The Effect of Virtual Education in Parenting Skills on the Parenting Sense of Competence in First-time Mothers with a 0-2-year-old Baby: A Quasi-experimental Study.

Background: Parental competence is a key aspect of parenting. Since they have no previous experience of having a baby, first-time mothers should acquire certain skills to be competent enough in caring for their baby. The present study aimed to investigate the effect of virtual education in parenting skills on the parenting competence of first-time mothers with a 0-2-year-old baby. Methods: This quasi-experimental study was conducted through convenience sampling; 72 first-time mothers were selected from 12 healthcare centers, 62 of whom met the criteria for entering the study, and divided into an experimental (n=31) and a control (n=31) group. The mothers in the experimental group received virtual education in parenting skills in six sessions, each lasting 10 minutes for two weeks. The data were collected using a demographics questionnaire and Gibaud-Wallston's parenting sense of competence scale. Sense of competence was assessed in three stages: before, immediately after, and one month after the completion of the intervention. The collected data were analyzed using SPSS v. 22 at a significance level of less than 0.05. Results: Results showed a statistically significant increase in the experimental group's parenting competence mean score immediately and one month after the intervention (P<0.001). There was a statistically significant difference between the mean scores of the study groups as measured immediately after (P=0.043) and one month after the intervention (P<0.001). Conclusion: Virtual education of parenting skills could have a positive impact on the mothers' parenting competence. It is suggested that first-time mothers should be educated in parenting skills on a face-to-face basis in maternity wards and online after discharge.

The effect of the communication skills training on the sensitivity and cultural competence of the nurses in the pediatric wards: A quasi-experimental study.

BACKGROUND: This study aimed to investigate the effect of the communicative training skills on the sensitivity and cultural competence of the nurses in the pediatric wards. MATERIALS AND METHODS: The participants included 54 nurses from the pediatric ward of Namazi Hospital affiliated with REDACTED. The sample members entered the study through voluntary registration in the in-service training system. RESULTS: The results showed that cultural sensitivity score was 44.22±11.78 before the intervention, 48.51±13.34 immediately after the intervention, and 55.55±20.20 one month after the intervention. Cultural sensitivity score significantly increased immediately and one month after communication skills training for nurses compared to before the intervention (P < 0.001). The results also showed that cultural competency score was 51.68±9.43 before the intervention and increased significantly immediately after the communication skills training and one month after the intervention (57.64±10.43 and 62.56±11.53, respectively), showing significant improvement (P < 0.001). CONCLUSION: The communication skills training promoted the nurses' cultural sensitivity and competence in childcare wards. Therefore, the implementation of the theoretical and practical methods of teaching communication skills is suggested to improve nurses' cultural competence and consequently, improve childcare quality in different cultures.

The effect of a virtual child disease management programme on burden and social adjustment of caregivers of children with coagulation factor deficiencies.

INTRODUCTION: The use of virtual interventions is of interest to patients with chronic disease and healthcare professionals. This study aimed to determine the effect of virtual child disease management programme on burden and social adjustment of caregivers of children with coagulation factor deficiencies. Moreover, the effect of this intervention on children's acute pain and bleeds was assessed. METHODS: This clinical trial was conducted on 80 caregivers of children with coagulation factor deficiencies. The subjects were randomly assigned into the intervention and control groups. A comprehensive virtual child disease management programme was conducted for 8 weeks and caregiver' burden and their social adjustment were assessed with the HEMOCAB and social adjustment subscale of Bell Adjustment Inventory, respectively. Data were analysed using ANCOVA and Wilcoxon test. RESULTS: Before the intervention, both groups were similar regarding the caregivers' burden and social adjustment and children's acute pain and bleeds. However, a significant difference was observed between groups in concern to caregivers' burden (P < .001), women's and men's social adjustment (P = .001, P = .03), and children's acute pain and bleeds (P < .001) after the virtual disease management programme. CONCLUSION: This study showed that using a virtual child disease management programme reduced burden and improved social adjustment of caregivers of children with coagulation factor deficiencies. This intervention decreased frequencies of acute pain and bleeds in children. Therefore, using this effective intervention in clinical practice is warranted to decrease the caregivers' burden as well as acute pain and bleeds in children.

The Effects of Virtual Directed Painting Therapy on Anxiety, Depression, and Self-efficacy of Children with Type 1 Diabetes: A Randomized Controlled Clinical Trial.

