity and mortality and long term disability in infants. The aim of this study was to determine prevalence of apparent major congenital malformations and some associated factors in terminated pregnancies in Hajar hospital of Shahrekord in 2005-2006. Methods: In this cross-sectional and descriptive-analytical study, a total of 2854 pregnant women with gestation age of 16 weeks or more who referred to the hospital for termination of pregnancy or delivery was enrolled and interviewed using structured questionnaires. Congenital malformation and other information about their newborns were obtained from hospital chart. Data were analyzed using SPSS software, x2, T student and logistic regression model. Results: Congenital malformation was observed in 72 of 2854 (2.5%) of the neonates studied. The most common congenital malformation was neural tube defects (19.8%). There was significant relationship between herbal drug use in first trimester (P<0.001), chronic diseases )P<0.01) environmental smoke (P<0.05), history of malformation in close relationships (P<0.05), proximity to power station (P<0.001) and trauma (P<0.05). But there was not significant association with maternal and paternal age, parity, gestational age, sex and number of newborn, maternal and paternal jobs, high fever in first trimester, treatment of infertility, problem in pregnancy and congenital malformation. Conclusion: The present study showed a high prevalence of congenital malformation among our population. Therefore, primary preventive programs could be initiated to reduce congenital malformation particularly education of pregnant women to avoid herbal, synthetic drugs, and environmental smok

Research barriers from the viewpoint of faculty members and employees of Shahrekord University of Medical Sciences

Aims: Undoubtedly the power, development and real independency of countries have a straight relationship with their ability to produce science and developing research activities. This research was performed to determine the research barriers from the view point of Shahrekord University of Medical Sciences faculty members and employees. Methods: In this descriptive analytic cross-sectional study which was carried out on in 2006-07, 480 of the faculty members and employees of on Shahrekord University of Medical Sciences were selected by census (for faculty members) and randomize cluster (for employees) sampling methods. The instrument for data collection was a questionnaire consisting of 3 individual characteristics, organizational barriers and individual barriers in Likert scale. Data analysis was done by student’s T, Chi square and variance analysis tests. Results: 452 questionnaires were returned. The most important barriers of research were “inadequate incentives in researchers”, “inadequate time and lots of work”, “too much official red tapes”, “not using the research results” and “inability to translate Persian articles to other languages”, respectively. The least important barriers were “not interesting in research”, “difficulties in computer usage” and “limited benefit of research to patients”. The mean of organizational barriers was more than personal barriers (p<0.0001). There was a significant difference between the mean of organizational and individual barriers of research among faculty members and employees (p<0.0001). Conclusion: Removing these barriers by the research officials & hospital managers is necessary

The role of maternal diet on fetal sex selection: A Review

Introduction: The desire of the human to control the gender of fetus prior to conception has always been important. The aim of this study was to determine the role of maternal diet on fetal gender. Materials and Methods: In this narrative review study, a comprehensive review of databases including Pubmed, Scirus, Cochrane library, ScienceDirect, MD Consult, google scholar, Iranmedex, Magiran, and SID from 1982 to 2013 was performed. Key words to search databases included fetal sex, sex ratio, sodium, potassium, magnesium, calcium, fructose, eating disorders, sex selection, maternal diet, Ionic diet, fatty acid, calorie, and famine. Results: Results of studies on the effects of nutritional deficiencies and disorders on sex ratio were controversial. Studies showed that a combination of environmental factors such as stress, time of conception and maternal diet had effects on sex ratio. Preconceptional nutritional status of mothers was very important in changing sex ratio. Increasing the intake of K + + Na+/Ca 2 + + Mg2+ in diet and high calorie diet could increase the ratio of male offsprings. Conclusions: Preconceptional diet was important in fetal sex ratio. However, low sample size in most human studies and the complex mechanisms of sex determination make it difficult to conclude definitively on this issue. Further human studies with larger sample size in this field are suggested

Effect of Companionship during Labor on Level of Anxiety of Primiparous Mothers and Midwives Points of View in Iranshahr, 2010

