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This quasi-experimental study aimed to assess the impact of a midwife-led psycho-education intervention on reducing fear of childbirth (FOC) and perceived stress (PS) in pregnant women. The present study involved 96 pregnant women. The intervention group received three 30–45 min telephone sessions using 'BELIEF' (Birth Emotion-Looking to Improve Expectant Fear) psycho-education approach. The outcomes were assessed using questionnaires on childbirth attitudes and PS. Data analysis was performed using Stata version 17. In the intervention group, the mean score for FOC decreased from 39.41 ± 7.02 to 29.91 ± 5.60 (9.5; 24.1%). The mean difference (MD) of 28.22% was statistically significant (adjusted MD: −10.51, 95% CI: −11.60, −9.41, P  < 0.001). In the intervention group, mean scores for PS decreased from 22.77 ± 6.94 to 18.23 ± 5.69 (4.54; 19.93%). In the control group, scores increased from 22.68 ± 6.76 to 24.82 ± 6.58 (2.14; 9.43%). The 29.36% MD was statistically significant (aMD: −6.95, 95% CI: −8.73, −5.18, P  < 0.001). The findings of this study indicate that the midwife-led psycho-education intervention, utilizing the 'BELIEF' protocol over the telephone, has a significant effect on reducing FOC and PS, as well as increasing the preference for vaginal birth. [ABSTRACT FROM AUTHOR]

Ethical climate is one of the important factors in the working climate of the hospital. Considering the difference in the Ethical climate in different departments of the hospital and the importance of the ethical climate in the delivery ward, this study aimed to assess the characteristics of hospital ethical climate in delivery ward of educational hospitals in southeast Iran. This descriptive and multi-center study was conducted from 2020 to 2021 in educational hospitals in southeast Iran. Two hundred forty midwives working in delivery wards, midwifery instructors, and midwifery students were included in the study by census method. Data collection tools included a demographic information form, Olson's Hospital Ethical Climate Survey, completed using the self-report method. The mean ethical climate in the midwifery group (3.82 ± 0.63 out of 5) was higher than in the instructors' and students' groups. The lowest mean score obtained from the ethical climate questionnaire of participants was associated with the inability to use their experiences in the delivery ward. The lowest mean of ethical climate from the midwives' point of view is the Physicians' dimension and the patient's dimension from the instructors' point of view. The highest mean score belonged to the ethical climate of the supervisors. According to the results of the present study, it is suggested to implement protective laws to support the higher independence of midwives to improve the ethical climates by using their experiences in the delivery department. [ABSTRACT FROM AUTHOR]

Background: The presence of accompanying midwives (doulas) in the delivery room always entails many challenges. This study was carried out to determine the challenges of attendance with training from the point of view of midwives and expectant mothers in selected hospitals of Chaharmahal and Bakhtiari province, Iran. Methods: The present study was a descriptive study on 70 midwives working in the delivery block, 120 pregnant mothers, and 20 trained attendants. The sampling of midwives and doulas was performed using the census method, and the sampling of pregnant mothers was conducted using the convenience method. The study tool included questionnaires made by the researcher about demographics and socioeconomics, therapeutics, and psychological challenges for the group of mothers and midwives. The face validity and content validity of the questionnaires were confirmed by midwifery professors and reproductive health specialists, and their reliability was confirmed by internal consistency. The data were analyzed using descriptive statistics with SPSS software (version 21). Results: In this study, 70 midwives working in selected hospitals of Chaharmahal and Bakhtiari province, 120 pregnant mothers, and 20 trained attendants were examined. Most of the pregnant women (n = 39, 32.5%) mentioned that the most important motivation for requesting a doula during pregnancy and labor was to overcome the fear of childbirth. Most of them (n = 101, 84.9%) also stated that they used doula services at the right time. Meanwhile, 54 women (45%) were familiar with doula services during pregnancy, and most of them (n = 67, 56.3%) stated that doula services can be useful and effective in all three stages of pregnancy, labor, and delivery. Conclusions: There are dissatisfactions and challenges regarding the support of doulas during pregnancy and childbirth. Therefore, it is recommended to provide the necessary training to healthcare providers, especially obstetricians, midwives, and mothers, regarding the importance and place of doula's supportive care in this era. Additionally, doula activities should be integrated and promoted in the care of the health team. [ABSTRACT FROM AUTHOR]

