The effect of in-home supportive counseling on maternal functioning and self-efficacy following cesarean section among primiparous women.

BACKGROUND: Women require follow-up care and ongoing counseling after childbirth. The present study aimed to evaluate the effect of in-home supportive counseling on the maternal functioning and self-efficacy after CS among primiparous women. MATERIALS AND METHODS: This randomized controlled clinical trial was performed on 60 primiparous women aged 18-35 years following CS in Ardabil, Iran from April to November 2021. After convenience sampling, participants were randomly assigned into the intervention and control groups with a ratio of 1:1 by block randomization using Random Allocation Software with block sizes of 4 and 6. The intervention group received in-home supportive counseling during three sessions on days 3, 7, and one month after birth. The control group received only routine postpartum care. The data were collected using the demographic and obstetric characteristics, maternal self-efficacy questionnaire, and Barkin index of maternal functioning, completed by both groups 10-15 days, two, and four months after birth. Independent t-test and RMANOVA were used to analyze the data. RESULTS: The mean score of maternal functioning in the intervention group was significantly higher than that of the control group 10-15 days, 2 and 4 months after birth (AMD: 28.51, 95% CI: 24.91 to 32.10, P < 0.001). There was no significant difference in the mean (SD) score of maternal self-efficacy between the two groups 10-15 days after birth. However, this difference was statistically significant 2 and 4 months after birth and after adjusting the time effect (AMD: 10.56, 95% CI: 9.46 to 11.67, P < 0.001). CONCLUSION: In-home supportive counseling can be effective in improving maternal functioning and maternal self-efficacy after CS. Acquiring functional skills increases mothers' self-confidence and self-efficacy in caring for the newborn.

The Effect of Decision Aid on Satisfaction With Decision and Anxiety Among Women With Abnormal Cervical Screening Results.

BACKGROUND: Most women in the face of stressful situations such as risk of a cancer diagnosis (abnormal Papanicolaou smear results) need guidance to choose the appropriate method to follow the diagnosis process, but few studies have identified appropriate interventions to support these women. OBJECTIVE: To determine the effect of decision aid on anxiety and satisfaction with decisions (SWD) regarding the type of follow-up method after receiving an abnormal Papanicolaou smear result. METHODS: This interventional study was conducted on women referred to the oncology clinic in Tabriz, Iran. Women were assigned to the intervention (n = 27) and control groups (n = 27) in a ratio of 1:1 using blocked randomization. The intervention group received a decision aid booklet. Participants in both groups completed questionnaires assessing demographic and obstetric characteristics, anxiety, SWD, and shared decision-making before and after the intervention. RESULTS: The mean score for SWD in the intervention group was significantly higher than that in the control group after the intervention (median, 6.43 with 95% confidence interval of 3.11-7.76; P = .03). There was no significant difference between groups in the mean score of anxiety after intervention (median, 1.14; 95% confidence interval, -0.5 to 2.70; P = .19). CONCLUSION: A decision aid can increase SWD among women with abnormal results in their cervical cancer screening. IMPLICATIONS FOR PRACTICE: It is recommended that healthcare providers use decision aid tools to support and guide patients.

The effect of cognitive-behavioral therapy and sexual health education on sexual assertiveness of newly married women.

BACKGROUND: The present study aimed at investigating the effect of sexual health education and cognitive-behavioral therapy (CBT) on sexual assertiveness (primary outcome) and sexual satisfaction (secondary outcome) of newly married women. METHOD: This RCT was conducted on 66 newly married women with cases in pre-marriage counseling centers in Tabriz, Iran. Participants were assigned into three groups using block randomization. Eight group sessions of CBT were held for one of the intervention groups (n = 22) and 5-7 sessions of sexual health education for other intervention group (n = 22). The control group (n = 22) received neither education nor counseling during the research. The data were collected using the demographic and obstetric characteristics, Hulbert sexual assertiveness index, and Larson sexual satisfaction questionnaires, and analyzed using ANOVA and ANCOVA tests. RESULTS: The mean (standard deviation: SD) score of the sexual assertiveness and sexual satisfaction in the CBT group enhanced from 48.77 (13.94) and 73.13 (13.53) before the intervention to 69.37 (7.28) and 86.57 (7.5) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the sexual health education group increased from 48.9(11.39) and 74.95 (8.30) before the intervention to 66. 94 (7.42) and 84.93 (6.34) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the control group changed from 45.04 (15.87) and 69.04 (10.75) before the intervention to 42.74 (14.11) and 66.44 (10.11) after the intervention, respectively. Eight weeks after the intervention, the mean scores of sexual assertiveness and sexual satisfaction in two intervention groups were more than that in the control group (P < 0.001), However, there was no significant difference between the two intervention groups (P > 0.05). CONCLUSION: The results of this research indicated that CBT and sexual health education are effective in improving women's sexual assertiveness and sexual satisfaction. Considering that sexual health education, does not require complex counseling skills compared to CBT, it can be used as a preferred intervention in promoting sexual assertiveness and satisfaction of newly married women. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT20170506033834N8. Date of registration: 11.09.2021. URL: http://en.irct.ir .

