Comparison of the effects of a positive reappraisal coping intervention and problem-solving skills training on depression during the waiting period of the result of intrauterine insemination treatment: a randomized control trial

Background: The outcomes of fertility treatments are unpredictable, and levels of depressive symptoms increase in patients during the waiting period of the result of intrauterine insemination [IUI] treatment

The aim of this study was to compare the effects of a positive reappraisal coping intervention [PRCI] and problem-solving skills training [PSS] on depression during the waiting period of the result of IUI Treatment

Materials and Methods: This randomized control clinical trial was done among 108 women undergoing IUI treat- ment. In the control group, the women received routine care. In the PRCI group, women attended two training sessions and were asked to complete coping thoughts cards and fill out daily monitoring forms during the waiting period. In the PSS group, PSS were taught over three sessions. The depression was measured by the beck depression inventory

Results: On the 10th day of the IUI waiting period, there were significant differences between the control group [21.42 +/- 11.42] and the PSS group [12.52 +/- 8.05] and PRCI groups [13.14 +/- 9.7] [P<0.001], but no significant difference between the PRCI group and the PSS group

Conclusion: According to the results of this randomized control trial there is no difference between a PRCI and PSS on depression during the waiting period of the result of IUI treatment. This suggests that both interventions can be used to help infertile women combat depression during the waiting period of the result of fertility treatments

effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: an RCT

Background: waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination [IUI] treatment

Objective: the aim of this study was comparing the effect of the positive reappraisal coping intervention [PRCI] with the problem-solving skills training [PSS] on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad

Materials and Methods: in this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period

Results: results showed that the mean score for problem-focused were significantly different between the control [28.54+/-9.70], PSS [33.71+/-9.31], and PRCI [30.74+/-10.96] [p=0.025] groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control [32.09+/-11.65], PSS [29.20+/-9.88], and PRCI [28.74+/-7.96] [p=0.036] groups. There were significant differences between the PRCI and the control group [p=0.047]

Conclusion: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers

Effects of web-based training and educational simulation on midwifery students' self-confidence in postpartum hemorrhage management

Self-confidence, as one of the key elements of clinical competence, plays an important role in one's actions and behaviours. Selection of proper instructional methods influences students' self-confidence. Therefore, this study aimed to compare the effects of web-based training and educational simulation on midwifery students' self-confidence in postpartum hemorrhage management. This experimental study was conducted on 44 midwifery students of Mashhad School of Nursing and Midwifery, Mashhad, Iran, in 2013. The subjects were selected via convenience sampling. The web-based group was trained at the clinical skill laboratory of School of Nursing and Midwifery; both groups were taught the same educational content. Data were collected using a demographic questionnaire, visual analogue scale to evaluate students' self-assessment of their ability to manage postpartum hemorrhage and C-scale to measure students' self-confidence Descriptive analysis, independent t-test, paired t-test, and two-way ANOVA were performed, using SPSS version 11.5. Both groups showed a significant increase in self-confidence in postpartum hemorrhage management one month after the training [P=0.003 and P=0.030 in web-based and simulation groups, respectively]. No significant difference was found between the two groups in terms of self-confidence in postpartum hemorrhage management. Since the two groups showed no significance difference in self-confidence, web-based education, which is a more accessible method, could be applied as an alternative to the conventional method of simulation

Risk factors of dystocia in nulliparous women

Background: Detection of women at risk for dystocia will allow physicians to make preparations and treatment decisions that can minimize maternal and neonatal morbidity. We aimed to determine the risk factors for dystocia in nulliparous women

Methods: This case series enrolled 447 nulliparous women who presented with a single pregnancy in the vertex presentation and gestational age of 38-42 weeks. Maternal anthropometric measurements were obtained upon admission. We defined dystocia as a cesarean section or vacuum delivery for abnormal progression of labor as evidenced by the presence of effective uterine contractions, cervical dilation of less than 1 cm/h in the active phase for 2 h, duration of the second stage beyond 2 h, or fetal head descent less than 1 cm/h. Data were analyzed by SPSS software version 11.5. Kruskal-Wallis, logistic regression, chi-square, Student's t test and the Mann-Whitney tests were used as appropriated

Results: The state anxiety score [OR=10.58, CI: 1.97-56.0], posterior head position [OR=9.53, CI: 4.68-19.36], fetal head swelling in the second stage of labor [OR=6.85, CI: 2.60-18.01], transverse diagonal of Michaelis sacral

