[Attitude of parents towards children's mental disorder]

Introduction: the attitude of parents is an important factor for the prevention, control and treatment of psychological disorders. Despite Western countries, in developing countries, few studies have been done on people knowledge and attitude about mental disorders. The aim of this study was to determine the attitude of parents towards children mental disorder

Methods: This study was a cross-sectional study conducted in child psychiatry clinics of Tehran University of Medical Sciences during 2013. The parents of children [n=400] who referred to the psychiatric clinics were recruited for the study by the convenience sampling method. Data were collected by questionnaire and analyzed using descriptive and analytical statistics

Results: Among the total study sample, 93.7% of parents had a totally appropriate attitude towards children's mental disorder. The results of ANOVA showed that the attitude of parents toward mental disorder had a statistically significant relationship with parent education level [P<0.001] and their familial status [P<0.006]

Conclusion: This study showed that the parents of children referred to the psychiatric clinic have a totally appropriate attitude towards the mental disorder of their children. Logically, having totally appropriate attitude can empower family members to overcome different challenges with the child mental disorder. Such attitude can facilitate the process of disorder management from the step of early diagnosis of any psychological disorder to the treatment adherence

Assessment of effect spontaneous pushing in second stage of labor on maternal and fetus outcomes

Background and Aim: In more than 75% of delivery nursing staff members encourage prolonged Valsalva-type pushing during the second stage of labor. The objective of the present study is to the assessment of effect Spontaneous Pushing in second stage of labor on maternal and fetus outcomes

Methods and Materials: In this quasi-experimental study was completed on 160 pregnant women in second stage of labor and average 18-35 years old. The participants were allocated in two groups spontaneous pushing [n=80] and Valsalva pushing technique [n=80]. In group spontaneous pushing, used the spontaneous pushing method [open glottis pushing while breathing out] and in other group, used the Valsalva pushing technique [closed glottis pushing while holding their breath] during the second stage of labor. Duration stage of delivery, perineal tears, 1- and 5- minute APGAR score were evaluated in both group .Data were analyzed by SPSS

Results: Rate intact perineum in spontaneous pushing group was higher than Valsalva pushing technique group [p<0.001]. Moreover, first-degree and second-degree tears were not significant difference between two group. Rate the need for episiotomy was less in spontaneous pushing group [%33.8 versus %66.2] [p<0.001] that the group were significantly different. The baby fared better with spontaneous pushing, with higher 1 minute APGAR score

Conclusion: It seems that spontaneous pushing method during the second stage of labor is associated with less perineal trauma and improved newborn outcome

[ effect of the assertiveness training program on nursing students' assertiveness skills]

Assertiveness is an important skill for nurses in order to successfully communicate with patients, families and colleagues. Assertiveness increases people's self-esteem and self-confidence, improves interpersonal communication, and leads to the development of personality and internal locus of control. The purpose of this study was to investigate the effect of the assertiveness training program on nursing students' assertiveness skills. Using a quasi-experimental design, two out of three nursing classrooms held for students entering fall 2011 [n=55], and one out of two for those entering spring 2012 [n=34] were randomly selected. The former as the control group was pre-tested and post-tested after two weeks. The latter as the experimental group was undertaken the assertiveness training program and was tested similarly to the control group. The Gambrill and Richey assertiveness questionnaire along with some demographic questions were used to collect data. The data was analyzed using descriptive and inferential statistics. The mean of assertiveness scores in the pre-tests in both groups did not show a significant difference [P=0.6]. While no statistically significant change in the control group [P=0.09] was reported, a significant increase in the scores of the experimental group was shown after the training program [P=0.005]. The assertiveness training program increased the students' level of assertiveness. It is recommended to investigate the effect of improving self-esteem, problem-solving and social communication skills on nursing students' level of assertiveness

[Comparison of the effect of clinical evaluation by two methods: Portfolio and popular, on satisfaction of nurse students]

Introduction: Clinical evaluation is one of the important factors in nursing education, and there are some difficulties in evaluation of clinical skills, representing more practical and effective ways in this field is the topic of many researches. So, in this research we designed a lesson plan based on portfolio evaluation method and used it in nurse student's clinical courses. Then we compared their satisfaction from clinical evaluation with popular method

