ملیحه نصیری

The postpartum period predisposes women to a variety of mental health problems, one of which is postpartum depression, a common and serious condition affecting 8% to 26% of women worldwide. It is also recognized as a major public health concern. One potential cause of postpartum depression is exposure to stressful events before birth. Evidence suggests that continuous maternal support during labor may help reduce the incidence of this condition. Therefore, this study aimed to compare the prevalence of postpartum depression between women who received continuous support during labor and those who did not in Bandar Abbas in 2016.

In this prospective, descriptive-analytical study, 220 postpartum women were divided into two groups: one receiving continuous support from a doula (including emotional, physical, and informational support) and the other receiving no doula support (routine care). Participants were observed and assessed at the maternity ward of Bandar Abbas Social Security Hospital from August 2016 to January 2017. Data were collected using a demographic questionnaire and the Edinburgh Postnatal Depression Scale (EPDS), administered eight weeks postpartum. The results were compared between the two groups. Statistical analysis was conducted using SPSS (version 20), employing the independent t-test, Chi-square test, Mann-Whitney test, and two-way logistic regression.

There was a statistically significant difference in the prevalence of postpartum depression between the two groups (P<0.001). After adjusting for other variables, a significant association was found between postpartum depression and doula support (P< 0.001, OR= 0.17). The odds of developing postpartum depression were reduced by 83% among mothers who received doula support.

The findings of this study indicate that continuous doula support during labor significantly reduces the risk of postpartum depression.

During the Covid-19 pandemic, due to the contagiousness and epidemic of this virus, many restrictions were imposed on hospitals and care centers in order to prevent the spread of this virus. The purpose of this study was to investigate the implementation of family-centered care in neonatal intensive care units before and during the covid-19 pandemic.

This cross-sectional descriptive study was conducted in the neonatal intensive care unit in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences and Health Services. Nurses working in the neonatal intensive care units participated in this study. The data collection tool in this study was a 20-question researcher-made questionnaire. Research data were analyzed using SPSS 18 software and descriptive (mean, frequency, standard deviation) and analytical statistics (Wilcoxon) were used.

The results of the average test before the pandemic and during the covid-19 pandemic showed that the nurses' point of view of the implementation of family-centered care in the neonatal intensive care units has significantly decreased in most of its dimensions during the covid-19 pandemic.

According to the results of the present study and the less willingness of nursing personnel to implement family-oriented care during the covid-19 pandemic, it is suggested to emphasize the necessity of implementing family-oriented care and more preparation of nursing personnel to implement this care in order to deal with possible next pandemics.

 Postoperative care presents diverse needs that affect the quality of life in children with congenital heart disease. The objective of the study was to determine the effect of a family-based care transition program on the health-related quality of life of children with congenital heart disease undergoing corrective surgery. 

This quasi-experimental study involved 78 mother-child dyads diagnosed with congenital heart disease and undergoing corrective surgery at the Shaheed Rajaie Cardiovascular Hospital in Tehran. The samples were divided to one of two groups: an intervention group (n=40) and a control group (n=38). Convenience sampling was employed to select participants during the 2023-2024 period. Data were collected using the TNO-AZL Preschool Quality of Life Scale across four assessment stages. The intervention group participated in 11 sessions of the family-based care transition program, while the control group followed routine discharge protocols. Data were analyzed using SPSS software version 22, employing independent t-tests, the Bonferroni test, and both one-way and two-way repeated measures analysis of variance.

Within-group comparisons showed a significant increase in quality of life scores for both the intervention and control groups (P<0.001), with the intervention group indicating a more pronounced improvement. However, between-group comparisons showed no significant differences in quality of life scores at baseline, immediately post-intervention, or one month post-discharge. Notably, a significant difference was observed three months post-discharge (P=0.003).

The implementation of a family-based care program may improve the health-related quality of life of children with congenital heart disease undergoing surgery. These findings suggest that pediatric nurses can utilize family-centered interventions to improve the health-related quality of life of these children.

Although the psychometric properties of the Persian version of the short form of the Female Sexual Function Scale (FSFI-6) was studied, the sensitivity and specificity of the Persian version of this instrument have not been investigated. The present study aimed to assess the sensitivity, specificity and clinical cut-off point of the FSFI-6 in Iranian women.

