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Educating healthy lifestyle behaviors through game can help children and adolescents achieve healthy habits. The aim of the present study was to develop a game to promote children's and adolescents' lifestyle behaviors. The 'Toward Health' is a board game designed by a multidisciplinary team consisting of nurses, nutritionists, physical activity experts, pediatricians, pediatric psychologists, graphic artists, and experts in designing board games to help children adopt healthy eating and sleep habits and become physically more active. Players move their tokens based on the number of squares indicated by a dice rolled. If a player's token lands on the square containing questions or points related to a healthy lifestyle, he/she must answer the question or read the point loudly. If answers to the questions are correct, the player takes the card. Interventional studies are recommended to confirm the potential of these games in preventing and/or treating childhood obesity. In the future, we are going to assess the validity and acceptance of the game in various age groups., Author(s): Fatemeh Azizi-Soleiman [1]; Motahar Heidari-Beni [2]; Zeinab Hemati (corresponding author) [3]; Roya Kelishadi [3] 1. Introduction Obesity and overweight in childhood increase the risk of mortality and morbidity, as [...]

Background: Spirituality is an important dimension of holistic nursing, and spiritual care is essential to ensure the achievement of optimal care in nursing profession. The aim of this study was to explain the obstacles to providing spiritual care from the perspective of nurses. Materials and Methods: The present qualitative study was conducted between November 2020 and June 2021 with a content analysis approach. Participants included 30 nurses, selected through purposive sampling, working in the general wards and intensive care units of Isfahan University hospitals. Data collection method was semi-structured personal interviews. After recording and transcription word by word, all data were analyzed through qualitative content analysis. MAXQDA 11 was used for data analysis.Results: Research findings included 323 primary codes and two main categories "individual barriers and organizational barriers" and eight subcategories "non-compliance with human resources standards, lack of attention of organizational managers to the importance of holistic care, motivational barriers, training barriers, barriers to interprofessional collaboration, environmental barriers, barriers related to the nurses, and communication barriers."Conclusions: Using the results of the study, policymakers and nursing managers will be able to help facilitate spiritual care, and ultimately, improve the quality of nursing care by improving the infrastructure and removing existing barriers. [ABSTRACT FROM AUTHOR]

Objective Use of narcotics to relieve pain in labor affects neurobehavioral and nutritional conditions of newborns after birth. However, there are inadequate data on the effects of drugs currently used in labor. This study was performed to examine the association between newborns' breastfeeding behaviors in the first two hours after birth and drugs used for their mothers in labor in Isfahan, central Iran, from 2014 to 2016. Materials & Methods In this descriptive-analytical study, 300 women were selected who had vaginal delivery in the Labor and Gynecology Wards of Al-Zahra and Shahid Beheshti hospitals, Isfahan, Iran from 2014 to 2016. Data were collected by a demographic questionnaire and the Newborn Breastfeeding Behaviors Tool completed by the researcher as she observed the newborns during breastfeeding after birth. The data were analyzed by one-way ANOVA, chi-square test and Kruskal-Wallis test in SPSS 20. Results There was no significant difference between demographic characteristics of the studied groups (P>0.05). In addition, there was significant difference in breastfeeding behaviors between groups. More clearly, breastfeeding ability was higher in the infants of the women administered with no drug than those of the women in the group (P=0.000). Conclusion Physicians, nurses, and midwives can be informed about the side effects of the drugs used in labor on the newborns' breastfeeding, and improve their breastfeeding outcomes by decreasing the dose of used drug and the duration of the women's treatment with these drugs. [ABSTRACT FROM AUTHOR]

