[Effect of mirror therapy on walking ability in patients with stroke]

Background and Aim: Stroke is one of major causes of disability. Therefore, it is important to introduce and develop new treatment approaches in order to improve and enhance post-stroke recovery process for medical, social, and economical purposes. The present study aimed at determining the effect of mirror therapy on walking ability of patients with stroke regarding the muscular power of the affected leg

Materials and Methods: This semi-experimental study was done on 50 stroke patients that were hospitalized in Mashhad Imam Reza and Quaem hospitals. They were randomly classified into two equal groups of control and mirror therapy[experimental group]. For the experimental group, twenty 30 -minute sessions were daily held, so that every patient did the range of motion of lower extremitiy of the healthy side in front of a mirror and observed just its mirror image. In addition to mirror therapy, the routine program physiotherapy was performed for both groups. Power of muscle in the affected leg was assessed on the basis of a 5-score scale and every patient`s walking ability was assessed before, during, and after intervention using function ambulation classification. Finally, the obtained data was analyzed by means of SPSS software [V:11.5], using independent T, paired T, Mann-Whitney and Wilcoxon statistical tests

Results: The two groups showed no significant difference in terms of walking ability regarding the muscular power of the affected leg and confounding variables before intervention [P=0.210]. Walking ability of the affected leg in mirror therapy group did not significantly improve.in comparison with the control group after intervention [P=0.756]. But the walking ability regarding the muscular power of the affected leg in mirror therapy group was significantly improved in comparison with the control group in the 10[th] session [P=0.038]

Conclusion: Mirror therapy can improve walking ability of patients with stroke as a simple, inexpensive and a patient-oriented treatment

Predictors for maternal self-efficacy in early parenthood

Many parents do not believe in their ability to fulfill their parental responsibilities. Parental self-efficacy is crucial to parents' sense of well-being and is considered a predictor for quality of life. However, evidence is scarce on the factors that influence parents' perception of efficacy. Therefore, this study aimed to investigate the predictors for parental self-efficacy in the early postpartum period. This descriptive analytical study was conducted on 150 primiparous women referring to the health care centers of Mashhad during their early postpartum months. For data collection, we used demographic questionnaires, Bates' Infant Characteristics Questionnaire [ICQ], Scale of Perceived Social Support, Reece's parent expectations survey [PES], and Edinburgh Postnatal Depression Scale [EPDS]. For data analysis, independent T-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise regression were performed, using SPSS version 16. In this study, a significant association was observed between self-efficacy scores and the parents' income, educational status, depression, and infant's gender. Furthermore, there was a significant correlation between self-efficacy scores and infant's characteristics, mother's satisfaction with childbirth experience, perceived support from friends, infant's perceived temperament, infant's gender, mother's educational level, and depression, which could predict 26.1% of parental self-efficacy. According to the results of this study, the most significant predictors of maternal self-efficacy during the early postpartum months were maternal depression and educational status, infant's gender, and infant's characteristics

Relationship between psychological hardiness and coping strategies during pregnancy

Although pregnancy seems to be a pleasant experience in a women's life, the accompanied physical and psychological changes lead to high levels of stress in mothers. Prenatal stress widely affects the physical and mental health of mothers and infants; therefore, adopting appropriate coping strategies are highly required. Considering the importance of coping strategies in psychological hardiness, we aimed to determine the relationship between psychological hardiness and prenatal coping strategies. This correlational study was conducted on 500 pregnant women, referring to the healthcare centers of Mashhad, Iran in 2014. The study subjects were selected via convenience sampling. Data collection tools included Kobasa Hardiness Scale, the Revised Prenatal Coping Inventory and Perceived Stress Scale. For data analysis, Spearman correlation coefficient and regression analysis were performed, using SPSS version 16. The significance level was considered to be 0.05. Psychological hardiness had a significant positive correlation with planning/ preparation [r=0.70, P<0.001] and positive/spiritual coping strategies [r= 0.75, P<0.001]. However, a significant negative correlation was found between psychological hardiness and avoidance coping strategy [r=- 0.81, P<0.001]. Considering that psychological hardiness was correlated with planning/preparation and positive/spiritual coping strategies, it is recommended to encourage pregnant women to adopt these adaptive strategies to overcome stress during pregnancy

Postpartum sexual function in women and infant feeding methods

To assess postpartum sexual function in mothers using different infant feeding methods. The comparative cross-sectional study comprising women referred to health centres in Mashhad, Iran, was conducted from July 7 to December 11, 2011. Sexual function and infant-feeding method of the subjects were assessed four months after childbirth. Data was collected using the standard Female Sexual Function Index and baby's feeding method questionnaire. SPSS 11.5 was used for statistical analysis. There were 366 women in the study with a mean age of 26.70 +/- 4.70 years who were using four methods of infant-feeding: exclusive breastfeeding, breastfeeding plus complementary feeding, formula milk, and breastfeeding plus formula. There was a significant difference between women's sexual function score and infant-feeding method [p=0.04]. The highest score 6.23 +/- 3.5 belonged to women who had exclusive breastfeeding. There was a difference in women's sexual function between different groups of infant feeding methods. The highest score of sexual function was found in breastfeeding women. Women need to be educated about exclusive breastfeeding and its positive effects on sexual function

Comparing postpartum stressors and social support level in primiparous and multiparous women