This descriptive cross-sectional study was conducted on 165 women with and 131 women without sexual dysfunction. In addition to a demographic questionnaire, the Female Sexual Function Index (FSFI-19) questionnaire was administered. Using the Receiver-Operating Characteristic curve (ROC) analysis and indicating cut-off point, sensitivity and specificity were determined

Based on the short form of the original instrument, which included questions 4, 2, 7, 11, 16, and 17 from the longer version, the cut-off point for the FSFI-6 was 18.5 and the sensitivity and specificity were 61% and 52%, respectively. Considering that the calculated sensitivity and specificity of the index was relatively low and had a significant difference compared to the reported sensitivity and specificity for this instrument in the literature. Therefore, questions 5, 8, 12, and 18 were replaced with questions 4, 7, 11, and 17 and the analysis was repeated. Based on the replaced questions, the cut-off point was 20.5 and the sensitivity and specificity of the tool was 90%.

The findings suggest that the Persian version of FSFI-6 with questions 2, 5, 8, 12, 16, and 18 has a better performance for diagnosing sexual dysfunction in Iranian women.

Diabetic foot ulcers are among the most challenging and expensive wounds. Untreated diabetic foot ulcers significantly impact patients’ quality of life. Nurses play a comprehensive and central role in preventing, providing care for, and managing diabetic foot ulcers.

The current research is a descriptive cross-sectional study of the type of clinical audit based on the National Institute for Health and Care Excellence (NICE) model, which was conducted in the hospitals affiliated with Shahid Beheshti University of Medical Sciences in 2022-2023. In order to collect data, a checklist was designed by the researcher. Data were analyzed using descriptive statistics and SPSS software Version 20.

In this research, the general performance of nurses in caring for diabetic foot ulcers in older adult patients hospitalized in academic hospitals was evaluated at poor and very poor levels. In the observation area, 38.7% were at a poor level; in the touch area, 82.1% were at a very poor level; in the evaluation area, 86.8% were at a very poor level; and in the implementation and registration area, 89.6% were at a poor level.

Nurses significantly fall below the standards of care in managing, treating, and evaluating diabetic foot ulcers. Providing appropriate training programs can enhance nurses’ skills and clinical competence, reduce complications, and improve the quality of nursing care for diabetic foot ulcers.

Physiologic edema in the feet can cause discomfort such as pain, muscle cramps and fatigue in the feet when walking and as a result lack of movement and increased probability of thromboembolism in pregnant women. Many non-pharmaceutical methods have been used to improve physiologic edema in pregnancy. None of these methods have been studied in a self-care context. Therefore, the present study was performed with aim to determine and compare the effects of self-care education with effleurage massage, hydrotherapy, and leg elevation on physiologic edema in pregnancy.

The randomized controlled clinical trial study was conducted in 2022 on 129 primigravid women who visited the Mahdieh Tehran Health Center. The samples were randomly divided to four groups: hydrotherapy, massage therapy, leg elevation, and control. The data collection tools included a demographic and obstetric questionnaire, investigation of complications and satisfaction from the intervention, observation checklist and examination before and after the intervention, and a non-elastic meter. After collecting information, data analysis was done using SPSS statistical software (version 24) and parametric and non-parametric statistical tests. P<0.05 was considered statistically significant.

In the intragroup comparison, leg edema decreased significantly after the intervention compared to before the intervention (p<0.001). The results of the analysis of covariance indicated a significant difference in the mean size of foot circumferences after the intervention among the groups (p<0.001). In a side-by-side comparison of the groups after the intervention, leg elevation had the greatest effect among other interventions (p<0.001).

Self-care with effleurage massage, hydrotherapy, and leg elevation were effective in improving physiologic edema in the legs during pregnancy. Furthermore, leg elevation was found to be more effective in reducing degree of leg edema compared to other self-care interventions, and effleurage massage had the least effect in improving physiologic edema.

Although chemical drugs are effective for postpartum pain, herbal medicines with relative safety and fewer side effects are more suitable. The aim of the present study was to compare the impact of “Ginger-Lavender” and “Mefenamic acid” capsules on postpartum pain.