Background: Empathy has been known as one of the fundamental principles of medical professions. Objectives: This study aimed to explore the perspectives of midwives' trainers, students, and personnel about empathy in maternity hospitals. Methods: A qualitative design using a content analysis approach was used to explore the experiences of midwives' trainers, students, and personnel in the maternity setting in Gachsaran, Iran. The study involved the recruitment of 41 participants, including 24 students, 14 personnel, and 3 midwifery trainers, who were selected using purposive sampling. Data were collected through 2 rounds of semi-structured interviews conducted via WhatsApp, with participants responding to 2 sets of questions. The text was analyzed using conventional qualitative content analysis, and the extracted codes were managed using MAXQDA software. Results: In general, 265 codes were extracted from the participants' interviews, which were classified into 3 categories (ie, "Client management is a top priority for every midwife, "the meaning of empathy," and "essentials in empathy") and 9 subcategories. A total of 121 codes explained how to manage clients, 64 codes were related to the meaning of empathy, and 77 codes were linked to what people must consider in empathy. Conclusions: Empathy is a crucial concept in the field of midwifery and should be included in the curriculum. It is essential to emphasize the correlation between empathy and other aspects of midwifery, such as communication skills, clinical competence, and ethics. We recommend that both staff and students undergo ongoing training in the area of professional conduct to enable them to make informed decisions in challenging situations. [ABSTRACT FROM AUTHOR]

Background: Possessing sensitive and multiple responsibilities in the country's health system, particularly after the implementation of the health reform in Iran, midwives must be able to optimally perform their duties in their new job as healthcare providers. This study aimed to identify the factors that predict job adjustment for Iranian midwives working in healthcare. Methods: In this cross-sectional study, 310 midwives were recruited from 209 health centers in the Iranian province of West Azerbaijan using the census method and asked to complete research questionnaires. Data were collected using job adjustment, job satisfaction, and organizational commitment scales. SPSS version 25 was used to perform ANOVA and calculate multiple linear regression coefficients for data analysis. In addition, the AMOS software was employed for path analysis and the identification of predictive variables. Results: The mean age of the participants was 37.67 ± 7.1 years. Most participants (35.5%) were interested in their occupation as a midwife, and 27.1% were very interest. They had a moderate to strong tendency (76.1%) to remain in their new profession. In addition, 58.1% of participants experienced moderate job adjustment. For healthcare midwives, "desire to remain in the midwifery profession" and "organizational commitment" were significant predictors of job adjustment. "Desire to remain in the midwifery profession" directly affected midwives' job adjustment, while "interest in the new profession" had an indirect effect. Furthermore, "adequacy of income to expenses," "job satisfaction," and "organizational commitment" through the mediating role of "desire to remain in the profession" can, directly and indirectly, influence their job adjustment. Conclusion: To better prepare midwives for their role as healthcare providers, organizational managers should focus their efforts and plan primarily on providing incentives to increase the longevity of staying in the profession of midwifery increase job adjustment, job satisfaction, and organizational commitment, thereby improving the quality-of-service delivery. [ABSTRACT FROM AUTHOR]