Background: Prematurity could result in the long admission of the neonate to the Neonatal Intensive Care Unit (NICU) and development of some complications for both mother and newborn. The early discharge programs make the neonatal transference to home much easier and are beneficial to both parents and newborns. However, there are limited studies investigating the real needs of the preterm neonates discharged early. Therefore, the identification of the post-discharge needs of these newborns could help the nurses, as the most important health care members, to consider these needs and mitigate the complications affecting the neonates. This study aimed to describe the care needs of the preterm infants with early discharge from the NICU. Methods: The present study was conducted on 25 participants (i.e., 10 mothers, 3 physicians, and 12 nurses) selected by purposive sampling technique. Data collection was performed by Observer as participant and in-depth interviews by qualitative content analysis for analysis. Results: Data analysis led to the emergence of four categories, namely need to follow nasogastric tube feeding, need for oxygen level monitoring, need to obtain sufficient information about medication, and need to acquire skill for daily care delivery. Conclusion: The enhancement of the nurses' knowledge about the needs of the preterm neonates with early discharge would result in the improvement of their abilities in the relevant domain. Accordingly, these nurses could help the mothers to prevent the incidence of several complications in the neonates, such as readmissions to the NICU. More importantly, these measures could prevent from the consequences of failure to fulfil these needs emerging in the later stages of life. [ABSTRACT FROM AUTHOR]

Background: Opioids are used to relieve pain during labor and may affect the neurobehavioral conditions of infants. However, effects of using drugs, such as oxytocin, as a routine component of pre- and post-delivery care on the breastfeeding behaviors of newborns remain unclear. The present study aimed to investigate the association between the maternal use of oxytocin during labor and breastfeeding behaviors of neonates within two hours after birth. Methods: This descriptive-analytical study was conducted on 160 women selected via convenience sampling. The participants were assigned to two groups of oxytocin administration (n=70) and physiologic delivery (n=90). Data were collected using demographic questionnaires and infant breastfeeding assessment tool (IBFAT). IBFAT was completed by the researcher through observing the behaviors of infants during breastfeeding after birth. Data analysis was performed in SPSS version 20, using descriptive and analytical statistics, including independent t-test, correlationcoefficients, and analysis of variance. Results: Mean age of the mothers in the oxytocin administration and physiologic delivery groups was 26.9±5.9 and 27.8±5.5 years, respectively. Breastfeeding was significantly stronger in the infants whose mothers had physiologic delivery compared to the group administered with oxytocin during labor. Conclusion: According to the results, use of oxytocin during labor directly weakens the breastfeeding of neonates. Therefore, it seems necessary to inform and prepare women for physiologic delivery during pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: A child afflicted with facial deformities such as cleft lip and palate usually affects their parents, because of difficulties in nutrition, speech, aesthetics and social connections, and also imposing a lot of stress on them. The aim of this study was to investigate the effects of a happiness program on the perceived stress in the mothers of children with cleft lip and palate. Methods: This study was a quasi-experimental study in which 64 mothers of children with cleft lip and palate were divided by simple random sampling into intervention and control groups (n=64). The program of happiness training was implemented within 10 sessions and the questionnaires of demographics and Cohen perceived stress were filled out prior to and two months after the last session in intervention group. Data analysis was done using SPSS Ver.13. Results: Independent t-test indicated a significant difference in the perceived stress mean score after training in the intervention and control groups. Also paired t-test indicated a significant difference in perceived stress mean score before and after training in the intervention group, but the difference was not statistically significant for the control group. Conclusion: Considering the effect of happiness program on reducing stress in the mothers of children with cleft lip and palate, it is recommended that this model can be used as an intervention in the maternal care for more involvement in the process of treatment and care of their child, in addition to reduce psychological problems in the parents. [ABSTRACT FROM AUTHOR]

Background: Mothers with premature infants face certain challenges such as uncertainty on how to deal with their infant's condition and care for it after discharge from neonatal intensive care unit (NICU). Methods: A qualitative design was used to explain mothers' challenges after their infant's discharge from NICUs in Isfahan, Iran, 2015. Purposive sampling was adopted to interview the mothers who could provide us information about the challenges after their infant's discharge. Data collection was performed by interviewing mothers. Data saturation was reached after conducting 23 in-depth, semi-structured interviews. All the data was analyzed by qualitative content analysis. Results: Four themes and nine categories were identified. The themes were incompetence in breastfeeding, dependence on hospital and nurses, feeding tube as a reason for stress, and constantly worried mothers. Conclusion: Mothers have difficulty in meeting their infants' basic needs after discharge. Supporting these mothers can enable them promote their infant's health. [ABSTRACT FROM AUTHOR]