This triple-blind clinical trial study enrolled 94 multiparous women complaining of moderate to severe postpartum pain in Valiasr Hospital, Fasa, in 2021. They randomly divided into 2 groups (n=47): the “Ginger-Lavender” 300 mg capsules (A) and the “Mefenamic acid” 250 mg capsules (B). Measuring the pain score started 2 hours after delivery and continued every 6 hours, before and 1 hour after receiving the related drugs, until 24 hours using VAS.

The demographic information of the two groups, including mothers' age and BMI, weight of newborns, breastfeeding, receiving oxytocin and the number of pregnancies and deliveries, were not significantly different. Before the intervention, there was no significant difference in pain severity between the two groups (A=5.02±1.24, B=4.72±0.97). Consuming “Ginger-Lavender” and “Mefenamic acid” capsules at different hours decreased pain severity significantly (p<0.05). No significant differences were found between the “Ginger-Lavender” and “Mefenamic acid” groups for the mean postpartum pain severity at different hours after the first (A=2.38±0.922, B=2.553±0.928), second (A=2.0217±1.242, B=2.021±1.188), third (A=1.55±0.97, B=1.61±1.07), and fourth (A=1.42±1.01, B=1.38±0.99) interventions.

Since “Ginger-Lavender” capsules reduced postpartum pain, it is recommended to use them instead of standard drug, “Mefenamic acid” capsules, as an effective and safe herbal medicine.

Considering the increasing prevalence of obesity and the importance of examining the relationship between sexual dysfunction and obesity in women and the need for systematic reviews that summarize the results of similar studies, the present study was systematically conducted with aim to determine sexual performance in women with obesity using the questionnaire of the female sexual function index (FSFI). 

In this systematic review, based on the PRISMA checklist, a literature review was conducted with a systematic approach in the field of examining sexual function in obese women using the FSFI questionnaire. In this regard, a systematic review was conducted in Web of Science, PubMed, MEDLINE, etc. databases. The keywords that were selected included sexual function, obesity, and women. In this systematic review, all English and Persian observational articles from the inception to 2022 were used.

In this study, 761 articles were initially extracted from the investigated databases and sources, and finally, five published articles met the criteria for entering this systematic review. Among the articles, four articles were in English and 1 article was in Persian. In these studies, the sexual performance scores obtained from the obese group were evaluated as a total score, sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, and pain. As this review was conducted with the aim of determining sexual function in obese women using the FSFI questionnaire, in most studies, a decrease in scores of the questionnaire and in different areas of sexual function was observed.

According to the results of most studies examined in this systematic review, sexual dysfunctional in obese women is high. Therefore, it is recommended to evaluate the sexual function in obese people in order to identify and treat people who need intervention.

According to the high prevalence of primary dysmenorrhea and its consequences on the quality of life and the effects of nonsteroidal anti- inflammatory drugs consumption, the present study was performed with aim to investigate the effect of the capsella bursa-pastoris on the severity of primary dysmenorrhea.

This triple-blind clinical trial study was conducted in 2022 on 80 girls referred to the comprehensive health service centers of Kermanshah University of Medical Sciences with a history of primary dysmenorrhea. The participants were divided into two groups of 40 people, intervention and control. The intervention group received capsules containing 400 mg of hydroalcoholic extract of the "Capsella bursa pastoris" plant and the control group received 250 mg capsules of mefenamic acid every 8 hours for 3 days for 2 consecutive periods. The research tools were demographic profile questionnaire, menstrual status and physical activity questionnaire, and visual analog scale. Data were analyzed by SPSS software (version 19) and independent t-tests, chi-square, Bonferroni and analysis of variance with repeated measures. P<0.05 was considered statistically significant.

Before the intervention, the two groups were similar in terms of pain intensity (p=0.689). The two-factor variance test showed that the two groups had a significant difference in terms of pain intensity after the intervention (p=0.001), but the reduction of pain was more in the capsella bursa-pastoris group.

The Capsella bursa-pastoris plant can reduce the severity of primary dysmenorrhoea; Therefore, it is recommended to conduct more researches to confirm the effectiveness and safety of the Capsella bursa pastoris plant.

The prevalence of chronic renal failure is increasing dramatically all over the world. This disease causes a decrease in the quality of life, increased health care costs, and death. Health literacy as a vital indicator of health care results, and self-management as a critical indicator of disease control and chronic conditions can play together crucial role in these patients. Therefore, the research aimed to investigate the relationship between health literacy and self-management in patients with a kidney transplant.

