Editorial
Mohammad Ali Baghapour
Review Article
Manavi Handa; Mary Donovan Sharpe
Abstract
Context: This article discusses the paradigm shift in health care and bioethics from the concept of informed consent to informed choice.
Evidence Acquisition: Informed consent is linked to the concept of respect for autonomy-one of the four pillars of bioethics. This concept requires health care givers ...
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Context: This article discusses the paradigm shift in health care and bioethics from the concept of informed consent to informed choice.
Evidence Acquisition: Informed consent is linked to the concept of respect for autonomy-one of the four pillars of bioethics. This concept requires health care givers to share information with patients so they can make appropriate health care decisions. However, the concept of informed consent has been critiqued as being paternalistic and not attentive to the complexities of modern health care decisions.
Results: As a result of a paradigm shift in health care and ethics, favoring autonomy over other principles-informed consent evolved to the more patient-centered concept of informed choice. Even so, feminist bioethicists critique the mainstream model of informed choice as being inattentive to inherent power dynamics within health care and society which may influence decision making. Drawing on the model of midwifery in Canada, this paper outlines an approach to health care that incorporates feminist definitions of informed choice.
Conclusions: This paper reviews the necessary criteria for informed choice to be attentive to the individual needs of women. Using the model of midwifery in Canada as an example, this paper demonstrates how feminist approaches to informed choice should be preferred in modern health care settings.
Research Article
Masoumeh Delaram; Narges Khatoon Dadkhah
Abstract
Background: A large number of women were affected from the Post episiotomy pain and the common method for pain relief is use of oral non-steroidal anti-inflammatory drugs.
Objectives: With considering the adverse effects of these drugs, the aim of present study was to compare the effects of lidocaine ...
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Background: A large number of women were affected from the Post episiotomy pain and the common method for pain relief is use of oral non-steroidal anti-inflammatory drugs.
Objectives: With considering the adverse effects of these drugs, the aim of present study was to compare the effects of lidocaine cream and mefenamic acid capsule on post episiotomy pain.
Patients and Methods: In a clinical trial study, sixty of women with singleton pregnancy and 38-42 weeks of gestation who had episiotomy, were randomized by consecutively numbered sealed envelopes to one of the two study arms that is 2% lidocaine cream (n = 30) or 250 mg mefenamic acid (n = 30). Data collection was performed by questionnaire and visual analogue scale (VAS). The intensity of pain was compared with the first compliant of mother and 6, 12, and 24 hours after the delivery. For data analysis, we used SPSS package, t test and paired t test and P < 0.05 was considered significant.
Results: With the first compliant of women, the mean intensity of pain was 4.92 ± 1.9 in lidocaine group and 4.90 ± 1.5 in mefenamic acid group and the difference was not significant (P = 0.20). Also there was not a significant difference in mean intensity of post episiotomy pain in the two groups in 6 (P = 0.05), 12 (P = 0.36) and 24 (P = 0.98) after childbirth.
Conclusions: The effect of lidocaine cream and mefenamic acid capsule was similar in the relief of post episiotomy pain and the Lidocaine cream is a good alternative for mefenamic acid that is commonly used to reduce of pain after episiotomy especially in women who are breast feeding and oral analgesic drugs are secreted in their milk.
Research Article
Zahra Kochaki Nejad; Alireza Mohajjel Aghdam; Hadi Hassankhani; Mohammad Asghari Jafarabadi; Zohreh Sanaat
Abstract
Background: Self-efficacy refers to an individual’s belief in his or her capacity to execute behaviors necessary to produce specific achievement. Past studies have shown probable increases in self-efficacy with growing age. Iranian women with breast cancer are one decade younger than their western ...
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Background: Self-efficacy refers to an individual’s belief in his or her capacity to execute behaviors necessary to produce specific achievement. Past studies have shown probable increases in self-efficacy with growing age. Iranian women with breast cancer are one decade younger than their western counterparts.
Objectives: The present study aims to investigate the level of cancer-related self-efficacy in Iranian women, and its demographic and medical predictors.
Patients and Methods: This is a descriptive cross-sectional study comprised of 91 breast cancer patients referring for chemotherapy to one of the largest oncology centers in northwest of Iran. The patients’ demographic and medical characteristics were determined and their cancer related self-efficacy was assessed using cancer behavior inventory containing 33 items. Data analysis was completed using SPSS software version 13. Descriptive and Regression analysis were used to describe demographic and medical characteristics of the patients and their predictors of cancer-related self-efficacy.
Results: The sustained cancer-related positive attitude had, in total, the highest mean score of 7 subscales of cancer behavior inventory and the seeking of social support had the least mean score. Only Patient’s education and the time of cancer diagnosis were associated with self-efficacy of Iranian women in relation to cancer.
Conclusions: According to the results obtained, it is necessary to consider the level of education, social support, and the time of cancer diagnosis in order to assess the self-efficacy in Iranian women with breast cancer.