Background: Woman-centered care (WCC) is the cornerstone of the midwifery profession. However, no study has been conducted on WCC provided by Iranian midwives and its associated factors. Thus, this study aimed to determine WCC and factors associated with midwives' WCC for midwives working in urban health centers and public and private hospitals in Tabriz, Iran. Methods: This cross-sectional study was the first part (i.e., the quantitative phase) of a sequential explanatory mixed-method study conducted on 575 midwives working in urban health centers and public and private hospitals in Tabriz-Iran from November 2022 to January 2023. The required data was collected by distributing a socio-demographic and job characteristics questionnaire and woman-centered care scale-midwife self-report (WCCS-MSR). To determine the factors associated with WCC, an independent t-test or one-way analysis of variance (ANOVA) was used in bivariate analysis, and a general linear model (GLM) was employed in multivariate analysis to control possible confounding variables. Results: The statistical population consisted of 575 midwives, with a response rate of 88.2%. According to the GLM, the total mean WCCS-MSR score of single [β (95% CI) 23.02 (7.94 to 38.10)] and married [β (95% CI) 21.28 (6.83 to 35.72)] midwives was significantly higher than that of divorced midwives after adjusting their demographic and job characteristics. Also, the total mean WCCS-MSR score of midwives with sufficient income was significantly higher than those with insufficient income [β (95% CI) 8.94 (0.12 to 17.77). In addition, the total mean WCCS-MSR score of midwives with < 5 years of work experience [β (95% CI) − 7.87 (− 14.79 to − 0.94)], and midwives with official-experimental employment status [β (95% CI) − 17.99 (− 30.95 to − 5.02)], was significantly lower than those with more than 5 years of work experience and contractual employment status. Conclusions: The findings indicate that marital status, level of income, years of practice, and employment status were significantly related to WCC provided by midwives. Focusing only on the midwifery community is insufficient to ensure the improved quality of WCC. However, arrangements should be made at three levels, including policy-makers, managers, and health care provider (midwives). Plain Language Summary: As the cornerstone of the midwifery profession, WCC represents a universal, integrated, and synonymous concept with practice, which implies focusing on women as individuals. This cross-sectional study determined WCC and its associated factors of midwives working in urban health centers and public and private hospitals in Tabriz, Iran. A sample size of 575 midwives was used to determine the factors associated with WCC. The required data was collected by distributing a socio-demographic and job characteristics questionnaire and woman-centered care scale-midwife self-report (WCCS-MSR). A generalized linear model (GLM) was used to determine the factors associated with WCC. Midwives obtained the highest total mean score in the Works in Partnership with the Woman (WP-W) subscale and the lowest total mean score in the Ensures Midwifery Philosophy Underpins Practice within the Context of the Maternity Service (EMPUP-MS) subscale in the obtainable scores, which ranged from 0 to 100. Our study found that the total mean WCCS-MSR score of single and married midwives was significantly higher than that of divorced midwives. Also, the total mean WCCS-MSR score of midwives with sufficient income was significantly higher than those with insufficient income. In addition, the total mean WCCS-MSR score of midwives with < 5 years of work experience, and midwives with official-experimental employment status, was significantly lower than those with more than 5 years of work experience and contractual employment status. The findings indicated that marital status, level of income, years of practice, and employment status were significantly related to WCC provided by midwives. Therefore, to improve the quality of WCC, identifying the mentioned factors will help policy-makers to consider facilitating measures, providing practical solutions, and designing future interventions. [ABSTRACT FROM AUTHOR]

Background: Respectful care during labour and childbirth, which has recently received a great deal of attention around the world, is vital for providing high-quality maternity care. However, this area has been underexplored in developing countries including Iran. Research aim: This study aimed to assess postpartum women's views regarding disrespect and abuse during labour and childbirth in Iran. Methods: A qualitative study that involved a purposive sample of 21 postpartum women was conducted in Tehran, Iran, between 2019 and 2020. Following the semi-structured individual interviews, a conventional content analysis was performed. Ethical considerations: This research approved by Shahid Beheshti University of Medical Sciences in Tehran, Iran, with the ethical approval number 1396.810. Following explanation of the study's objectives, eligible women consented to participate in the study. The confidentiality of the participants' information and the anonymity of the analysis were maintained at all stage of the study. All data was stored on the password protected file in the researcher computer The findings were only disseminated in summary form, with no identifying of individual participants. Results: Analysis of the data resulted in two main themes: 'inappropriate interaction' and 'inadequate quality care'. The 'inappropriate interaction' theme includes 'lack of empathy' and 'verbal abuse'. The second theme includes five sub-themes 'lack of participation in decision-making', 'lack of privacy', 'ignorance of women's pain and medical needs', 'rushed labour and painful procedures', and "unsatisfying facilities'. Conclusion: Providing supportive care, respectful communication, adequate participation in decision-making, maintaining privacy, attending to women's labour pain and medical needs, and improving the quality of the physical birth environment are all examples of what labouring women consider to be respectful maternity care. To minimise disrespect and maltreatment of women during childbirth, an all-inclusive strategy engaging women, communities, healthcare professionals, managers, and educators is required. [ABSTRACT FROM AUTHOR]