Methods: In this experimental research, students in fifth semester of nursing at Tehran University of Nursing and Midwifery are participated. These students were divided into subgroups of 7 and 8. Each of these subgroups passed the clinical probationary in cardiac unit. After explaining the research goals, these subgroups were put in two research groups randomly. In portfolio group [n=21] students evaluated by using portfolio method and portfolio evaluation tool. And in other group [n=20], popular form of clinical evaluation in university was used. Both groups answered the satisfaction questionnaire in last day. Content validity and reliability of questionnaire was tested. Data analyzed by SPSS software and with Chi square, Fisher Exact, Mann Whitney, Wilcoxon and spearman's rho tests

Results: Findings showed that students had 21.5 +/- 1.36 years of old and most of them was female and married. Satisfaction in portfolio group was meaningfully greater than popular group in three aspects: alignment of subjects in evaluation method and form with clinical course objects [P=0.04], creating interest and motivation for participation of students in learning [P=0.005], motivating students to use books and other scientific references [P=0.01]. Satisfaction of popular group from fairness of evaluation method was greater than portfolio group [P=0.017]. There were no meaningful results in other aspects

Conclusion: More satisfaction in some aspects from portfolio method represents acceptance of new active methods of learning and evaluation by students. so, using portfolio as one of the best method of clinical evaluation in nursing and doing more researches advised

[Staff nurses' adherence to oxygen therapy standards]

Oxygen therapy is a method in which oxygen is provided with more density than that in the atmosphere. Oxygen is used in the treatment of many diseases and since it is considered as a drug, it has to be prescribed and controlled like a drug. This research was done with the purpose of determining the observance of oxygen therapy standards by nurses before and during oxygen therapy. In this descriptive study, 36 nurses, working in lung wards of the hospitals affiliated to Tehran University of Medical Sciences, were included in the study and their practice on oxygen therapy procedure was studied during the year 2006. Data collection tools were questionnaire and checklist and data collection methods were interview and observation. The researcher collected data on staff nurses practice of oxygen therapy, before and during the therapy, twice for each staff. Descriptive statistics were used to analyze the data. The performance before the oxygen therapy for all staff nurses [%96.3] was at a low level. Also, the performance during oxygen therapy for majority of staff nurses was at a low level. In general, many mistakes occur by staff nurses regarding oxygen therapy

[Effect of halogen light stimulation on nonreactive pattern of nonstress test [NST]]

The Non Stress Test [NST] is a main assessment tool for fetal wellbeing; however, it has a high rate of false-positive results. External stimulation with halogen light has been recommended to aid in provoking fetal response, decreasing false-positive results and promoting the test. This study aimed to assess the effect of halogen light stimulation on nonreactive pattern of NST. From 850 women who underwent NSTs, 50 women with singleton and cephalic fetuses who had nonreactive NSTs were allocated to receive halogen light stimulation through a halogen light source of 1,000,000 candle power. The light was applied to the lower abdomen above symphysis pubis over fetal head for 10 seconds. Results were compared to BPP scores as a backup test. We used mean +/- SD, chi-square Test and Fisher's Exact Test. The alpha<0.05 was considered as significant level. Following stimulation, 68% of nonreactive results changed to reactive patterns. In half of the cases, first acceleration occurred in less than two minutes. Almost 90% of fetuses had reactive pattern within nine minutes. Halogen light stimulation decreased the incidence of non reactive tests and testing time. Halogen light stimulation is safe and efficient in fetal well being assessment

[Assessment the synergism effect of acupoints on preoperative anxiety]

To assess the effectiveness of acupressure [acupuncture without needle] and synergism of acupoints in reducing and maintaining patient's anxiety before abdominal surgeries. Participants in this randomized controlled trial were 70 patients who were scheduled to undergo abdominal surgery. Patients were randomized to an acupressure group or a placebo group, received acupressure either at the right points or at sham points for 10 mins. Anxiety [recorded on a Visual Analog Scale [0-10]] measured before, following pressure application and 30 minutes after intervention in both groups. The anxiety decreased in both group following pressure application for 10 min [P<0.001], but these effect sustained 30 mins after intervention only in acupressure group [P<0.001] not in placebo group. Comparison anxiety in following pressure application and 30 mins after intervention between groups was significant. Acupressure at the Yintang and Shen men points can decrease the anxiety level in patients before abdominal surgeries and sustained lower for 30 mins

[Nurses and inpatient adolescents' perceptions on observance of privacy and its importance]