This cross-sectional study was conducted with 120 participants in Tehran city using a convenience sampling method. Data were collected using a health literacy questionnaire and Kozaka’s self-management behavior specific to kidney transplant patients. SPSS ver. 20 used for data analysis.

The results showed a significant relationship between health literacy and self-management in kidney transplant patients. In addition, health literacy had a statistically significant association with education level, employment, income, and age. Also, self-management had a statistically significant relationship with age, education level, employment, and income.

A significant relationship was found between health literacy and self-management behaviors. Thus, it can be suggested to pay more attention to health literacy, which increases the client's knowledge regarding their condition and its evaluation. Health literacy can also be added to their educational program, both in medical centers and The Associations for the Support of Kidney and Kidney Transplant Patients.

Loneliness is one of the problems experienced by the aging population, and the lack of social communication plays a major role in the emergence of loneliness. This study was conducted to determine the effects of telenursing on the loneliness of the elderly.

This field trial was conducted on 100 elderly people over 60 years of age who were selected by convenience sampling from the clients of Gonabad (Iran) community health centers during 2017. The elderly participants were randomly assigned to 2 groups of 50 people, intervention and control. Then, the demographic information questionnaire, the Informant Questionnaire for Cognitive Decline in the Elderly, and Dehshiri et al.'s Loneliness Scale were completed. The intervention group received face-to-face training by the researcher for 2 hours. There was no intervention for the control group, and the elderly received routine care from the family health unit. After the face-to-face meeting, phone calls were made by the researcher to the intervention group for 12 weeks. One month after the end of the intervention, the questionnaires were completed again by the two groups and evaluated and compared.

The mean (standard deviation) score of loneliness was 60.82±21.07 and 57.48±18.76 before the intervention in the intervention and control groups, respectively, and this value after the intervention was 35.06±14.20 and 61.40±18.72, respectively, in the intervention and control groups. After the intervention, a statistically significant difference was found in terms of a reduction in the loneliness score of the elderly in the intervention group compared to the control group (P<0.05).

This study showed that telenursing was effective in reducing the loneliness of the elderly.

Childbearing is an important phenomenon in demographic movements and the basis of sustainable development in countries with low replacement fertility rates. The present study was performed with aim to summarize the existing knowledge about the effectiveness of structural factors of social determinants of health on childbearing of Iranian women.

In this systematic review, observational Persian and English studies published from 1/1/2010 to 23/1/2022 were included in the study. Studies were searched in Magiran, SID, Embase, google scholar, Scopus, web of science, and PubMed databases using related keywords including: Reproductive Behavior, Childbearing, Socioeconomic Factors, Ethnic Groups, Culture, Structural Determinants of Health and Iran. The Newcastle-Ottawa tool was used to evaluate the quality of the articles.

In this review study, 36 studies which met the inclusion criteria were included in the study, and health structural factors (education, income, occupation, ethnicity, and culture) on women's childbearing were examined. Women's childbearing is related to these structural factors of health. In this review study, the highest frequency was related to women's education; so that 18 articles showed the negative effect of education on childbearing.

The results of the present systematic review showed the effect of structural social determinants of health (education, income, occupation, ethnicity, and culture) including women's education on childbearing. This confirms that if population policies can implement programs that make the mother's role compatible with the continuation of women's education after marriage, they can be much more effective.

Designing valid and reliable tool to measure the sexual self-care status of reproductive age women in order to identify the strengths and weaknesses and design appropriate interventions to improve the sexual health status of reproductive age women is considered a necessity for the society. Therefore, this study was conducted with aim of designing and psychometrically evaluating sexual self-care questionnaire in women of reproductive age.

This was a methodological study with a cross-sectional design conducted in 2021. A questionnaire was designed using a comparative approach based on the Waltz model. Then, to check the psychometric characteristics of the tool, quantitative and qualitative face validity and quantitative and qualitative content validity were investigated. Finally, the reliability of the tool was assessed by the internal consistency assessment and determining the Cronbach's alpha coefficient, and the stability assessment by the test-retest method and determining the intra-cluster correlation coefficient (ICC).