Background and Aim Nosocomial infection is a health problem in all countries. Considering the role of midwives in controlling nosocomial infection, the aim of this study was to determine the effect of an educational intervention based on model on preventive behaviors of nosocomial infection by Babol hospitals midwives was done. Methods & Materials The present study was a quasi-experimental study with intervention and control group. The interventions were performed in three 40-minute sessions in the Shahid Yahya Nejad Hospital in April and May 2017. The data collection tool was a structure Health Belief Model based(Awareness, structure Health Belief Model and behavior) on a questionnaire completed Its validity and reliability were assessed two months before and one month after Midwives who met the inclusion criteria education. Data were collected and analyzed by SPSS software v. 24 by Anova, T-test and ANCO one-way Covariance tests. Ethical Considerations This research paper has been approved by the ethics committee IR.IAU.TMU. REC.1398.068 and informed consent will be taken from the participants in the study the information will remain confidential. Results Before the intervention, the two groups did not differ significantly in terms of, mean scores of different model structures. After intervention, there was a significant difference in the mean and standard deviation of the effect of education on knowledge score (1.0±0.3), perceived sensitivity (2.8±1.5), perceived severity (3.6±1.7) Perceived barriers (-6.4±1.3), perceived benefits (5.1±4), self-efficacy (4.6 ± 2.6) and behavior( 3.1±1.1) was seen in the intervention group (P>0.05). Conclusion By increasing the scores obtained from the structures Especially self-efficacy and reduction of perceived barriers, designing and implementing an educational program based on model in midwives can increase their performance regarding the prevention of nosocomial infections. [ABSTRACT FROM AUTHOR]

Introduction: Professional quality of life is affected by various factors, such as people's perception of professional empowerment. This study aimed to investigate the role of midwives' personal perception of empowerment in their professional quality of life. Methods: This cross-sectional study was conducted with 380 midwives providing maternal and neonatal care services across five provinces of Iran. Data were collected using virtual platforms and analysed using descriptive and analytical tests including regression analysis. Results: The mean professional quality of life was high (59.7%) in most participants. Midwives' personal perception of empowerment alone predicted 17% of professional quality of life. Conclusions: Given midwives' role in maintaining and improving maternal and neonatal outcomes, it is important to devise policies and plans to enhance midwives' perception of empowerment, especially with regards to autonomous practice and management. [ABSTRACT FROM AUTHOR]

Background Occupational stress is one of the undesirable risk factors found in the midwifery profession. It can lead to job burnout, job loss and negatively affect the quality of patient care. This study aimed to estimate the prevalence of occupational stress among Iranian midwives. Methods Through searching national and international databases, a total of 11 observational studies with full texts were extracted. Observational studies in Persian or English that reported the prevalence or frequency of job stress among Iranian midwives were included in the analysis. Irrelevant studies, those conducted on midwifery students and gray literature were excluded. The metaanalysis was conducted using the random-effects model. Results 11 articles reviewed occupational stress in 1196 midwives (an average of 108 midwives per study). Analysis of the articles showed that the pooled prevalence of occupational stress was 70.82% in Iranian midwives. Meta-regression analysis showed that the prevalence of occupational stress was not related to mean age, work experience, articles' publication year or sample size. Conclusions The prevalence of occupational stress is high among Iranian midwives and it can have harmful consequences for them and their patients. Therefore, the training of stress coping strategies seems to be appropriate for this group. [ABSTRACT FROM AUTHOR]

Background/Aims: Ongoing education of midwives plays a key role in high-quality prenatal care and pregnant women's health. In Iran, online education has received growing attention because of the COVID-19 pandemic. This study aimed to compare the effects of interactive and non-interactive e-learning on midwives' knowledge and self-efficacy. Methods: This quasi-experimental study involved 76 midwives working in prenatal care in health centres who were randomly divided into two groups: interactive e-learning via computers and non-interactive e-learning via mobile applications. Knowledge and self-efficacy were measured pre- and post-intervention using an online questionnaire and differences were analysed using the chi-squared and t tests. Results: Knowledge scores in nutrition, exercise, and overall care during pregnancy increased significantly in both groups in the post-intervention phase. Self-efficacy scores increased in exercise and overall care in the interactive e-learning group. The self-efficacy scores for all four studied items improved significantly in the smartphone group. The two groups' knowledge and self-efficacy scores were not significantly different post-intervention. Conclusions: E-learning had positive effects on the knowledge and self-efficacy of midwives. The researchers suggest using these approaches alongside conventional in-service education methods. [ABSTRACT FROM AUTHOR]