Privacy is one of basic rights of the patients. Privacy becomes important for the adolescents when they hospitalize in an unfamiliar environment. This study aimed to compare the perceptions of inpatient adolescents with nurses on the observance of privacy and its importance. In this cross-sectional study, 175 nurses and a convenience sample of 180 inpatient adolescents who had met the inclusion criteria were recruited to the study. Data was gathered using a questionnaire. Man-whitney u and kruskal-wallis statistical tests were used to analyze the data. The results showed that there was significant differences between nurses' and inpatient adolescents` perceptions on the observance of privacy and its importance [man-whitney u, P<0.001]. The most important priority regarding the privacy from nurses' point of view was "covering the unnecessary parts of the body while caring"; whilst it was "providing a pleasant decorated environment, telephone, toilet and bath in room, and hospitalization in a room with peers" from the adolescents' point of view. The most observed case about privacy from the nurses' point of view was "taking immediate action to help the teenagers if necessary"; whilst, from the adolescents view, it was "calling them with their favorite names". The mean perceptions of nurses were higher than the adolescences toward observance of privacy and its importance. The results can guide nurses to improve quality of care for this group

[Effect of clinical teaching partner model [CTP] on nursing students' clinical training outcomes]

The Clinical Teaching Partner model [CTP] integrates theoretical knowledge with professional skills and brings the reality to workplaces. Closing educational and practical aspects in nursing discipline has been a challenging goal for nursing which requires cooperation between faculty instructors with nurse practitioners; such collaboration will led to development and promotion of nursing discipline. Therefore selecting an effective and efficient approach in order to integrate theoretical knowledge with practical experiences would be crucial for nursing profession. This study was conducted in order to investigate the effect of CTP on nursing students' clinical skills outcome. A quasi experimental, only post test design was applied. Study sample consisted of 1] three faculty instructors, 2] seven registered nurse practitioners who were staff nurses in three pediatric wards and voluntarily participated in the study and 3] fifty two nursing students which were in the 5th semester of nursing BSc. program and had eligible criteria to enter the study. Students were allocated randomly to the intervention [n=28] and control [n=24] groups. Participants in the control group, initially started their internship period in 3 pediatric wards and were evaluated by faculty instructors regarding their clinical skills at the end; students in the intervention group, then started their clinical training course in the same ward as control group, but their clinical education was conducted by the nurse practitioners who voluntarily participated in the study and trained initially in the nursing faculties' skill lab. Students' clinical skills were evaluated by nursing mentors via some instruments at the end of the educational period; in addition, clinical education outcomes and nursing students' satisfaction of achievement to apprenticeship goals were assessed at the end of the training period. Data were analyzed using the statistical tests including Chi square, Fisher exact test, Mann-Whiney U, and t-test in SPSS. Considering students demographic characteristics, both groups were homogenous. There was a significant difference in the students' clinical skills between two groups [P<0.001]. A significant difference was shown in the nursing mentors and faculty instructors' satisfaction of application of cooperative education method between both groups [P=0.004]. No significant differences were found between students' satisfaction of reaching to educational outcomes between both groups [P=0.058]. There were also no statistical differences between nursing mentors and faculty instructors' satisfaction of achieving to clinical education outcomes [P=0.109]. According to this study, CTP is an effective approach in clinical education and development of clinical skills for nursing students; therefore, application of this method is recommended in clinical nursing education

[Assessment of vitex agnus -castus L. extract effect on treatment of premenstural syndrome]

Premenstrual syndrome is a cyclic recurrence of the luteal phase of the menstrual cycle of combination of distressing physical, psychological of sufficient severity to result in deterioration of interpersonal relationships and/or interference with normal activities. Traditionally, Vitex agnus castus fruit extract has been used in the treatment of many female conditions. Assess of Vitex agnus -castus effect [4.3 - 4.8 mg dry extract] on treatment of premenstrual syndrome. Randomized, double blind, placebo controlled, parallel group comparison over two menstrual cycles on students of Tehran Medical University and Tehran University, that live in dormitory. Volunteers under vent a preliminary screening interview, completed Daily Symptom Rating [DSR] [contain 18 symptoms] for two cycle, and attended a medical screening visit before being diagnosed with premenstrual syndrome and screening for depression by Beck questionary. 116 students were screened and 99 were evaluated [active: 49; placebo: 50]. Participants took Vitex agnus- castus [dry extract tablets] one tablet daily or matching placebo for two cycles. Data were analyzed by descriptive and analytic statistics [chi-square, fisher exact test, willcoxon, mann-whitney u and t test]. Decrease of severity of premenstrual syndrome was significantly greater in the Vitex group compared with placebo group in total symptoms of premenstrual syndrome [60.73% versus 20.79%, p<0.001], psychological symptoms [65.62% versus 28.19%, p<0.001] and physical symptoms [57.98% versus 16.22%, p<0.001]. Sixteen of eighteen symptoms of premenstrual syndrome indicate significant superiority for Vitex, other symptoms including [suicide and swelling of extremities] being unaffected by treatment. There was no statistically significant difference between two groups in regard to adverse events. Vitex is an effective treatment for the relief of symptoms of the premenstrual syndrome