The final version of this questionnaire was designed with 40 items in four areas including prevention of sexually transmitted diseases and genital infections, prevention of gynecology cancers, prevention of unwanted pregnancy and promotion of sexual health. The psychometric characteristics of this questionnaire showed that the validity index of the total tool was 0.93 and the validity ratio of the total tool was 0.96. The relative reliability of the total tool was also shown with Cronbach's alpha of 0.94. The stability of the tool was also shown by the ICC in the total tool of 0.97 with a confidence interval of 0.94-0.98.

The Female Sexual Health Self-care (FSHS) questionnaire has acceptable validity and reliability in the Iranian population, which can measure the broad concept of sexual self-care. The results of this study can be available to experts and planners to review the current situation and design suitable interventions.

Mother's physical and mental health and ability are the key factors in the breastfeeding process. In traditional medicine, grape juice is called Debs or Doshab. It has also been said that its properties are similar to mother's milk. Molasses syrup consisting of concentrated grape juice, Omani lemon and saffron is a source of strengthening the mother after childbirth in Iranian medicine. The present study was performed with aim to investigate the effect of molasses syrup on the breastfeeding pattern in the first three months after childbirth.

This three-blind randomized clinical trial study was conducted on 92 mothers who gave birth in Hafez and Shushtri hospitals in Shiraz in 2020-2021. In the intervention group, molasses syrup and in the control group, placebo was received for six weeks. Data were collected with demographic and midwifery questionnaire and breastfeeding pattern questionnaire. The breastfeeding pattern was examined on the first, tenth, one month and three months after delivery. Data were analyzed by SPSS software (version 26) and independent t, Mann-Whitney, Chi-square and Fisher's exact tests. P< 0.05 was considered statistically significant.

The pattern of breastfeeding on the first day of birth, exclusive breastfeeding (EBF) in both intervention (97.82%) and control (95.70%) groups had no statistically significant difference (p=0.500). The pattern of exclusive breastfeeding with breast milk showed a significant difference on the 10th day in the intervention (71.7%) and control (32.6%) groups (p=0.001), on the 30th day in the intervention (82.6%) and control (34.8%) groups (p<0.001), and three months later in the intervention (82.6%) and control (32.6%) groups (p<0.001).

The consumption of grape juice, saffron and Omani lemon syrup (Debs) by the mother can be effective on the breastfeeding pattern on the 3rd day, 10th day, 30th day and third month and can improve the mother's breastfeeding.

Premature birth, in addition to causing health problems in infants, increases stress in the mother and reduces attachment between mother and baby. Therefore, the present study was conducted to determine the effect of guided visualization on stress and attachment of mothers of preterm infants in the neonatal intensive care unit (NICU).

This quasi-experimental study was performed on 35 mothers with premature infants admitted to the NICU of Mahdieh Hospital of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mothers were selected by available sampling method and randomly assigned into intervention and control groups. For mothers in the intervention group, the intervention was performed from the first to the fifth day of birth through training and sending guided imagery files. On the day of admission and discharge, the parental stress questionnaire and the postpartum attachment questionnaire were completed by the mother. SPSS software (version 20) was used to analyze the data.

The mean total score of maternal attachment on the fifth day of the intervention was significantly higher in the intervention group (P<0.001). Also, the mean total score of mothers' attachment status on the day of discharge was significantly higher in the intervention group (P<0.001).

Implementation of guided visualization program reduced stress in mothers with premature infants admitted to the NICU, and consequently increased the level of attachment.

Mothers are the primary caregivers of infants, and promoting maternal health has an effect on infants. In addition to reducing stress in preterm infants, this study can help improve the quality of infant care and increase attachment and parenting. The present study offers a completely cost-effective way to reduce the costs of long-term hospitalization and improve the quality of nursing.

Objective (s):

 Sexual health is one of the most important aspects of health However, few healthcare providers are capable of sexual counseling skill in clinical environments. Considering that in Iran most of the reproductive and sexual health services are provided in comprehensive health centers by midwives, the present study was conducted to explain the factors related to the provision of sexual health services by midwives in these centers.

This qualitative study was conducted in Rafsanjan, Iran in 2018-2019. Participants were 16 midwives, 7 key informants, and 6 women who referred to comprehensive health centers. Data were collected through 3 sessions of focus group discussion and 8 semi-structured interviews and analyzed via the conventional content analysis method. MAXQDA 10 software was used to perform analysis.

