Women's sexual and reproductive health care needs assessment: an Iranian perspective

Background: Reproductive health problems are a leading cause of women's ill health and mortality worldwide. There is a need to investigate sexual and reproductive health care needs in different societies and cultural contexts. Despite the success in health care promotion in the Iranian health care system, women still need to receive sexual health care and appropriate HIV/AIDS services. However, studies on the sexual and reproductive health care needs of Iranian women are lacking.

Aims: This study aimed to investigate the sexual and reproductive health care needs of women referred to health care centres in an urban area of the Islamic Republic of Iran.

Methods: We carried out a cross-sectional study in 2013 on 514 women living in an urban area in the north of the Islamic Republic of Iran. Taking into consideration ethical principles, data were collected using the Sexual and Reproductive Health Care Needs Assessment Questionnaire.

Results: The findings showed a greater need for the provision of care by practitioners in the sexual history and activities domain [73%] compared with other domains. Also, the woman's age and the location where she sought treatment and care for sexually transmitted infections were predictors of sexual activities needs.

Conclusions: Owing to the high prevalence of women's referral to health care centres seeking treatment of sexual disorders, there is a need for the provision of sexual counseling centres and services promoting women's reproductive health care

Postanesthetic emergence agitation in pediatric patients under general anesthesia

Objective: Postanesthetic emergence agitation is a common problem in pediatric postanesthetic care unit with an incidence ranging from 10 to 80%. This study was done to determine the prevalence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia

Methods: This cross-sectional descriptive and analytic study was performed on 747 pediatric patients aged 3- 7 years that underwent general anesthesia for various elective surgeries at Bou-Ali Sina Hospital in Sari, Iran between January 2010 and January 2011. A non-probability quota sampling technique was used. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium Scale. The factors linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software 16 and independent sample t-test, chi[2] and binary logistic regression. P-values less than 0.05 were considered as significant

Findings: One hundred thirty-four [17.9%] children had emergence agitation. The most frequent surgical procedures were ENT surgical procedures 315 [42.2%], abdominal surgery 177 [23.7%], orthopedic surgery 137 [18.3%], urology 97 [13%] and ophthalmic surgery 24 [3.2%]. Otorhinolaryngological surgical procedures [P=0.001], pain [P<0.05] and induction behavior of children [P<0.005] were associated with higher rates of post anesthetic emergence agitation [P=0.001]

Conclusion: This study identified the multiple independent risk factors which are associated with emergence agitation in children. To minimize the incidence of postanesthetic emergence agitation, these risk factors should be considered in the routine care by care providers in postanesthetic care unit

effects of listening to preferred music on pain intensity after open heart surgery

Pain is a common phenomenon after surgery. Cardiac surgeries are no exception and patients generally experience acute pain after these surgeries. Inadequate pain management after cardiac surgery predisposes patients to many complications. Therefore, the aim of this study was to determine the effects of listening to preferred music on pain intensity after open heart surgery. This study was a randomized clinical trial [RCT] conducted in open heart intensive care unit [ICU] of a university hospital in Sari, Iran. A total of 60 patients who were scheduled to undergo open heart surgery were randomly allocated in two groups. Patients in the intervention group [n = 30] listened to their preferred music by headphones for 30 minutes, whereas those in the control group [n = 30] did not listen to music. Using a Numerical Rating Scale [NRS], pain intensity was measured among the patients before the intervention, and immediately, 30 minutes and one hour after the intervention. Data was analyzed by Chi-square test, student's t-test and repeated measures analysis of variance [ANOVA]. Mean pain intensity in the intervention group before, immediately after, 30 minutes and one hour after the intervention were 5.8, 3.1, 2.5 and 2.4, respectively. Corresponding numbers in the control group were 4.7, 4.7, 4.8 and 4.9, respectively. Repeated measures ANOVA showed music to significantly reduce pain intensity [p = 0.0001]. Music can be effective as a non-pharmacological, inexpensive, non-invasive and side effect free method for pain management after open heart surgery.

[ view of delivery by practitioners in routine episiotomy: a qualitative study]

Many studies have determined desirable outcomes of elective episiotomy. However, the clinical practice is not based on results in many hospitals. For this reason, the present study assessed the view of practitioners regarding routine episiotomy. This qualitative study was done by content analysis. A through semi-structured interview was done with obstetricians, midwives and midwifery trainers. After gathering information, common points of interviews were coded and stratified. Continuous comparison was done to obtain confidence of internal constancy in coding. For validity and reliability, three members of group coded the interviews independently, followed by defining the final theme. Themes were then returned to participants for confidence of their accuracy. Twenty-four participants were assessed. Factors that influence the usage of routine episiotomy included 5 total concepts. Also, some partial concepts appeared as subcategory of total concepts. They were: 1. delivery agent [personal experience, skill, deficit of agents, fatigue and impatience, low knowledge, ability of communication with mother, and agent's role]; 2. Mother [prevention and decline of injuries, anatomical differences, culture, not cooperating and, diseases]; 3. Fetus [prevention and decline of trauma, conditions]; 4. Legal problems [mother's complaints, remonstrance by seniors]. 5. Method of management [non availibity of advanced technology, non usage of new methods for delivery, Mothers not being prepared]. In a prolonged clinical practice, such as routine episiotomy, change is difficult. As studies recommend the limited use of episiotomy, intervention is necessary for changing practitioners' attitude and practice. Training of delivery agents, students and pregnant women are basic