Background: Diabetes-induced anxiety, depression, and decreased self-efficacy lead to poor adherence to treatment in diabetic children. Since painting therapy seems to be helpful to express their feelings, this study aimed to investigate the effects of virtual directed painting therapy on anxiety, depression, and self-efficacy in diabetic children. Methods: This randomized controlled trial was conducted on 40 children with type 1 diabetes aged 8-12 years who were referred to Imam Reza Clinic of Diabetes in Shiraz, from July to October 2020. Children were randomly selected and assigned to intervention and control groups, using block randomization. The intervention group received the routine care plus virtual painting therapy directed by WhatsApp (six 2-hour group sessions once a week for six weeks). Spence Children's Anxiety Scale, Maria Kovacs Children's Depression Inventory, and Diabetes Management Self-Efficacy Scale were completed before and after the intervention. Data were analyzed through SPSS 23, using Chi-square, Mann-Whitney U, and Wilcoxon tests. P value <0.05 was considered as significant. Results: After the intervention, the median (interquartile range) total scores for anxiety, depression, and self-efficacy in the intervention group were 48.50 (45.00-51.75), 7.00 (4.00-9.00), and 169.00 (154.00-178.00), and in the control group 55.00 (48.50-62.25), 13.00 (10.00-17.50), and 152.00, respectively (110.50-184.00). After the intervention, there was a significant difference between the groups regarding anxiety (P=0.02) and depression (P<0.001); however, the difference in self-efficacy was not significant (P=0.20). Conclusion: Painting therapy should be considered as a part of care programs in diabetes centers and other community settings to control anxiety and depression of diabetic children. Trial Registration Number: IRCT20200118046181N1.

The Effect of Peer Education on Self-Care Behaviors and the Mean of Glycosylated Hemoglobin in Adolescents with Type 1 Diabetes: A Randomized Controlled Clinical Trial.

BACKGROUND: Diabetes control in adolescents is a difficult and tedious process. Diabetic teens need training to control it and prevent its complications. This study aimed to investigate the effect of peer education on self-care behaviors and glycosylated hemoglobin among adolescents with type 1 diabetes. METHODS: This controlled clinical trial was conducted in Iran from July 2018 to June 2019. 84 teenagers with type 1 diabetes were selected using a simple random sampling and randomly divided into control and intervention groups using block randomization. The intervention group received 4 sessions of training by peers on self care behaviors in diabetes. The control group received the routine training. The self-care questionnaire was filled out, and glycosylated hemoglobin was measured before and three months after the intervention. Data were analyzed using SPSS version 23.0. The significance level was set at P<0.0. RESULTS: Three months after the intervention, the intervention group reported significantly higher levels of score of self-care behaviors (P<0.001) and lower levels of mean glycosylated hemoglobin (P<0.001), as compared with the control. Also, the mean self-care score was not significantly different in the control group before and three months after the intervention (P>0.05). Besides, the mean glycosylated hemoglobin significantly increased three months after the intervention in the controls (P<0.001). CONCLUSION: The implementation of peer education can improve the self-care behaviors and glycosylated hemoglobin in adolescents. Hence, regarding its low cost and high safety, it is suggested that this approach should be established in the control of other chronic diseases in order to strengthen the self-care behaviors in adolescents.Trial Registration Number: IRCT20180904040944N1.

The Effect of Coping Skills Training on Depression, Anxiety, Stress, and Self-Efficacy in Adolescents with Diabetes: A Randomized Controlled Trial.

BACKGROUND: Diabetes patients are at risk of psychosocial problems. Some interventions might decrease these problems. This study aimed to evaluate the effect of coping skills training on depression, anxiety, stress, and self-efficacy of adolescents with type I diabetes. METHODS: This randomized controlled trial with pre- and post-test design was performed in the diabetes clinic in Shiraz from June to November 2015. This study was conducted on 100 adolescents with type 1 diabetes who were randomly divided into an intervention (receiving coping skills training in groups for eight sessions) and a control group (usual care). Depression, Anxiety, and Stress Scales (42-items, scores=0-42) and General Self-Efficacy questionnaire (17-items, scores=17-85) were used. The variables were measured at baseline and two months after starting the intervention. Data were analyzed using SPSS, version 16 through Chi-square test, independent t-test, and paired t-test. P<0.05 was significant. RESULTS: After the intervention, the mean scores of depression, anxiety and stress in the intervention group were 5.41±4.58, 6.44±7.01, and 7.46±7.01, and in the control groups they were 19.73±11.80, 18.28±10.51, 21.10±10.94, respectively. Moreover, after the intervention, the mean scores of self-efficacy were 70.82±10.84, and 50.13±15.42 in the intervention and control groups, respectively. The results showed differences between the two groups regarding depression, anxiety, stress, and self-efficacy after starting the intervention (P<0.001). CONCLUSION: As coping skills training reduced depression, anxiety, and stress and improved the patients' self-efficacy, the use of this intervention could be a part of community-based nursing practice for adolescents with diabetes and more research for improving evidence-based practice in this regard are warranted. - Trial Registration Number: IRCT201505011369N4.