In all 87 codes, 27 sub-categories, and 9 categories were extracted. Further examination of the categories led to emergent of three main themes: ‘professional competence of midwives in providing sexual health services’, ‘educational gap in sexual health’, and restrictions to providing sexual health services’.

The results showed that due to the lack of adequate education in sexual health and obstacles such as attitudes of policymakers, limited time and resources, and cultural issues, sexual health services are not provided proficiently. Indeed, considering the professional capacity of midwives, revising the midwifery educational curriculum in sexual health, is recommended.

Vasomotor symptoms during menopause occur on average in 75% of women. Hot flashes are the most common of these symptoms. Hormonal drugs  are the most effective method of treatment. Due to the known risks of hormone therapy, many researchers have investigated the effect of herbal medicines to improve vasomotor symptoms, especially hot flashes. This study was performed with aim to investigate the clinical trial studies conducted on the effectiveness of various herbal medicines on hot flashes.

In this study, to find the related articles, databases of Google scholar, Scopus, PubMed, Web of science, Science direct and national databases such as (MagIran), (SID), (IranDoc) and (IranMedex) were searched from the beginning of January 2005 to January 2020. Data were combined using STATA software (version 12.2) and using meta-analysis method, random effects model.

In the present study, 11 clinical trials were included in the meta-analysis according to the inclusion criteria.In the medicinal plants group, mean reduction in the number of hot flushes was 2.41 times (95% CI: -1.56 to -3.27%) less than the control group, which was statistically significant (p<0.05).In addition, in the medicinal plants group, the intensity of hot flashes was 20.28 degrees (95% CI: -71.70 to -22.87) compared to the control group, and this difference was statistically significant (p<0.05).

Medicinal plants containing phytoestrogens have good effects on reducing the frequency and intensity of hot flashes in menopausal women and can be a suitable treatment for hot flashes in menopausal women.

Cervical cancer is the fourth common cancer in women and human papillomavirus is the most common risk factor of it. The present study was performed aimed to determine the relationship between Vitamin D and human papillomavirus in women referring to the hospitals of Shahid Beheshti University of Medical Sciences.

This comparative study was conducted on 140 women referring to the hospitals of Shahid Beheshti University of Medical Sciences of Tehran in 2020. The case group were women with HPV infection and the control group in the same centers were the women with no HPV infection based on liquid based pap smear. Data was collected by interview and completing the questionnaire of Pap smear and measuring serum level of vitamin D. Data were analyzed by SPSS software (version 26) and Mann-Whitney test, independent t, chi-square, Fisher's exact and logistic regression. P<0.05 was considered statistically significant.

Logistic regression results and control of confounding variables of education and hookah consumption showed that 64 women (91.43%) in control group and 70 women (100%) in case group had vitamin D level less than 20 ng/ml and 6 women (8.57%) in control group had vitamin D level of 21-29 ng/ml. There was significant relationship between vitamin D and HPV infection (OR: 0.3, CI: 95%, P<0.001, 0.69-4.03). The risk of HPV infection increased as 0.3 by each 1 ng/ml reduction of vitamin D level.

In the present study, serum level of vitamin D was lower in women with HPV, but due to the limitations of the present study, more extensive research is needed in this regard.  Sufficient vitamin D level can help maintain and promote women's health.

Chronic kidney failure is one of the diseases that affect the quality of life of people today. Peritoneal dialysis is one of the treatments for chronic kidney failure. Education is an important part of the care program that helps the patient to play an important role in the treatment process. The aim of this study was to evaluate the needs of patients undergoing peritoneal dialysis, which is based on nursing diagnoses, nursing interventions and the results obtained during the nursing process. Then, according to the needs of patients, a self-care educational program was developed.

The present study is a descriptive study that was performed on 74 patients referred to peritoneal dialysis wards of 5 medical centers. Demographic-clinical information was collected through patients' medical records and educational needs through face-to-face and telephone interviews with patients undergoing peritoneal dialysis. The training needs were determined based on the nursing diagnoses of the International Association of North America, and finally the self-care program was developed through nursing interventions related to common diagnoses and their expected outcomes. Data were analyzed by SPSS software version 26.