Introduction: Facial deformities and aesthetic and functional anomalies in children may be a cause of real distress in families. Problems faced by parents in coping with a child's anomaly can be upsetting and lead parents to exhibit over-severe behavior. The present study was conducted in order to study the effect of happiness program on the happiness of the mothers of children with a cleft lip and palate. Materials and Methods: In this semi-experimental study, 64 mothers of children with a cleft lip and palate enrolled by convenience random sampling were assigned to an intervention or control group based on a simple random sampling. Then, a program of happiness training was implemented consisting of 10 sessions of 2 hours each. A demographic questionnaire and the Oxford Happiness Questionnaire were completed prior to and 2 months after the last session of intervention. The data were analyzed using descriptive and analytical statistics, consisting of a paired t-test, independent t-test and Chi-square test using SPSS version 20. Results: The independent t-test indicated a significant difference in mean happiness score after training between the intervention and control groups (P<0.05). Moreover, the paired t-test indicated a significant difference in mean happiness score between before and after training in the intervention group, although the difference was not statistically significant for the control group (P>0.05). Conclusion: In light of the efficacy of happiness training on the promotion of happiness in the mothers of children with a cleft lip and palate, this model is recommended as a healthcare intervention to decrease stress in mothers following the birth of an infant with a cleft lip and palate. [ABSTRACT FROM AUTHOR]

Background: Idiopathic thrombocytopenic purpura (ITP) is a chronic disease which is accompanied with hopelessness and loss of the sense of well-being due to its symptoms and treatment. It also affects patients' sense of social and spiritual well-being. This disorder decreases patients' self-esteem and their quality of life by changing their mental image and self-confidence. This study was performed to find the relationship between self-esteem and quality of life of patients with ITP. Subjects and Methods: This was a descriptive-analytical study on 64 patients with ITP who referred to Isfahan's Sayed Al-Shohada Hospital, Iran. In this study, patients with ITP were selected randomly using a random number chart. The data collection tools consisted of the World Health Organization Quality of Life (WHOQOL)-BREF and Coopersmith Self-esteem Inventory (CSEI). Data were analyzed using SPSS and chisquare and Mann-Whitney tests and the Pearson and Spearman's rank correlation coefficients. Results: In total, 64 patients completed the questionnaires. Results showed that 32% of subjects were over 36 years of age and 59% were women. In addition, 29.7% of ITP patients had low self-esteem and quality of life. Chi-square test showed a significant relationship between self-esteem and quality of life of patients with ITP. Conclusions: The results of the present study showed that considerable attention must be paid to selfesteem, as one of the most important factors influencing the promotion of quality of life. Therefore, it is suggested that patient's self-esteem be improved by the implementation of educational and psychological programs in order to decrease the consequences of poor quality of life. [ABSTRACT FROM AUTHOR]

Background: Self- esteem is defined as confidence in one's own worth or abilities. Low self- esteem may lead to failure to solve problems or not being able to use one's abilities. However, due to the chronic nature of this disease, this study was conducted to compare self-esteem in idiopathic thrombocytopenic purpura patients and healthy cases. Methods: This is a descriptive-comparative study in which 64 randomly selected idiopathic thrombocytopenic purpura patients referring to Seyed Al-Shohada Hospital in Isfahan along with the same number of healthy people from the patients' neighborhoods (as the control group) participated. The data collection instrument used in the study was Coppersmith self-esteem inventory which was completed by the subjects. The data were analyzed by SPSS 15 and through using independent T-test, chi-square, and Mann-Whitney tests. Results: The study results showed that 64.1% of the subjects in both the treatment and control groups were older than 35 years old, 59.4% were females, and 53.1% had primary educational degree. Independent T-test showed a significant difference between the two groups in terms of the mean score of self-esteem. (p<0.01) Conclusion: Considering patients' low self-esteem and the fact that their ability to make decisions and control the disease and its treatment have important role in raising their self-esteem, treatment team is responsible to recognize related factors and empower the patients' self- worth to help them to achieve this goal. [ABSTRACT FROM AUTHOR]