Research Article
Maryam Yazdani; Elnaz Amirshahi; Aria Shakeri; Reza Amirshahi; Leila Malekmakan
Abstract
Background: The increased maternal age is associated with many prenatal and perinatal complications including stillbirth, preterm birth and cesarean delivery.
Objectives: This study was carried out to investigate the prenatal and maternal outcomes among mothers older and younger than 35 in Fars province, ...
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Background: The increased maternal age is associated with many prenatal and perinatal complications including stillbirth, preterm birth and cesarean delivery.
Objectives: This study was carried out to investigate the prenatal and maternal outcomes among mothers older and younger than 35 in Fars province, Iran.
Patients and Methods: This study included 1962 singleton deliveries. The prenatal and neonatal outcomes were recorded retrospectively and compared between mothers aged older and younger than 35 years. A designed questionnaire was used for data collection of parity, gravida (gravidity and parity are two terms that refer to the number of times a female has been pregnant and carried the pregnancies to a viable gestational age), outcomes of the pregnancy, labor, and neonatal outcome. Data were analyzed using SPSS, version 15, and the P < 0.05 was considered significant.
Results: The mean age of 978 mothers < 35 years-old and 984 of those aged ≥ 35 years was 31.6 ± 6.8 years. Mothers aged ≥ 35 years experienced higher risk of preeclampsia (P < 0.001), gestational diabetes mellitus (P < 0.001), placental abruption (P = 0.003), cesarean delivery (P < 0.001), low Apgar at 1 minute (P = 0.001) and low Apgar at 5 minutes (P = 0.001) compared to those aged less than 35 years.
Conclusions: Women should be alerted by the higher risks for prenatal and maternal morbidity associated with delayed pregnancy. Health care providers should be aware of the impact of delayed childbearing on the health care resources.
Research Article
Fatemeh Jafarzadeh; Mahmood Golzari; Farhad Jomehri; Seyedeh Leyla Poursamar; Kimia Sahraian
Abstract
Background: Nowadays infertility issue has become a social concern and is associated with numerous social and psychological problems. Infertility can influence interpersonal, marital and social relationships.
Objectives: The aim of this study was to determine the type of coping strategies regarding ...
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Background: Nowadays infertility issue has become a social concern and is associated with numerous social and psychological problems. Infertility can influence interpersonal, marital and social relationships.
Objectives: The aim of this study was to determine the type of coping strategies regarding stress and the level of marital satisfaction in infertile women associated with their infertility factors and to obtain the relationship between these two variables.
Materials and Methods: The sample group included 50 women with female infertility factor and 50 women with male infertility factor. The participants contacted upon their treatment course with Assisted Reproductive Technology (ART) in Mehr infertility clinic, Tehran, Iran. Enrich marital satisfaction questionnaire and standard scale for measuring coping strategies were used during this study.
Results: Data analysis showed that coping strategies and marital satisfaction were different in the two groups of participants based on their infertility factors. The women with female infertility factor used more "emotion- focused" and "less useful coping strategies" than the women with male infertility factor (P < 0.001). The women with male infertility factor had significantly more marital satisfaction than their infertile counterparts (P = 0.019).
Conclusions: The results provided useful evidence about the types of coping strategies in infertile women. Also considering infertility factor, a significant relationship was found between the type of coping strategies and marital satisfaction in infertile couples.
Brief Report
Azar Shamsi; Azam Baheiraei; Shahnaz Khaghani; Afshin Mohsenifar; Anoshirvan Kazemnejad
Abstract
Background: The number of cigarette smokers in people of all ages and the resulting second hand smokers are increasing worldwide. Smoking at home, work or in public places puts others at risk of exposure to second hand smoke.
Objectives: To study the effects of second-hand smoking on breast milk proteins.
Patients ...
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Background: The number of cigarette smokers in people of all ages and the resulting second hand smokers are increasing worldwide. Smoking at home, work or in public places puts others at risk of exposure to second hand smoke.
Objectives: To study the effects of second-hand smoking on breast milk proteins.
Patients and Methods: This cohort study was conducted on 45 mothers exposed to second-hand smoke (cases) and 45 non-exposed post-partum mothers (controls) who attended health care centers. Milk samples were collected twice, (5-7 days and 4 months after delivery). Exposure was assessed through questionnaires which measured total levels of milk protein and albumin, and milk cotinine, a major metabolite of nicotine.
Results: Cotinine levels in the breast milk of mothers in the exposed group were significantly higher than non-exposed group at baseline and 4 months after delivery (P = 0.001). Milk protein profiles in the non-exposed group were significantly higher 5-7 days after delivery in the non-exposed group, but the albumin profile was not significantly different at 4 months post-partum (P = 0.004).
Conclusions: Second-hand smoke affects the levels of breast milk proteins that are essential for infant growth.