Introduction: In psychology, happiness is defined as a positive emotion which lasts longer than a temporary good feeling; it is a steady condition among one's positive emotions and understanding of life. Happiness is beneficial to the whole society, but the effects of happiness on university students, as the new blood and future makers of nations, have been of greater interest to researchers. The present study aims to explore the factors that induce happiness in nursing and midwifery students. Methods: The present study is a descriptive-comparative work of research conducted in 2017 on 200 nursing and midwifery students at the Islamic Azad University of Jahrom in the south of Iran. The subjects were selected based on the census sampling method. To determine the degree of happiness in the subjects, the researchers used the Oxford Happiness Questionnaire developed by Argyle et al. in 1979. The questionnaire consists of 29 multiple-choice items scored on the Likert scale between 0 and 3. The reliability and validity of the questionnaire have been tested and confirmed in several studies. The collected data were analyzed using SPSS v. 15. Findings: Of the 200 students studied, 81% (171) were female and 65.4% (138) were single. The mean happiness score of the subjects was found to be 40.1±9.1. On the happiness scale, the students' happiness level was medium. 21.9% of the students had low happiness levels (a score of 0 to 28), 71.5% had acceptable happiness levels (a score of 29 to 57), and 6.6% had high happiness levels (a score of 58 to 87). An analysis of the data showed that there was not a significant relationship between the subjects' levels of happiness and any of their demographic characteristics except their term of study (p=0.05). Conclusion: The findings of the present study show that the degree of happiness among nursing and midwifery university students is medium. Since nursing and midwifery university students are potential labor force in the healthcare systems of societies, it is essential that they maintain acceptable levels of happiness which is a criterion of psychological health. Accordingly, it is recommended that organized measures be taken to improve the psychological health of students and keep it at satisfactory levels throughout the duration of their education. [ABSTRACT FROM AUTHOR]

Background: Job Burnout (JB) is a multifactorial psycho-cognitive syndrome that leads to physical and psychological problems and declines the efficiency and productivity. Psychological Empowerment (PE) indicates that an individual feels motivated and competent to fulfill work expectations actively. This study assessed the correlation between PE and JB in midwives. Materials and Methods: This cross-sectional correlational study was conducted on 282 midwives working in labor wards of hospitals in Isfahan (Iran). Convenience sampling was used. Psychological Empowerment Questionnaire (PEQ) with four domains (meaning, competence, autonomy, and impact) and Maslach Burnout Inventory (MBI) with three domains (emotional exhaustion, depersonalization, and personal accomplishment) were used. Partial correlation and regression analysis were used to analyze the data. p < 0.05 was considered significant. Results: None of the demographic variables had a significant association with PE and JB. There were no significant correlations between the total scores of PE and three domains of JB. However, personal accomplishment was positively correlated with the domains of meaning and competence (r = 0.16, p = 0.02; r = 0.27, p < 0.001, respectively). Autonomy was the only significant predictive variable for emotional exhaustion and depersonalization, respectively (β =0.17, t235 = 2.34, p = 0.020, β =0.09, t249 = 1.29, p = 0.020); also, competency was the only significant predictive variable for personal accomplishment (β = 0.29, t263 = 4.20, p < 0.001). The domains of PE were significant predictors of variance of JB in personal accomplishment domain (R² = 0.10, F6 = 4.85, p < 0.001). Conclusions: Meaning and competence could be promoted through attendance in continuous training programs to increase personal accomplishment. In addition, it is suggested to promote midwives' authority to decline their emotional exhaustion and depersonalization. [ABSTRACT FROM AUTHOR]

Background: Midwives have a major role in the improvement of health indicators in every country. In order for midwives to be able to play their role well, they must have sufficient updated knowledge. For this purpose, it is necessary to review their educational needs. The aim of the present research was to review Iranian studies that have investigated midwives' educational needs. Materials and Methods: In this narrative review, PubMed, Scopus, Web of Science, Google Scholar, ProQuest, Ovid, SID, and Magiran databases were searched for the full texts of Iranian studies published in Persian and English languages in the period of 2000–2018. Review, descriptive, and interventional articles consistent with the research aim were included in this study. Results: Of the 53 found articles, 23 articles that were relevant to midwives' educational needs in Iran were investigated. The findings of the studies showed that the educational needs of the midwives can be categorized into the four groups of knowledge and performance, communication skills, occupational rules/regulations, and religious rules. Conclusions: The results showed that midwives in Iran have different educational needs. Because the midwifery practice leads to the promotion of public health, it is imperative that midwives have comprehensive knowledge and the skills necessary for providing optimal care. In order to achieve this, short-term and long-term training programs tailored to the needs of midwives are recommended. [ABSTRACT FROM AUTHOR]

