ABSTRACT
Objectives: Midwives have a crucial role in providing optimal care for pregnant women.One of the most important policies for quality improvement in maternity care is implementation ofevidence-based practice. However, the application of evidence-based practice within the maternityhealth care setting faces many challenges. The purpose of this study was to describe Iranianmidwives’ attitude and perceived barriers of evidence based practice in maternity care.Methods: In this descriptive, cross-sectional study, a census sample of 76 midwives fromtwo public hospitals and urban health centers in Torbat Heydariyeh, a city east of Iran weresurveyed. Data collection tools were two reliable and valid questionnaires that measure midwives'attitudes and barriers of implementation of evidence-based practice. Data were analysed usingSPSS version 16.Results: The mean age and years of experience were 29.30 ± 4.86 and 5.22 ± 4.21 years,respectively. The mean score of attitude was 40.85 ± 4.84 (range = 30–60). This study also foundtime constraints (2.70 ± 0.92), inadequate facilities (2.64 ± 0.72), non-compilation of literaturein one place (2.59 ± 0.92), lack of cooperation of physicians (2.48 ± 1.06) and the feeling ofinadequate authority (2.45 ± 0.88) as the top five barriers to implementing EBP.Conclusion: Survey participants demonstrated a positive attitude toward EBP.Organisational comprehensive strategies such as time efficiency, adequate material and humanresources, familiarity with organisations such as the Cochrane Collaboration and managerialsupport for increasing professional legitimate authority are recommended to promote the use ofEvidence-Based Practice in Iran.
ABSTRACT
Background: Long-acting and permanent contraceptive methods [LAPMs] are the most effective approaches to reduce fertility. The study of factors associated with the use of LAPMs is one of the key steps in finding the population involved in reduced fertility
Objectives: The aim of this study was to assess factors affecting the use of LAPMs among married women of reproductive age in Torbat Heydariyeh city, East of Iran
Methods: This cross-sectional study was conducted on 304 married women aged 15 - 49 years in Torbat Heydarieh in 2016. Data were collected using demographic and fertility questionnaires. The data were analyzed using SPSS 13 by descriptive statistics and multivariate regression analysis
Results: The current overall prevalence of using LAPMs was 21.4%. The multivariate analysis showed that utilization of LAMPs was less frequent among the participants with diploma [AOR = 0.357, 95% CI = 0.156 - 0.817] and academic education [AOR = 0.418, 95% CI = 0.174 - 1.003] compared to women who had primary and secondary education. However, the utilization of LAPMs was more frequent in those with high income level [AOR = 8.364, 95% CI = 3.994-17.511] and those with higher number of living children [AOR = 2.247, 95% CI = 1.585-3.187]
Conclusions: The persistent use of LAPMs is largely determined by education and income level and the number of surviving children. Reproductive health programmers can consider this group of women for interventions aiming at improving the fertility rate
ABSTRACT
Episiotomy is a common medical procedure for widening the perineum. In fact, perineal pain is the most common complaint after episiotomy. Therefore, it is important to determine factors associated with postoperative pain following episiotomy in order to provide comfort for women after delivery. This study aimed to investigate factors associated with postoperative pain following episiotomy in primiparous women. This analytical, descriptive study was conducted on 119 eligible mothers, selected via convenience sampling, referring to Mashhad Omolbanin Hospital. Childbirth-related information was collected using a questionnaire. Neonates and mothers were also evaluated using Redness, Edema, Ecchymosis, Discharge, and Approximation [REEDA] scale and McGill Pain Questionnaire for perineal pain on days 1, 7, 10, and 14 after delivery. Kolmogorov-Smirnov, one-way ANOVA, Spearman's test, and Pearson's correlation were performed, using SPSS version 16. P-value = 0.05 was considered statistically significant. A significant direct relationship was found between the severity of episiotomy pain on day 7 and length of wound cut [P=0.034], neonatal weight [P=0.040], and number of sutures [P=0.028]. There was also a significant relationship between the severity of episiotomy pain on day 10 and the duration of active phase during the second stage of labor [P=0.047], duration of sitting position [P=0.011], and number of sutures [P=0.020]. However, a reverse significant correlation was found between the severity of postoperative pain following episiotomy and wound recovery on days 7 [P=0.015] and 10 [P=0.035]. Perineal pain was related to factors such as long perineal cut, slow wound recovery, prolonged active phase in the second stage of labor, neonatal overweight, and mother's prolonged sitting position. Therefore, it is recommended to train health care providers and mothers about these factors