Among the 20 nursing diagnoses presented in NANDA in patients undergoing peritoneal dialysis, 5 diagnoses including: water and electrolyte disorders, infection, constipation, sleep disorders, and skin integrity disorders are the most common. Self-care was developed to meet these needs.

Postponed childbearing is a social phenomenon in Iranian families. There is a controversy about its effect on mental health. Therefore, this study was conducted aimed to determine the role of childbearing in the rate of depression, stress, and anxiety in Iranian women of childbearing age.

This cross-sectional study was performed in 2021 on 581 eligible non-pregnant married women from 31 provinces of Iran. Non-random available sampling was performed as electronic form in virtual space. Data were analyzed by Demographic and Medical History Questionnaire, Sleep Quality (adapted from LSQ), Marital Satisfaction (EMS), Perceived Social Support (MSMPSS), Socioeconomic Status (Ghodratnama Questionnaire), and Stress-Anxiety-Depression (DASS-21). Data were analyzed by SPSS software (version 22) and Independent t-test, Chi-square, and binary logistic regression. P<0.05 was considered statistically significant.

Female and spouse education (P <0.001), female employment (P = 0.004), and higher socioeconomic status (P = 0.04) were significantly higher in women without children. The marital satisfaction (P = 0.061), social support (P = 0.13), sleep quality (P = 0.58), history of chronic disease (P = 0.64), and place of residence (P = 0.058) were not significantly different between the two groups. After adjusting the data, the rate of depression in childless women is twice that of women with children (AOR=2.06 95% CI: 1.11-3.82). Stress (P = 0.38) and anxiety (P = 0.9) were not significantly different between the two groups.

Having children not only does not increase the rate of stress and anxiety, but also protects women against depression. Therefore, encouraging childbearing seems to promote the mental health of women in Iranian society.

Postpartum hemorrhage is the most leading cause of maternal mortality worldwide; prevention of it can be effective in reducing mortality and complications. Studies have shown the contractile and anti-inflammatory properties of Urtica dioica and its effect on reducing menstrual bleeding, so the present study was performed aimed to determine the effect of Urtica dioica drops on postpartum hemorrhage.

This triple-blind randomized clinical trial study was conducted in 2019 on 100 women referred to Kamali Hospital in Karaj (Iran) for vaginal delivery in two groups of intervention and control. The intervention group received 10 drops of Urtica dioica and the control group received 10 placebo drops after delivery. Bleeding was measured using PBLAC chart up to 24 hours after delivery. Hemoglobin and hematocrit levels were measured at arrival and 6 hours postpartum. Data were analyzed using SPSS software (version 20) and independent t-test, Mann-Whitney, Fisher, Chi-square and repeated measures ANOVA. P<0.05 was considered statistically significant.

There was no statistically significant difference between the two groups in terms of demographic and obstetric variables (p>0.05). The mean of bleeding in the first 24 hours after delivery was 55.94±11.55 ml for the intervention group and 71.48±12.45 ml for the control group, which was significantly different (p=0.001). Also, the mean decrease of hemoglobin (p = 0.006) and hematocrit (p = 0.001) level was significantly lower in the Urtica dioica group than the control group.

Urtica dioica drop have a significant effect on reducing bleeding and reducing hemoglobin and hematocrit after childbirth and is helpful in reducing postpartum hemorrhage.

With age increases, the risk of cancer increases, and the importance of examining important sources of adjustment, including a sense of coherence, physical function, and social support to control the living conditions of these people, is of particular importance. Therefore, the present study was conducted to determine the relationship between a sense of coherence and physical function, and social support.

The present study is a correlational study that was performed on 120 elderly people with cancer by available sampling in selected hospitals of Shahid Beheshti University of Medical Sciences in Tehran. Data collection tools were a short cognitive test scale, sense of coherence, activities of daily living, instrumental activities of daily living, and social support questionnaires.

The results showed that the sense of coherence had a significant positive relationship with physical function in the field of instrumental activities of daily living and activities of daily living and social support, but social support did not have a significant positive relationship with the two variables of physical function. Also, the mean of a general sense of coherence was 15/28±54/88, physical function was 99/60±13/3 and 56/70±9/4 and social support was 78/96±61/14.