Conclusion: Critical care during labor and delivery in women who have a height to fundal height ratio of <4.7 or transverse diagonal of Michaelis sacral

Effect of late-pregnancy consumption of date fruit on cervical ripening in nulliparous women

Cervical ripening before the onset of labor is an important factor for the prediction of delivery mode, and is directly associated with vaginal delivery. The search for a safe, inexpensive, and easy method of cervical ripening is of great significance. Few studies have focused on the effect of date fruit on uterine contractions and cervical ripening. Therefore, the purpose of this study was to determine the effect of late pregnancy consumption of date fruit on cervical ripening in nulliparous women. This randomized clinical trial was performed on 210 women with a singleton pregnancy, cephalic presentation, and gestational age of 37-38 weeks. The study was conducted at Omolbanin Hospital, Mashhad, Iran in 2013. The subjects were randomly assigned into two groups of 105 women [experimental and control groups]. Since the 37th week of gestation, the experimental group consumed date fruit [70 to 75 gr per day] until the onset of labor pain, and the control group received routine care.Data were collected using demographic questionnaires, fetal movement record form, and the checklist related to daily consumption of date fruit. Data analysis was performed using SPSS version 14, and Chi-square, t student, and Mann-Whitney test. P-value less than 0.05 was considered statistically significant. The mean Bishop score at admission was higher in the experimental group [7.67 +/- 2.28], compared to the control group [5.12 +/- 2.77] [P<0.001]. Mean cervical dilatation at admission was 4.05 +/- 1.63 cm in the experimental group and 2.97 +/- 4.63 cm in the control group [P<0/05]. Also the success rate of labor induction was higher in the experimental group compared to the control group [P=0.006]. Mean cervical dilatation was higher in women consuming date fruit, compared to the non-consuming group. Since date fruit is full of energy and nutrients, it is recommended for pregnant women to help with cervical ripening, particularly in the last weeks of gestation

Relationship between occupational stress and work ability among midwives in Mashhad, Iran

Occupational stress is one of the key factors in reducing staff productivity in organizations with physical and psychological impacts on employees. Nursing and midwifery are among the most stressful professions. Therefore, this study aimed to determine the relationship between occupational stress and work ability of midwives in Mashhad, Iran in 2011. This cross-sectional study was carried on 123 midwives employed in the public hospitals and health centres in Mashhad, Iran using two-stage sampling method. Demographic and work-related data were obtained through a self-structured questionnaire. Occupational stress and work ability were measured using Occupational Stress Assessment Questionnaire [OSAQ] and Work Ability Index Questionnaire [WAIQ]. The statistical analysis was performed using student's t-test, One Way ANOVA, correlation coefficient, and linear regression model through SPSS statistical software [version 11.5]. The results showed that the mean score of occupational stress and work ability was 149 +/- 0.01 and 38.81 +/- 0.05, respectively. There was a negative correlation between job-related stress and work ability. Midwives with higher occupational stress experienced poorer work ability [P=0.021, r=-0.061]. Sever work stress is associated with reduced work ability. So it is recommended to eliminate or decrease occupational stress and increase work ability among Iranian midwives using preventive measures, although identification of sources of occupational stress seems necessary in order to adopt appropriate stress management strategies

Comparing diagnostic accuracy of purple line with transverse diagonal of michaelis sacral to predict labor progress in nulliparous and multiparous women

One of the key aspects of maternal care is observing labor progress. Careful assessment of labor progress could provide mothers to be referred on time and could minimize the maternal and neonatal morbidity. This study aimed to compare diagnostic accuracy of purple line with transverse diagonal of Michaelis sacral rhomboid to predict labor progress in nulliparous and multiparous women who referred to Om-ol-banin Hospital, Mashhad, Iran from April to August 2012. In this double-blind diagnostic accuracy study, 350 nulliparous and multiparous women with a single pregnancy in vertex presentation and gestational age of 38-42 week who admitted in state hospitals of Mashhad were selected using convenience sampling. The transverse diagonal of the Michaelis sacral rhomboid area was measured in cervical dilatation of /= 98.5 millimeter was accompanied with normal labor progress with 86.5% sensitivity, 59.45% specificity and 79.65% validity. Transverse diagonal of the Michaelis sacral is better predictor for observing labor progress in comparison with purple line