Abstract Background and purpose: Child birth is the most emotional experience of women that influences their health state throughout life. Being alone in labor suites, results in high anxiety level and complications among mothers. This study aimed at evaluating the effects of psychosocial support during labor provided by a female relative on anxiety level of primiparous women and midwives’ points of view regarding this intervention in Iran hospital, Iranshahr. Materials and methods: This randomized clinical trial was conducted in 210 primiparous women attending Iranshahr hospital, 2010. The subjects were aged between 18-35 years old, at 37 weeks gestational age who were carrying a single fetus and cervical dilatation (> 3 cm) with no indication for elective caesarean section. They were randomly assigned into experimental (n=105) and control groups (n=105). Spielberger's State Anxiety Inventory was used to record the anxiety score in admission time and in 6-8 cm dilation of cervix. All subjects received similar midwifery helps, however, women in experimental group were accompanied by a female relative until one hour after birth and the mothers in the control group received routine care. Midwives’ points of view were also recorded regarding the intervention. To analyze the data independent t-test, paired t-test, and x2 test were used. Results: There was no significant difference between the two groups regarding demographic features, gestational age, fetal weight and state anxiety score. Mothers' anxiety score on 6-8 cm dilation was significantly lower in intervention group (43.9%) while this score was 51.4% in control group (P<0.05). The anxiety score increased significantly in control group during labor (51.4%) compared with that in admission time (44.6%), (P<0.05). But no significant difference was found in the state anxiety score during labor and admission time among experimental group (44.5% and 43.9%, respectively). Midwives’ rate of satisfaction with the intervention was 81.9%, disturbance made by companions in delivery room was 14.3%, and interfering with physician orders was 23.8%. Conclusion: Psychosocial support by female companion is a low cost and useful way to decrease anxiety of primiparous mother during labor. This intervention also increases satisfaction of midwives

The Correlation between Post-Abortion Grief and Quality of Life in Females With a History of Abortion Visiting Health Centers and Hospitals of Shahid Beheshti University of Medical Sciences, Iran During Year 2016

Background: Grief is a common reaction pf parents to abortion. It may be followed by various psychological complications that affect women's individual-social quality of life. This study aimed to determine the correlation between post-abortion grief and quality of life of women with a history of abortion.Materials and Procedures: This descriptive-correlational study was conducted in 2016. Convenience sampling was applied to select 165 women with a history of abortion from health centers and hospitals affiliated to Shahid Beheshti University of Medical Sciences (Tehran, Iran). A demographic and fertility questionnaire, the Perinatal Bereavement Grief Scale, and the World Health Organization Quality of Life Questionnaire were used to collect data. Descriptive statistics and Pearson’s and Spearman’s correlation tests were administered to analyze the data. All analyses were performed using SPSS 20.Findings: There was a significant relationship between quality of life and post-abortion grief (r = -0.387; p &lt; 0.001) and the mean score of quality of life decreased with an increase in the intensity of post-abortion grief. Women with a history of abortion had a moderate level of post-abortion grief (mean score out of 100: 47.52 ± 9.01 ) and intensity of post-abortion grief in less than 3 months from abortion occurrence until completion of the questionnaire has been at its highest level (with a mean and standard deviation of 421.3 ± 99.3) and has declined over the time. However, there was no significant relationship between the intensity of the grief and the time of abortion. and desirable quality of life (mean score: 91.90 ± 14.43).Conclusion: The findings of this study suggested an association between more severe post-abortion grief and decreased quality of life, i.e. post-abortion grief had adverse effects on women’s quality of life. Therefore, fertility health policy makers are recommended to develop appropriate measures to reduce grief and improve the quality of life of women after abortion.

Study about different types of medicinal plants used by elderly people in Shahrekord city, Iran, 2009

زمینه و هدف: سالمندان اغلب به بیماری های مزمن مبتلا می باشند. این افراد معمولاً بدون تجویز پزشک معالج و به شکل فزاینده ای از گیاهان دارویی استفاده می کنند. مطالعه حاضر با هدف تعیین انواع گیاهان دارویی مورد استفاده و کاربرد آنها در سالمندان ساکن شهرکرد سال 1388 انجام شد. روش بررسی: در این مطالعه توصیفی – تحلیلی تعداد 400 نفر سالمند 60 سال و بالاتر دارای پرونده بهداشتی در مراکز بهداشتی و درمانی شهر شهرکرد به صورت آسان انتخاب شدند. داده ها با استفاده از پرسشنامه خودساخته جمع آوری و با آزمون آماری کای دو تجزیه و تحلیل گردید. یافته ها: 4/74 از نمونه های مورد بررسی از گیاهان دارویی استفاده می کردند. بیشترین علل مصرف به ترتیب فراوانی سرماخوردگی، دردهای معده، سردرد، پادرد و فشار خون و بیشترین گیاهان دارویی مورد استفاده به ترتیب آویشن، گل گاو زبان، خاکشیر، گل برنجاسب و شیرین بیان بود. 91 از سالمندان معتقد بودند که گیاهان دارویی در درمان بیماری آنها موثر بوده است. در این مطالعه ارتباط معنی دار آماری بین جنس، سن، تحصیلات و شغل سالمندان و مصرف گیاهان دارویی مشاهده نشد (05/0P>). نتیجه گیری: با توجه به مصرف نسبتا زیاد گیاهان دارویی در سالمندان ، لزوم اطلاع رسانی صحیح در سطح جامعه نسبت به عوارض و تداخلات احتمالی و انجام مطالعات بیشتر در خصوص اثربخشی و عوارض احتمالی آنها ضرورت دارد