Background and Objectives: Abortion is one of the main causes of maternal mortality. The lack of knowledge of physicians and midwives about the abortion laws can lead to the deficiency of presenting accurate information to pregnant women, and consequently to increase unsafe abortions. The purpose of this study was to assess the relationship of knowledge and attitude towards legal abortion laws with the performance of midwives in Qazvin, Iran. Methods: This descriptive-correlational study was conducted on 122 midwives with private offices in Qazvin, Iran, from May to September 2012. The subjects were chosen according to the convenience sampling method. After obtaining informed consent for participation in the study, four questionnaires, including demographic characteristics, knowledge, attitude, and performance questionnaires were distributed by the researcher among the referrals. Results: The obtained results showed that approximately half of the midwives had good knowledge about abortion laws (55.7%); however, their attitude towards abortion laws was mostly negative (86.9%). In addition, their performance of abortion was reported as average (60.7%). There was no significant relationship between the knowledge and midwifes' performance; however, a significant statistical relationship was observed between their attitude and performance. Conclusion: Regarding the fact that providing abortion services is one of the healthcare strategies for preventing the complications of unsafe abortion, it is advised to increase the knowledge level of medical personnel by including the relevant courses in the university, holding retraining courses and congresses on the issue of abortion, and informing new guidelines. [ABSTRACT FROM AUTHOR]

Aim: Studies have shown that breastfeeding has both short-term and long-term useful effects on mother's and newborn's health. This study was conducted with the aim of determining predictors of breastfeeding performance in women who were referred to health centres in Tabriz City, Iran, in 2014 to 2015. Methods: This cross-sectional study cluster-sampled 220 breastfeeding women with infants aged 4 to 6 months. The Breastfeeding Self-Efficacy Scale, the Iowa Infant Feeding Attitude Scale, the personal resource questionnaire-85, and a researcherdeveloped knowledge questionnaire were used to collect data. Multivariate linear regression model was used to determine predictors of breastfeeding performance. Results: The results showed that participants' breastfeeding performance mean (SD) value was 3.6 (1.2) of 6. There were significant relationships between breastfeeding performance and breastfeeding self-efficacy (P = .033) but not between social support, knowledge, attitudes, and breastfeeding performance (P > .05). Breastfeeding self-efficacy, occupation, family income sufficiency, and living with the family were identified as predictors of breastfeeding performance. Conclusion: Given the relationship between breastfeeding self-efficacy and breastfeeding performance, strengthening mothers' self-efficacy should be considered, especially when compiling programs to promote breastfeeding. Increasing breastfeeding self-efficacy in women improves their breastfeeding performance: In developing programs to promote breastfeeding culture, women's self-efficacy should be considered. [ABSTRACT FROM AUTHOR]

Background & Aims: Happiness is a persistent feeling of positive emotion and perception of reality of life. Physiological signs of emotion and joy, including: Changes in the face or tone of speech which strongly affect the quality of our relationship with others. Communication performance is the most important characteristic for those who work in primary healthcare. Midwives as a key member in the treatment process, has close relationship with the patients. Therefore, the present study aimed to determine the level of happiness and its relationship with the quality of communication performance in midwives. Materials & Methods: This study was conducted among 90 midwives working in maternity of Mashhad University of Medical Sciences hospitals which were selected through census sampling. This is a descriptive-correlation study. Data were collected from the Oxford Happiness Questionnaire and observational Check list for communication performance. Data were analyzed by descriptive statistics, Spearman, ANOVA and Pearson test with Spss19. Results: 11 (12.2%) midwives had low level of happiness, 46 (51.1%) moderate, and 33 midwives (36.7%) had high level of happiness. Spearman correlation coefficient showed a significant and positive correlation between happiness and communication performance (p<0.001, r=0.771). Conclusion: Due to happiness and communicative performance show significant positive correlation, and also the result showed 63.3% of midwives had low and average happiness, authorities can increase the communication performance of midwives by increasing levels of happiness and through this, organizations provide patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: The present qualitative study was conducted to explain the experiences of secondary traumatic stress (STS) and its related factors in midwives working in maternity wards., Methods: Data were collected using semi-structured interviews with 11 midwives working in the maternity wards of hospitals in Urmia, Iran, through in-depth interviews with open-ended questions. Data were analyzed using the conventional content analysis approach., Results: The results of data analysis led to the extraction of three themes, seven main categories, and 18 subcategories. The first theme was "STS stimuli," with the two categories of "Discriminatory approach to midwifery" and "The nature of the midwifery profession". The second theme was "Traumatic outcomes", which included the subcategories of "Psychological-emotional trauma", "Physical trauma" and "Social trauma". The third theme was "Risk management", which had the two subcategories of "Reactive approach" and "Proactive approach"., Conclusions: The results showed that, in addition to the traumatic nature of events that midwives experience during work as the secondhand victims, factors such as governance-organizational structure, unbalanced distribution of power, and poor supportive laws undermine their professional role and provide conditions conducive to STS. Therefore, avoiding traumatic situations and scientific and skill self-empowerment were the most important strategies adopted by the midwives in this study to prevent risky situations and cope with the consequences of STS. The participation of midwifery stakeholders in policy-making and adopting supportive legislation in redefining the position and role of midwives can play a major role in reducing STS and sustaining their role and position in maternal care., (© 2022. The Author(s).)