Psychological Predictors of Resilience in Parents of Insulin-Dependent Children and Adolescents.

BACKGROUND: Parents of insulin-dependent children and adolescents need resilience to continue their lives. The aim of this study was to determine the psychological predictors of resilience in parents of insulin-dependent children and adolescents. METHODS: This was a descriptive correlational study performed in 2016. One hundred and thirteen parents of children and adolescents with diabetes who referred to a diabetes clinic in Shiraz participated in this study. Convenience sampling was used. Depression Anxiety Stress Scales (DASS-21) and Connor-Davidson Resilience Scale (CD-RISC) (25 items) were also used. The data were analyzed by SPSS software version 20 using t-test, ANOVA, Pearson correlation coefficients, and linear regression analysis. P<0.05 was considered as significant. RESULTS: The findings showed that the mean±SD score of resilience was 65.33±23.81 in parents of children and adolescents with diabetes. Indeed, 45.1% of the parents had mild to extremely severe levels of stress. Besides, 58.4% and 71.4% of them reported mild to extremely severe depression and anxiety, respectively. The lowest mean±SD scores of resilience were reported in parents with extremely severe levels of depression (37.57±16.26), anxiety (44.89±23.53), and stress (37.84±17.90). Moreover, 49% of changes in resilience was explained by such factors as stress, anxiety, depression, and life and health satisfaction. Among these variables, the association between resilience and depression (t=-6.97, P<0.001) and life satisfaction (t=-3.18, P=0.002) were statistically significant. CONCLUSION: Since nearly half of the parents experienced stress, depression, and anxiety, and there was an association between resilience and these psychological variables, parents' psychological problems, especially depression, might be reduced by improving their resilience.

Reinforcement Behavior Therapy by Kindergarten Teachers on Preschool Children's Aggression: A Randomized Controlled Trial.

BACKGROUND: Aggression is a kind of behavior that causes damage or harm to others. The prevalence of aggression is 8-20% in 3-6 years old children. The present study aimed to assess the effect of training kindergarten teachers regarding reinforcement behavior therapy on preschoolers' aggression. METHODS: In this cluster randomized control trial, 14 out of 35 kindergarten and preschool centers of Mohr city, Iran, were chosen using random cluster sampling and then randomly assigned to an intervention and a control group. All 370 kindergarten and preschool children in 14 kindergarten were assessed by preschoolers' aggression questionnaire and 60 children who obtained a minimum aggression score of 117.48 for girls and 125.77 for boys were randomly selected. The teachers in the intervention group participated in 4 educational sessions on behavior therapy and then practiced this technique under the supervision of the researcher for two months. Preschoolers' aggression questionnaire was computed in both intervention and control groups before and after a two-month period. RESULTS: The results demonstrated a significant statistical difference in the total aggression score (P=0.01), verbal (P=0.02) and physical (P=0.01) aggression subscales scores in the intervention group in comparison to the control group after the intervention. But the scores of relational aggression (P=0.09) and impulsive anger (P=0.08) subscales were not statistically different in the intervention group compared to the controls. CONCLUSION: This study highlighted the importance of teaching reinforcement behavior therapy by kindergarten teachers in decreasing verbal and physical aggression in preschoolers. TRIAL REGISTRATION NUMBER: IRCT2014042617436N1.

Effect of home visit training program on growth and development of preterm infants: a double blind randomized controlled trial.

BACKGROUND: Home visit program can be effective in infants' growth and development. The present study aimed to investigate the effect of home visit program on preterm infants' growth and development within 6 months. METHODS: It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital's routine care. Then, the infants' growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. RESULTS: The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants' mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting,  producing "Agha" sound, and taking objects by hand (P<0.05) during six months of age. CONCLUSION: The results showed that the home visit program was effective in preterm infants' weight gain and some development indexes at the sixth month. Considering the importance of infants' growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants' health. TRIAL REGISTRATION NUMBER: IRCT2014082013690N3 

The effect of educational program on the quality of life and self-efficacy of the mothers of the infants with congenital heart disease: a randomized controlled trial.