Introduction: Acquisition of chronic diseases such as asthma leads to psychological, mental and physical complications in adolescents, and hence their self-esteem may be compromised. Therefore, the present study was conducted to assess the effect of Orem's self-care model on self-esteem of adolescents with asthma. Materials and Methods: This semi-experimental study enrolled 64 asthmatic adolescents referred to Shariati Hospital, Isfahan. Subjects were assigned to two groups of control and intervention consecutively. Then, the self-care training program was conducted according to Orem's self-care model in eight two-hour sessions based on self-care needs, and self-esteem was measured in the two groups prior to and two months after the last training session. The data were collected by a questionnaire of demographic characteristics and the Coopersmith Self-Esteem Inventories (CSEI) and analyzed by SPSS version 20. Results: Independent t-test showed a significant difference in the mean score of self-esteem between the intervention and control groups after the training (P<0.05), but the difference was not statistically significant prior to the intervention. Paired t-test showed a significant difference in the mean score of self-esteem before and after the training in the intervention group (P<0.01), but this difference was not statistically significant in the control group (P>0.05). Conclusion: Regarding the effect of Orem's self-care model on self-esteem of adolescents with asthma, we recommend the use of this model as a care intervention in healthcare centers to promote adolescents' health. [ABSTRACT FROM AUTHOR]

Background: Considering the high prevalence rate of congenital hypothyroidism CH in Iran, an epidemiological study in each region would be helpful in understanding the etiology of the disorder and providing preventative strategies in this field. This study aims to determine the prevalence of CH in different cities of the Isfahan province., Materials and Methods: This descriptive and retrospective study was conducted among 918 primarily diagnosed CH neonates, who have been identified through the neonatal screening program from 2009 to 2015. At the age of ≥3 years, treatment was discontinued for 4 weeks, and T4 and thyroid-stimulating hormone were measured. Permanent (PCH) or transient (TCH) was determined from the results of the thyroid function tests., Results: From 389,101 screened neonates, 918 were diagnosed with primary CH. The overall prevalence rate of CH was 2.36 in 1000 live birth (ranged 1.58-7.22 in 1000 live birth in different cities). The highest prevalence rate of CH was reported in Ardestan, Khansar, Golpaygan, and Nain cities with prevalence rate of 4.86-7.22 in 1000 live birth and lowest prevalence occurring in Fereydan, Shahreza, Isfahan, and Mobarakeh cities with prevalence rate of 1.58-1.89 in 1000 live birth. In 392 cases which reached to 3 years of age, the rate of TCH was 47.45%. In Chadegan, Natanz, Fereydunshahr, Shahinshahr, Najafabad, Dehaghan, Borkhar, and Mobarakeh, the prevalence of PCH was <50%., Conclusion: The current findings indicate that the incidence rate of both PCH and TCH are high in Isfahan province with significant variability in different cities which could be due to the role of different genetic, prenatal, and different environmental factors. These epidemiological data could be used as baseline date to design more etiological studies., Competing Interests: There are no conflicts of interest.

Background: Birth of a child with cleft lip and palate, as a crisis, can affect family relationships and interactions seriously and hence self-esteem in family members. The present study was conducted to investigate the effect of a happiness training program on self-esteem in the mothers of children with cleft lip and palate., Materials and Methods: In this quasi-experimental study, 64 mothers of children with cleft lip and palate referring to health-care team in the Isfahan University Medical Sciences were enrolled by convenience random sampling. Then, the program of happiness training was implemented within 10 sessions, and a questionnaire of demographic characteristics and Coopersmith Self-Esteem Inventory was filled out before and 2 months after the last session. The data were analyzed by descriptive and analytical statistics (paired t -test, independent t -test, Chi-square, and Mann-Whitney) in SPSS 20 (SPSS Inc: Chicago)., Results: The mean age of the mothers in intervention and control groups was 33.3 ± 6.3 and 33.5 ± 5.8 years, respectively. The mean age of the children in the intervention and control groups was 6.34 ± 3.37 and 5.03 ± 3.36 years. Independent t -test indicated a significant difference in self-esteem mean score after training in the intervention and control groups. Moreover, paired t -test indicated a significant difference in self-esteem mean score between before and after training in the intervention group., Conclusion: In the light of the effect of happiness training on the promotion of self-esteem in children with cleft lip and palate, this program can be used as a care intervention to reduce psychological and mental problems and to enhance adjustment in parents., Competing Interests: There are no conflicts of interest.