The effect of a childbirth preparation program including posture correction and stretching movements on lordosis and lumbar pain.

AIM: The study aimed at evaluating the effect of posture correction and stretching movements on lordosis and lumbar pain in pregnant women. BACKGROUND: An increased lumbar lordosis during pregnancy is considered one of the most common causes of lumbar pain. METHODS: This quasi-experimental study was performed on 66 pregnant women referred to health centers in Tabriz, Iran, from November 2020 to June 2021. The participants were randomly assigned to the intervention and control groups. The intervention group received training of posture correction movements and stretching exercises during pregnancy from 16 to 18 to 35-37 weeks of pregnancy in six sessions for 45-60 min. The data were collected using a flexible ruler and a visual analog scale. Independent t-tests, repeated measures ANOVA, and ANCOVA tests were used. RESULTS: The mean (standard deviation: SD) of lumbar lordosis increased from 45.12 (2.07) to 54.97 (2.20) in the intervention group at 35-37 weeks and changed from 44.28 (2.03) to 55.54 (3.39) in the control group at 35-37 weeks (adjusted mean difference: -1.24, 95% confidence interval: -2.48 to -0.005, P = 0.04). The mean (SD) of lumbar pain at 28-30 weeks was 2.80 (1.72) in the intervention group and 3.74 (2.23) in the control group (P = 0.09). However, the mean (SD) of lumbar pain at 35-37 weeks in the intervention group 4.38 (2.45) was significantly lower than that in the control group 5.83 (2.96) (P = 0.04). CONCLUSION: This study provides evidence for the potential health benefits of training posture correction and stretching movements on controlling lumbar lordosis and reducing lumbar pain during pregnancy.

Effect of cup, syringe, and finger feeding on time of oral feeding of preterm neonate's: a randomized controlled clinical trial.

BACKGROUND: The oral nutrition is big challenge for preterm neonates. Since the best oral feeding method for preterm neonates is not yet known, the present study aimed to evaluate the effect of cup, syringe, and finger feeding methods on reaching the time of full oral feeding and weight gain among preterm neonates. METHOD: This randomized clinical trial study was conducted on 99 preterm neonate's, born at 30-34 weeks gestation, admitted to the neonatal intensive care unit (NICU) of Al-Zahra and Taleghani Therapeutic-Educational Centers in Tabriz, Iran. Subjects were assigned into finger feeding (n = 33), cup feeding (n = 33), and syringe feeding (n = 33) groups in the allocation ratio of 1:1:1 using block randomization with a block size 6 and 9. They were studied in terms of reaching the time of full oral feeding and weight gain. The data were analyzed using SPSS/version21 software, and ANOVA, chi-square, and ANCOVA tests. RESULTS: There was no significant difference in the mean score of reaching the time of full oral feeding among cup, finger, and syringe feeding groups (p = 0.652). The mean score of daily weight gain, oxygen saturation (SaO2), and heart rate after feeding was not significantly different among the three groups (p > 0.05). The effect of confounding variables, including birth weight and age, arterial oxygen saturation, and heart rate before feeding, was controlled. CONCLUSION: Based on the results, one of the cup, finger, and syringe feeding methods can be applied in the NICU, considering the staff's proficiency in feeding neonates. Trial registration IRCT20150424021917N11.

Implementation and effectiveness of continuous kangaroo mother care: a participatory action research protocol.

BACKGROUND: The efficacy of continuous kangaroo mother care (C-KMC) in reducing neonatal mortality and morbidity among low birthweight and premature infants has been confirmed. Despite the recommendations of the World Health Organization, UNICEF, and the Ministry of Health of Iran to use C-KMC for eligible hospitalized neonates, this type of care is not performed due to implementation problems. This protocol aims to describe the design, implementation, and assessment of C-KMC in one tertiary hospital by means of participatory action research. METHODS: The objective of this study is to design and implement a C-KMC program for neonates that will be performed in two phases using a stages-of-change model. The first phase will be conducted in three consecutive activities of designing, implementing, and assessing the introduction of C-KMC. The second phase of the study has a before-and-after design to assess the effectiveness of C-KMC by comparing the length of preterm neonates' stay in hospital and exclusive breastfeeding at discharge before and after implementing C-KMC. DISCUSSION: KMC is an important component of neonatal developmental care as part of family-centered care. Applying this type of care requires creating appropriate strategies, budget allocation, and clear and coordinated planning at different levels of the health system. The stages-of-change model is one of the appropriate approaches to the implementation of C-KMC.