[Effect of prone position on oxygenation in patients undergoing mechanical ventilation]

One of the nurses' roles in patient care is frequent position change in patients undergoing mechanical ventilation. Because of attaching many lines and tubes to these patients, they are in supine or lateral positions most of the time. Nurses prefer these positions due to making care simple. Many studies have shown that prone position has positive effects on oxygenation and ventilation. However, other studies have shown some negative effects. The aim of this study was to determine the effect of prone position on oxygenation in patients undergoing mechanical ventilation. In this quasi-experimental study, 36 patients were selected using simple sampling method. Data were collected using a questionnaire and oxygenation data sheet. First, patients were put in supine position. After 30 and 120 minutes, oxygenation was assessed. Then they were changed to prone position and after 30 and 120 minutes oxygenation was reassessed. Data were analyzed using paired t test, spearman, and fisher exact tests in SPSS. The results indicated that there was significant differences between prone position and the amount of spo2 and sao2 oxygenation after 30 and 120 minutes [P < 0.001]. Prone positioning was effective on oxygenation after 30 and 120 minutes; so nurse should use this position in their care

[Effect of education designed based on health belief model on choosing delivery mode]

High rates of cesarean delivery have worried health policy makers. One of the main reasons for cesarean section in Iran is cesarean election. Health Belief Model [HBM] is one of the most powerful models used in health education programs. The objective of this study was to determine the effect of education designed based on HBM on choosing delivery mode among pregnant women. In this experimental study, 128 nulliparous women were recruited from Shahrood health care centers and private gynecologists' offices. Samples were randomly allocated into two equal groups. Women in the experimental group participated in two 40-minutes educational classes which were designed based on HBM. Data were gathered both before and after the classes, and then were analyzed using SPSS. The results indicated that there were no significant differences between two groups in demographic characteristics, infertility history, disease history, perceived susceptibility, and perceived benefits and barriers. After the intervention, significant differences were found between perceived susceptibility [P < 0.001], perceived severity [P < 0.001], perceived barriers [P=0.004], with practice [choosing the delivery mode] [P < 0.001]. The results showed that using HBM in program designing was effective in the pregnant women's decision-making toward delivery mode

[Assertiveness and anxiety in midwifery and nursing students]

High levels of assertiveness and low levels of anxiety are important factors that result in suitable communication. They also increase intellectual abilities, abstract thought, power and autonomy, and personal well-being among nursing and midwifery students. The aim of this study was to determine the relationship between assertiveness and anxiety among midwifery and nursing students. In this correlational, cross-sectional study, 173 nursing students [68 males and 105 females] were recruited using census and rational methods. Seventy seven midwifery students were also recruited using census method. Data were collected using a self-report tool including "personal information form", "Trait Spilberger Anxiety", and "Assertion Inventory" [AI] of Gambrill and Richey. Data were analyzed using descriptive and inferential statistical methods. Results showed that more than half of the nursing and midwifery students [59.5% and 59.7%, respectively] had moderate assertiveness. Also, 43.3% and 36.4% of them had moderate and high levels of anxiety. Pearson correlation test revealed that assertiveness and anxiety had negative correlations in nursing [r=-0.51, P<0.001] and midwifery [r=-0.449, P<0.001] students. Some demographic variables had significant correlations with assertiveness and anxiety among the students. Regarding the relationship between assertiveness and anxiety and their effect on mental health, as well as educational and occupational functions of the students, more attention is needed to pay to theses issues. Also, it seems that appropriate interventions should be planned to increase assertiveness and to decrease anxiety among the students

relation between postpartum depression with total serum cholesterol changes before and after child birth

