Comparison of effects of home visits and routine postpartum care on the healthy behaviors of Iranian low-risk mothers

Postpartum care at home is a post delivery care method that can be provided by public health nurses, trained health workers, or midwifery nurses. A study conducted to compare effect of two midwife visits at home to usual postpartum care on the healthy behaviors of low-risk Iranian mothers. A randomized controlled trial conducted on 200 mothers at a reference center for screening for infant hypothyroidism in Tehran. Mothers were randomized to either home-based [n =100] or routine-based postpartum care [n= 100]. Each mother and her neonate received two cares. Home-based cares were provided by a midwife in the intervention group. Postpartum cares in the control group were provided by care providers of primary health care system. Healthy behavior was measured using a validated and reliable researcher made instrument. The data were analyzed using independent sample t-tests, paired t-test, and chi[2]-test. The data showed that a significant number of subjects in the control group did not receive their postpartum care [P< 0.001]. The mean score of maternal healthy behaviors in the intervention group increased from 120.5 [SE= 0.76] to 148.9 [SE= 1.02] [P< 0.001] and in the control group from 119.9 [SE= 1.06] to 140.9 [SE= 1.08][P< 0.001]. The mean score of maternal healthy behaviors in the intervention group had significant differences with that in the control group at the end of study [P< 0.001]. Early postpartum care at home by trained midwives can be positively effective for improving maternal healthy behaviors in less developed countries

effects of the counseling on life style of menopausal women and their husbands

By increasing the life expectancy, women experience longer menopause and more complications during this period of life. Men may also experience menopause. Improvement and treating the complications is based on the correcting the life style. The purpose of this study was to evaluate the effect of a counseling procedure on the life style of menopausal women and their husbands.This was an interventional study. 120 couples of menopausal women and their husbands were selected from Mohammadiyeh medical health center in Hamadan participated in the study. The participants were randomly divided to control and interventional groups. Initially, life style information was collected by a questionnaire through interview. Counseling about nutritional habits and physical exercise was performed for one hour in participants' houses. After two months there was first post test. Another counseling session and post test was performed similar to first one. Data was analyzed by Me Nemar, Paired T test, Wilcoxon, Independent T test and Chi- square tests, using SPSS 13. Results showed a significant difference in items such as food habits and physical activities of life style, before and after of first and secondary counseling process in women and men in intervention groups [P<0.05]. Counseling has significant effects on nutritional habits and physical activities of the menopausal women and their husbands. Counseling with couples particularly in their houses, is an effective intervention for improving of participants' life style

[Effect of home postpartum care on quality of life of low risk mothers]

Home care visits have unique advantages in many social problems and health complications such as psychologic complications and adverse birth outcomes. The aim of this study was to identify the effect of postpartum care at home on quality of life among low risk mothers. This interventional study was conducted in Akbarabad health center of Tehran University of Medical Sciences in 2010. A total of 200 mothers were randomly allocated in two intervention and control groups. Mothers in the control group received two post partum visits in health care center and the intervention group received care at home. Data were collected through a questionnaire including demographic characteristics and the mothers' quality of life items; along with a growth and development monitoring chart for newborns. For analyzing data, Mann-Withney U, Wilcoxon and Chi-square tests were used. Most of the mothers aged 20-29 years old. The number of visits were statistically different between the two groups [P=0.00, P=0.01]. Dimensions of quality of life in the two groups were not statistically different: [Physical dimension: P=0.052], [Emotional dimension: P=0.775], [Public health dimension: P=0.068], [Social performance dimension: P=0.780] and [Total score: P=0.213]. the results of our study did not show no positive improvements in home postpartum care in comparison with the health care centers care. More studies are recommended

[Prenatal care utilization rate and patients satisfaction]

Studies show, clients' satisfaction is an important indicator for service quality assessment. Finding causes of dissatisfaction helps to promote health care services quality. High quality prenatal care services and clients' satisfaction decreases maternal and neonatal mortality and morbidity. The perceived quality of the prenatal care by the mothers can not be effectively evaluated unless considering the opinions, demands and satisfaction rate of mothers who receive the care. The objective of this study is to measure prenatal care utilization rate and patients satisfaction in the clinics of Tehran University of Medical Sciences in 2005. In this cross-sectional study, 380 pregnant women who had received prenatal care services in two hospitals and eight health centers were selected randomly and interviewed. Data were gathered using a questionnaire including demographic characteristics and satisfaction questions. Data were analyzed using SPSS and tested with chi-square and Pearson exact test. According to the results, 53.4% and 14.8% of the pregnant women had received complete and incomplete prenatal care, respectively. Most of the pregnant women [54.7%] were completely satisfied, 23.7% and 21.6% were moderately and poorly satisfied, respectively. There was a significant relationship between the utilization rate and satisfaction of mothers [P<0.001]. 53.4% of mothers in health centers and 46% in hospitals had received complete prenatal care. Satisfaction with prenatal care in health centers and hospitals were 57.5% and 47%, respectively. This difference was probably related to the amount of emotional and physical care received by the patients in the different settings and the characteristics of the centers in which these services are provided. The kind of setting had significant relationship with the utilization and satisfaction rates [P=0.003, P=0.005, respectively]. The results showed that the utilization and satisfaction rates in the health centers in which health-care providers were midwives were better than the hospitals in which health-care providers were medical and midwifery students. But in both settings it was lower than 60%. As a result, the utilization rate and satisfaction of mothers were inadequate in health centers and hospitals [lower than 70%]. In the hospitals, they were lower than the health centers. The standardization of prenatal care and improvement of educational programs in hospitals should be considered

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

[Job satisfaction of midwives]

Job satisfaction of midwives, as key members of healthcare system, has special importance in the quality of midwifery care to the vulnerable groups of the society i.e. mothers and children. This is a survey and cross sectional study. Sampling size was 251 midwives, which were chosen through cluster sampling. Data were gathered by questionnaire in one stage and were analyzed by SPSS software, using descriptive and analytic [[2], Pearson correlation] statistical methods. Results: of this research demonstrated that satisfaction level of midwives in two aspects of job position [62.9%] and relationship with colleagues [48.2%] was moderate. It was low in the aspects of salary and benefits [92.8%], job security [69.7%], managerial policies and work condition [64.9%], supervisory [48.6%] and relationship with personal life [49.8%]. There was a significant relationship and correlation between job satisfaction and all of its aspects, strongest with the aspect of managerial policies [r=0.87] and weakest with the relationship with colleagues [r=0.547]. There was no significant relationship between job satisfaction and demographic characteristics such as age, academic degree, marital status, the number of children and monthly salary but there was a significant relationship between job satisfaction and the condition of house ownership, the years of job experience, the condition of employment, the place of work, work shift and whether they liked midwifery when they chose it [p<0.05]. Half of midwives [49.4%] had moderate job satisfaction, 49% had low and only 1.6% had high job satisfaction. Considering the results of this research, it can be concluded that the authorities must take efficient measures to omit the most important causes of low job satisfaction through increasing salaries and benefits, promoting job security, improving work condition, reformation of managerial and supervisory systems and using midwives' professional ability in areas of their skills