[Relationship between job stress with menstrual bleeding pattern among midwives]

Job stress can interfere with endocrine function and result in dysfunctional menstrual bleeding patterns. The aim of this study was to assess the relationship between job stress with menstrual bleeding pattern among midwives. In this cross-sectional study, we recruited 150 midwives working in hospitals and health centers of Mashhad using two-stage sampling. Data were collected using a questionnaire including demographic characteristics, Karazek Job Content, a daily diary for menstrual periods to record duration and interval of periods, and the Higham Chart for recording the bleeding amount. The diary was completed for three menstrual periods. Collected data were analyzed using independent t-student, one way ANOVA, Mann-Whitney U, Chi-squared test, correlation test and linear regression in the SPSS-14. The findings showed that 21.3% of the midwives reported mild job stress, 19.3% had moderate stress and 59.3% reported severe job stress. Mean of the duration of the periods was 7.06 days, the mean interval of the periods was 27.9 days and the mean amount of bleeding was 79.72 cc. There was a significant relationship between job stress and the duration and interval of periods [P<0.001]. There was not any significant relationship between job stress with the amount of bleeding. Our study showed that job stress was related to menstrual bleeding patterns among midwives. It is necessary introduce strategies to decrease job stress and provide professional support for midwives

[ effect of problem solving skills training on severity of depression symptoms in postpartum period]

Postpartum depression is a problematic and major disease, with the average prevalence of 13 percent, if not diagnosed and treated may be complicated. Problem solving skills training is one of simple treatments that could be trained in health centers. Therefore, this study was conducted to determine the effect of problem solving skills training on severity of depressive symptoms in postpartum women. This clinical trial was performed [during Jan 2009-Jun 2010] on 54 women after delivery from health centers of 2[nd] and 3[rd] zones of Mashhad. Women who fulfilled inclusion criteria and got the score of 10 or above on Edinburgh Scale and got score of 14 to 28 on Beck Depression Inventory and their depression was confirmed by clinical psychologist, were randomly allocated to two groups of intervention [n=26] and control [n=28]. In the intervention group, problem-solving skills were educated during six sessions of 45-50 minutes. In both groups, again, Beck Depression Inventory was completed in 9 weeks after delivery. Statistical analysis was done by one-way ANOVA and Kruskal-Wallis in SPSS software. The finding showed that severity of depressive symptoms are significantly different at 9 weeks postpartum between two groups [P=0.000]. The mean difference of severity of depressive symptoms are significantly different between two groups in the beginning of research and 9 weeks after delivery [P=0.000]. Depressive symptoms were decreased about 77.6% in problem solving skills group comparing 23.5% in control group. Based on this study, problem-solving skills training is an effective method in reducing the severity of depressive symptoms. Therefore it is recommended that problem-solving skills training could be used as one of the mental health strategies in health centers

[Comparison of the effect of early and late umbilical cord clamping on the Apgar score of the neonate]

After decades of discussion and dialogue, there is little agreement about suitable time for after birth umbilical cord clamping. By using the late cord clamping, neonate receives more placental transfusion that may affect the Apgar score. This study was designed to compare the effect of early and late cord clamping on the Apgar score of the neonate. This double blind, randomized, clinical trial carried out, in the year 2002 at Deziani Hospital of Gorgan, Iran. This study was approved by the local committee of medical ethics. Healthy full-term vaginally born neonates [n=64], were randomly allocated to early [30s] and late [3min] umbilical cord clamping group. During this period of time, the attendant held the neonate supine at the level of introitus. At the end of 1min and 5mins after birth. The Apgar score of the neonate, residual placental blood volume and estimated neonatal blood volume were determined. Data obtained by interview and observation, analyzed by SPSS software, Mann Whitney, t student and Chi-squared tests. There was a significant difference between early and late umbilical cord clamping groups [p<0.001], in the 1min and 5mins Apgar scores of the neonate. Placental residual blood volume in the late cord clamping group was 39.5% lower than the early cord clamping group [p<0.001]. Estimated neonatal blood volume in late cord clamping group was 7.1% higher than early cord clamping group [p<0.001]. Late cord clamping leads to a significant increase in the Apgar score of the neonate and the estimated neonatal blood volume. However, the placental residual blood volume significantly decreased. Further trials should delay cord clamping until cessation of cord pulse or alter the level that the newborn is kept