Postpartum depression is a severe and pervasive sadness with labile mood that affect 8-15% women after delivery. It can negatively impress mother-infant bonding. There are a lot of factors which make women vulnerable to postpartum depression so that controlling them can prevent from the postpartum depression incidence. Several researches have shown an association between serum cholesterol reduction and depression. The aim of present study is to determine relation between postpartum depression with total serum cholesterol changes before and after child birth in Lahijanian women in years 2006-2007. This research sought a descriptive-analytical design. Samples consisted of healthy Primigravidia women [101 persons] with normal labor, normal delivery at term, married, and a medium to high socio-educational level, without history of a depressive disorder, and metabolic disorders or hyperlipidemia. The excluded were the women with maternal or fetal complication before delivery, having problem with accepting infant gender, fetal death and being depressed during pregnancy. All women were visited in two stages: 3 weeks before the expected delivery and also 6 weeks after delivery. On both visits the Beck depression inventory and serum cholesterol registration questionnaire were completed. Data were collected using a questionnaire which had three sections: demographic characteristics, the Beck depression inventory and laboratory tests. Data were analysed using descriptive and inferential statistics [Spearman correlation coefficient and t-test] by SPSS computer software. Findings indicated that serum cholesterol declined considerably in the postpartum period, also it was shown that there was a significant correlation between reduced serum cholesterol and postpartum depression [r=-0.331, P<0.001]. Serum cholesterol reduction has a relation with postpartum depression

[Perceptions of parents and nurses on needs of hospitalized children's parents]

Due to the fact that family centered care have a crucial role in pediatric nursing, it seems compatibility of nurses' and parents' perception about parents' needs can lead to deliver higher quality care. The aim of this study was to compare parents' and nurses' perceptions about needs of hospitalized children's parents. This is a cross-sectional survey. One hundred and fifty parents and 80 nurses were selected using convenient sampling method. Data was gathered using Kristjansdottir's "parental needs of hospitalized children" questionnaire. Data were analyzed using descriptive and analytical [Chi-squared and Mann-Whitney U tests] methods. Research findings showed that there was significant difference between both parents' and nurses' perceptions about parents' needs [P=0.012]. Both groups believed that parents' needs are met partially in hospitals. There was not meaningful difference between the parents' and nurses' perceptions concerning meeting parental needs [P = 0.666]. Based on their perceptions, understanding of parents' needs help them to meet their requirements in health care facilities. There was a significant difference between parents' and nurses' perceptions regarding parents' need [P = 0.018]. Parents and nurses recognized all of the parents' needs to be important; there were also deficits in meeting these needs. Therefore, parents' cooperation with health care team is necessary to facilitate the recovery of sick children as well as meeting parents' needs

[Effects of lecture presentation and presenting educational packages on girls' knowledge about adolescence health]

Adolescents have important role in building the societies. Some deficits were observed in students' knowledge regarding puberty health. This study aimed to compare the effect of two educational methods [lecture-educational package] on girl students' knowledge about puberty health. In this interventional study, 200 students were randomly selected through a multi stage sampling method. Data were collected using a questionnaire. One group received a self-learning educational package and the other group took part in two lecture sessions which totally lasted about four hours. The post test was taken 6 weeks later. Data analysis was performed using Descriptive and inferential statistics. Results of this study showed that after intervention, both groups' knowledge mean scores increased significantly. Also the average of package group's score after the education was more than the other group's score [P < 0.001]. The difference in knowledge mean scores before and after the intervention was significantly higher in the package group than in the lecture one. The comparison of scores in both groups before and after the education was significantly different [P < 0.001]. Both educational methods can be considered to be effective in promoting students' knowledge; however, the educational package was more effective than the lecture

Effect of simultaneous educational program for mothers and daughters on osteoporosis preventive behaviors among girls

Osteoporosis is a metabolic disease which results from gradual destruction of bone mass. Prevention of Osteoporosis should be started from childhood by getting adequate calcium and doing weight-bearing exercises. Participating of mothers in health education interventions is likely to promote longer-lasting health behaviors in their daughters. The aim of this study was to investigate the effect of simultaneous education of mothers and daughters on Osteoporosis preventive behavior among high school female students. In this interventional study, 400 female students were randomly selected via a two-phased sampling method. At first stage, four schools were selected randomly. At the second stage, 400 students were divided randomly into two groups. Their Osteoporosis preventive behaviors were measured using a two-sectioned questionnaire: demographic section, and Osteoporosis preventive behaviors assessment section. The first group participated in the educational programs with their mothers and the other group participated without their mothers. The educational program had two sessions, each one lasted 45 minutes. The second stage of the study was performed three months later. Data analysis was carried out using t-test and chi squared test. Results showed that in both groups, Osteoporosis preventive behaviors scores increased significantly after intervention. It was higher in case group [P<0.001]. Eating behavior was significantly different in two groups [P=0.003]. Results showed that simultaneous educational program for mothers and daughters promotes eating behavior in the girls