The results showed the sense of coherence was positively related to the two variables of physical function and social support. Since a sense of coherence can help improve the physical function and social support of the elderly with cancer, the need for strategies and interventions based on promoting a sense of cohesion by nurses and other clinicians is emphasized.

One of the goals of the third millennium development is maternal and neonatal health. One of the harmful factors of health is natural disasters. This study was performed aimed to determine maternal complications in Kermanshah earthquake in 2017.

This cross-sectional study was conducted on 850 women who had delivery in Imam Khomeini hospital of Eslam Abad Gharb. The earthquake group included the women who had delivered in the earthquake of 2017 and the non-earthquake group included the women who were delivered in the same hospital in 2016. All data obtained from patients' records. Data were analyzed by SPSS software (version 21) and Independent t-test, and Mann-Whitney test, Chi-square and Fisher exact test. P<0.05 was considered statistically significant.

In women who had delivered in an earthquake, prevalence of maternal complications included preterm labour in 99 (22.3%), premature rupture of membrane in 30 (7.05%), caesarean section in 179 (42.1%), postpartum hemorrhage in 42 (9.9%), gestational hypertension in 24 (5.6%) and abortion in 11 (2.58%). In women who had delivered in 2016, there were preterm labor in 51 (11%), premature rupture of membrane in 12 (2.8 %), caesarean section in 153 (36%), postpartum hemorrhage in 20 (5%), gestational hypertension in 9 (2.1%) and abortion in 2 (0.5%). There were significant differences between the two groups in all cases (P<0.05).

Natural disasters such as earthquakes can increase maternal complications. Therefore, necessary precautions and health care should be increased in the event of a natural disaster.

Gavage feeding tubes increase the length of stay and reduce the growth process in neonates. The aim of this study was to determine the effect of non-nutritive sucking on weight gain and length of stay in neonates that required gavage feeding.

In a clinical trial, neonates were selected via convenience sampling and randomly assigned into an intervention group (n=37) or a control group (n=38). Data including demographic information, admission and discharge dates, and neonates’ weights were recorded. In the intervention group, non- nutritive sucking was performed by the mother's finger at the same time as the gavage feeding. Data analysis was performed in SPSS V20 applying independent t-test, Mann-Whitney, and Chi-square.

The mean weight at discharge was 90.73 g higher in the intervention group than the control group (P=0.121). The mean weight loss was found to be higher in control group than the intervention group (P= 0.818). The mean length of stay was 14.22± 8.32 days in intervention group and 14.61±7.34 in control group, indicating no significant differences between the two groups (P=0.830, statistical power=60%).

Non-nutritive sucking had no significant positive effect on length of stay and weight gain in preterm infants. Further studies with larger sample size are suggested.

The most common cancer known worldwide that causes widespread mortality of women is breast cancer. One of the less known risk factors in women is hyperinsulinemia. Since identifying the risk factors help primary prevention and early detection of breast cancer, this study was performed aimed to determine the relationship between gestational diabetes and breast cancer in women referred to the hospitals of Tehran Shahid Beheshti University of Medical Sciences.

This comparative study was conducted on 450 women (n=150 in case group, n=300 in control group) referring to the hospitals of Tehran Shahid Beheshti University of Medical Sciences. Case group consisted of women with breast cancer based on pathologic record and physician diagnosis that at least one year has passed from their disease and control group were women without breast cancer who referred to other clinics in the same centers. Women were collected through interview and completing the questionnaire. Data were analyzed by SPSS software (version 24) and Independent t-test, Chi-square, chance ratio and logistic regression. P<0.05 was considered statistically significant.

In case group, 30 (20%) and control group 17 (5.7%) had history of gestational diabetes. There was significant relationship between breast cancer and gestational diabetes (OR=3.64, CI= 95%, P<0.001,1.78-7.43), body mass index(OR=1.11,CI= 95%, P<0.001, 1.04-1.18) and age (OR=1.13, CI= 95%, P<0.001, 1.09-1.16). In women with a history of gestational diabetes, the risk of breast cancer was 3.64 times higher than the other of women (P<0.05).

Gestational diabetes can be regarded as a risk factor for breast cancer. It is suggested that gestational diabetes be used as an early indicator in the detection of breast cancer.