Postpartum period is an exclusive period after birth which can act as a potential stressor and could be accompanied with psychological disorders. Social support could play an important role in maternal mental health. Considering various stressors and different levels of social support for women, this study aimed to compare postpartum stressors as well as social support level between primiparous and multiparous women. This descriptive comparative study was conducted on 400 primiparous and multiparous mothers who referred to urban health centers, Mashhad, Iran in 2011. They had no history of medical or psychological problems and had healthy term neonates who were 8-25 days old. The sampling was carried out through a multistage cluster sampling. Data were collected using modified Hung questionnaire of postpartum stressors, Helen questionnaire of anxiety and Hopkins social support questionnaire. Data were analyzed using descriptive analytic statistics by SPSS version 11. The mean stress scores were 242.5 +/- 157.1 in primiparous and 28.8 +/- 179.8 in multiparous women. The main stressor of primiparous and multiparous women was neonate bathing and lower-back pain, respectively. The mean score of social support was 108.3 +/- 8.25 in the primiparous and 102.0 +/- 26.6 in multiparous women, which showed a significant difference between two groups [P=0.000]. Various care programs are essential to support primiparous and multiparous mothers from different stressors that they face in postpartum period. It is also recommended to provid more information regarding the social support for the families

Effects of spiritual self-care training on feeling of comfort in mothers of hospitalized preterm Infants

The stress resulting from premature delivery and the related neonatal care induces psychological and physical pressure on the mothers, and adversely affects their feeling of comfort. It seems that spiritual care as a sort of communication with a higher power [God] can bring peace to the stressed mothers, and prevent anxiety. Therefore, this study was designed to evaluate the effects of spiritual self-care training on feeling of comfort in mothers of preterm infants, hospitalized in the neonatal intensive care unit [NICU]. In this randomized clinical trial, 60 mothers of preterm infants hospitalized in NICU of Omolbanin and Ghaem hospitals, Mashhad, Iran in 2013, were selected, using convenience sampling, and were randomly assigned to intervention and control groups. In order to familiarize the mothers with their infants' condition, the mothers in both intervention and control groups were informed and trained for 15 minutes every day, over a 14-day period. The intervention group, in addition to infant-related information, received spiritual self-care training for 45 minutes in 6 sessions, every other day. Before and after each session of self-care training, the mothers filled a self-structured questionnaire related to feeling of comfort resulting from spiritual care. Data were analyzed using SPSS version 16, by repeated measures analysis of variance [ANOVA], t-test, and Chi-square tests. According to the results, the total mean of maternal feeling of comfort was 50.0 +/- 4.3 and 55.6 +/- 3.3 before and after the intervention, respectively. The results of t-test indicate that comfort significantly increased after the intervention [P=0.000]. Based on the results of this study, spiritual self-care training increases the feeling of comfort in mothers with premature infants, hospitalized in NICU

Effect of mothers training via newsletter and group discussion on the energy intake of preschool children

Mothers' training about suitable nutritional models plays an important role in the development of children's nutritional habits. These habits may continue into adulthood and promote the individual's lifestyle. In the present study, we aimed to compare the effects of mother's training via newsletter and discussion group on energy intake of preschool children. This experimental study was performed on 192 mothers of preschool children. The convenience method of sampling was employed, and the subjects were randomly assigned to three groups: group discussion, newsletter, and control group. In the newsletter group, the subjects received newsletters over 4 weeks. In the discussion group, subjects were trained about the same educational content, as the newsletter group, in 1-hour classes for a total of 4 weeks; the control group received no intervention. Data collection was carried out before, immediately, and one month after the interventions, using questionnaires to measure maternal knowledge and children's dietary intake. Data were analyzed using SPSS version 16 with ANOVA, Kruskal-Wallis, and Friedman tests. Energy intake was similar before intervention in three groups. Immediately after intervention, no significant difference was observed between newsletter [5.7 +/- 2.10] and discussion group [0.8 +/- 2.10]; however, it was significantly higher, compared to the control group [P=0.015]. After one month follow-up, no significant difference was observed between newsletter [5.7 +/- 2.10] and discussion group; but the energy intake in both groups was significantly higher than the control group [P=0.003]. The study results showed that training via newsletters and group discussion has the same effect on children's energy intake. Therefore, it is recommended to use newsletter as an effective and simple alternative educational method

effect of intravenous fentanyl on pain and duration of the active phase of first stage labor

Opioids are most widely used for pain relief during childbirth. An alternative opioid, fentanyl, has been shown to be a good option for pain management and has fewer side-effects on both mother and fetus. Therefore, the purpose of this study is to determine the effect of fentanyl on pain as well as the duration of the active phase of labor. This clinical trial was conducted on 70 multiparous parturients having labor from May to July 2006 at Tamin Ejtemai Hospital. They were selected by convenience sampling at the beginning of the active phase of labor. The samples were then randomly divided into the case and control groups. The case group received fentany l 50 micrograms in two doses, one hour apart after being diluted [0 and 60 mins]. Vital signs were recorded pre-administration and 5, 15, 30, 45, 60 minutes post-administration. Pain intensity was estimated by visual pain scale [0-10] four times [before and 1, 2, 3 hours after the intervention]. Data analysis was done using the student t-test, repeated measure ANOVA and chi-square tests via SPSS 11.5 software. The results showed a significant reduction in pain [p=0.002] and HR [p=0.001] in the case group. The mean pain score also decreased from 8 +/- 1 to 5 +/- 1. There was a significant difference in terms of the duration of the active phase between the two groups [p=0.001]. However, there were no significant differences in terms of systolic blood pressure and diastolic blood pressure between the two groups. Fentanyl provides good analgesic effect for pain management during labor by considerably reducing the duration of the active phase, and can therefore be used as an acceptable analgesic agent during labor.