Effect of acupressure on patients' anxiety and vital sign before abdominal surgeries

Anxiety is one of the emotional conditions among patients scheduled for surgery that can result in increasing postoperative pain, increasing analgesic and anesthetic requirements and prolonging hospital stay. The aim of this study was to assess the effectiveness of acupressure [acupuncture without needle] in reducing patients' anxiety before abdominal surgeries. In this randomized, blinded, sham controlled trial, 70 patients who were scheduled to undergo abdominal surgery in Tehran University of Medical Sciences' hospitals were selected using convenience sampling method. The patients were randomized to an acupressure group [n=35] or a placebo group [n=35], receiving acupressure either at the right points [Yintang and Shen men] in acupressure group or at sham points in the placebo group for 10 min. Anxiety was recorded on a Visual Analog Scale [0-10]. Vital signs were measured before and after pressure application in both groups. The anxiety was decreased in both groups following pressure application for 10 min [P<0.001]. The amount of anxiety was significantly different between the groups [P<0.001]. The heart rate, respiratory rate, and diastole/systole pressure [P<0.001] were decreased in the case group. Only heart rate [P=0.016] and respiratory rate [P=0.007] were decreased in the placebo group. Changes in respiratory rate and systole pressure following pressure application were statistically significant between two groups. Acupressure at the right points can decrease anxiety before abdominal surgeries but it has no clinical effect on vital signs

[Relationship between perception of health concept and health promoting behaviors: a comparative study among Tehran University Medical and non-medical students]

Health is one of the vital concepts in every society which is affected by several factors including age, gender and social situation of the people. Individuals' perception of health concept is also of paramount importance. The main objective of this study is to determine health concept perceptions and health promoting behaviors among Tehran University medical and non-medical students. This is a descriptive- analytical study. Four hundred medical students and four hundred non-medical students were recruited for the study using stratified sampling. A three-section self-evaluating questionnaire including demographic information, health perception information and health promoting behaviors information was used to gather data. Data were analyzed using descriptive statistics, t-test and Pierson Correlation Coefficient. 49.7 percent and 6.8 percent of the medical students had good and excellent perceptions about health concept, respectively. In non-medical students, it was 49.4 percent and 8.6 percent, respectively. 57 percent of the medical students and 54.9 percent of non-medical students had good health promoting behaviors, respectively. There was significant relationship between perceptions of health concept and health promotion behaviors among both groups [P<0.001]. Based on the results, there is a direct relationship between perception of health concept and health promoting behaviors among both groups. There is no difference in all aspects of health promoting behaviors, except for cigarette smoking in which the medical students showed more healthy behaviors

Evaluation of knowledge and practice of newly graduated midwives in normal vaginal delivery in hospitals affiliated to Tehran University of medical sciences

Evaluating the knowledge and practice of newly graduated midwifery students can reflect to some extent the results of midwifery educational planning. This study was done to assess knowledge and practice of newly graduated midwives in Normal Vaginal Delivery [NVD] in hospitals affiliated to Medical Sciences Universities in Tehran. In a survey study, all newly graduated midwives [n=30] employed in hospitals affiliated to Med-ical Universities in Tehran and graduated in the past two years were selected through census sampling method. A self-administered questionnaire containing 40 multiple-choice questions for measuring knowledge was completed by midwives. Then the practice of midwives while performing normal vaginal delivery and episiotomy was observed using a 109 item checklist. The data was analyzed by SPSS software using freque-ncy distribution, mean and standard deviation. Pearson Correlation Coefficient was used to measure the correlation between knowledge and practice scores, and age and experience of midwives. Most of the subjects had an average knowledge [90%] and desirable practice in all stages of NVD including first stage [60%], second stage [73.3%] third stage [73.3%] and forth stage [60%]. In immediate care of the new born 86.7% and in episiotomy 80% had a desirable practice. This study showed that graduated midwives were competent enough to perform a safe normal vaginal delivery