BACKGROUND: Congenital heart disease causes large expenditures as well as mental pressures for the parents and, consequently, endangers the mothers' quality of life and self efficacy. Thus, the present study aimed to determine the effect of educational program on the quality of life and self efficacy of the mothers of the infants with congenital heart disease. METHODS: The present randomized controlled trial was conducted on 56 mothers who had children with congenital heart disease (28 in the control and 28 in the intervention group) in Imam Reza Clinic, Shiraz, Iran in 2012. The mothers' quality of life and self-efficacy were assessed using SF-36 and Sherer's general self efficacy questionnaires before, immediately and 2 months after the training. The training was performed through four 90-minute sessions in 4 weeks. The data were analyzed using the SPSS statistical software and independent t-test, chi-square, and repeated measure analysis of variance. RESULTS: A significant differences was observed between the intervention and control groups regarding the mean of quality of life across the three study periods (F=59.91, P<0.0001). A significant difference was also found between the two groups concerning the mean of self efficacy at these times (F=114.11, P<0.0001). CONCLUSION: According to the results, providing appropriate training for the mothers of the infants with congenital heart disease increased their quality of life as well as self-efficacy. Trial Registration Number : IRCT2012080410489N1.

Comparing the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants: a randomized clinical trial.

INTRODUCTION: Maintaining body temperature and reducing stress are important challenges in bathing preterm infants. Swaddle bathing, which includes in itself the principles of developmental care, can be used as a low-stress and appropriate bathing method for premature infants. Given the limitations of the researches carried out on this bathing method, the present study was conducted with the aim of comparing the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants. METHODS: In this randomized clinical trial study, 50 premature infants hospitalized in Neonatal Intensive Care Unit (NICU) who were eligible for the study were divided by random allocation into two experimental and control groups. The infants in the experimental group were bathed using the swaddle bathing method and the infants in the control group were bathed using the conventional bathing method. Body temperature was measured 10 minutes before and 10 minutes after the bath. To record the crying, the infants' faces were filmed during the bath. The data were analyzed using chi-squared test, independent t-test, paired t-test and Mann-Whitney U test. RESULTS: The mean temperature loss was significantly less in the swaddle-bathed newborns compared to the conventionally-bathed newborns. Furthermore, crying time was significantly less in the experimental group than in the control group. CONCLUSION: Given the positive effect of swaddled bathing in maintaining body temperature and reducing stress, it can be used as an appropriate bathing method in NICU.

Healing effect of sea buckthorn, olive oil, and their mixture on full-thickness burn wounds.

OBJECTIVE: The purpose of this study is to evaluate the healing effect of silver sulfadiazine (SSD), sea buckthorn, olive oil, and 5% sea buckthorn and olive oil mixture on full-thickness burn wounds with respect to both gross and histopathologic features. METHODS: Full-thickness burns were induced on 60 rats; the rats were then were divided into 5 groups and treated with sea buckthorn, olive oil, a 5% sea buckthorn/olive oil mixture, SSD, and normal saline (control). They were observed for 28 days, and the wounds' healing process was evaluated. RESULTS: Wound contraction occurred faster in sea buckthorn, olive oil, and the sea buckthorn/olive oil mixture groups compared with the SSD and control groups. The volume of the exudates was controlled more effectively in wounds treated with the sea buckthorn/olive oil mixture. Purulent exudates were observed in the control group, but the others did not show infection. The group treated with sea buckthorn/olive oil mixture revealed more developed re-epithelialization with continuous basement membrane with a mature granulation tissue, whereas the SSD-treated group showed ulceration, necrosis, and immature granulation. The results show that sea buckthorn and olive oil individually are proper dressing for burn wounds and that they also show a synergetic effect when they are used together. CONCLUSION: A sea buckthorn and olive oil mixture could be considered as an alternative dressing for full-thickness burns because of improved wound healing characteristics and antibacterial property.

Olfactory stimulation by vanillin prevents apnea in premature newborn infants.

OBJECTIVE: Apnea is one of the most common problems in premature newborns. The present study aimed to determine the effect of olfactory stimulation by vanillin on prevention of apnea in premature newborns. METHODS: In this randomized controlled trial, 36 premature newborns with the postnatal age of 2 days and weight under 2500 grams referred to the hospitals affiliated to Shiraz University of Medical Sciences, were selected through simple random sampling and allocated into control and experimental groups. The experimental group received olfactory stimulation by saturated vanillin solution, while the control group received no interventions. The newborns of both groups were continuously monitored for presence/absence of apnea and number of episodes of apnea as well as arterial blood oxygen saturation and heart rate for 5 days. The data were analyzed by independent Student t-test and repeat measure ANCOVA. FINDINGS: The presence of apnea revealed to be significantly different between the two groups in the first, second, and fourth day of the study (P<0.05). The number of episodes of apnea during five days was also significantly different between the study groups (t=8.32, P<0.05). Using olfactory stimulation by vanillin caused a 3.1-fold decrease in apnea and the effect size was 0.72. Moreover, the two groups were significantly different regarding the arterial blood oxygen and heart rate during the study period (P<0.05). CONCLUSION: This study indicated the beneficial effect of saturated vanillin solution on apnea; therefore, it may be used for prevention and treatment of apnea in premature infants. Further studies are needed to improve evidence-based practice in this regard.