IntroductionNatural disasters have many effects on vulnerable groups, especially infants and children. Protecting breastfeeding in disasters is important, because artificial feeding puts a lot of risk to the child. In disasters, artificial nutrition is dangerous to children and its supplementation requires special equipment. There is little information on the nutritional status of infants after disasters in Iran.ProblemThe purpose of this study was to explore the barriers to appropriate lactation after disasters in Iran., Method: This was a qualitative study using a content analysis method. A total of 19 midwives with disaster-relief experiences were approached for interview. Data were collected using semi-structured interviews. Data analysis was performed using the Graneheim's approach., Results: The categories of maternal factors, neonatal factors, management factors, and context-base factors were extracted from the data., Conclusion: The challenges of social support, mothers' self-efficacy, educated staff for disasters, and privacy for breastfeeding can be considered as important barriers to breastfeeding in disasters. Training programs, as well as health system support, can help overcome the breastfeeding barriers in disasters. MirMohamadaliIeM, Khani JazaniR, SohrabizadehS, Nikbakht NasrabadiA. Barriers to breastfeeding in disasters in the context of Iran. Prehosp Disaster Med. 2019;34(1):20-24.

Introduction and Objective: Job stress is one of the major threats to health and it is associated with many diseases and family problems. Midwives experience high job stress due to the management of delivery emergencies. Personality traits and emotional intelligence can be helpful in confronting environmental pressures and selecting the strategy of coping with useful stress. Thus, the current research was conducted to evaluate the relationship between job stress, personality traits and emotional intelligence in midwives of Lorestan health care centers. Methodology: This research was a cross-sectional and correlational study. Midwives working in all cities of the Lorestan province were randomly selected and they completed the job stress, emotional intelligence and personality traits questionnaires. Data were analyzed using SPSS 16 software and a significance level of p <0.05 was considered. Results: The results of the research showed that mean and standard deviation of job stress, emotional intelligence and personality trait midwives were 94.36 ± 12.98, 11.87 ± 14.30, and 135.51 ± 15.73 respectively. The results showed a negative relationship between intelligence and job stress (r= -0/274, p=0.0001) and no significant relationship was found between personality traits and job stress (r = -0.288, p=0.079). Conclusion: A negative correlation was found between emotional intelligence and job stress, so emotional intelligence can reduce midwives' workplace stress.

Objective: Maternal mortality may increase after a disaster. Because midwives are at the frontline of offering reproductive health care services in disasters, they should be competent., Methods: This was a cross-sectional, descriptive study carried out in 2015 in Tehran. The sample consisted of 361 midwives selected by use of a cluster random sampling method. Data were collected by using a questionnaire on professional competency for preventing maternal mortality in disasters., Results: The midwives' mean professional competency score was 177.74±31, which was an average level of professional competency. The level of knowledge and skills of the midwives was reported as inadequate for most items, particularly for the items of "managing mothers affected by chronic diseases," "physical trauma," "recognizing patients who needed to be referred," and "stabilizing mothers when referring them." Statistically significant relationships were observed between the midwives' competencies and age (P=0.001), work experience (P=0.054), educational level (P= 0.043), previous experience in a disaster (P=0.014), and workplace (P=0.006). These data were drawn by using Spearman's correlation, t-test, and ANOVA, respectively., Conclusions: Given the average scores for midwives' professional competency in disasters and the inadequacy of prior training courses, extra educational programs for midwives are recommended. (Disaster Med Public Health Preparedness. 2018; 12: 305-311).