Background: There are standard guidelines for the provision of health care for pregnant women in prisons. There is no single guide to meet all the specific needs of imprisoned women. In this study, the related international guidelines were reviewed to reveal the existing gaps. Materials and Methods: In this narrative review, studies published from May 2010 to January 2019 were reviewed through investigating databases including PubMed, Scopus, the Cochrane Library database as well as Science Direct Google Scholar using keywords: Guideline AND Prison AND Pregnancy AND Prenatal Care. The contents of the guidelines were subjected to analogy comparison. Results: 13 guidelines were included in the study. Of these, 10 guidelines were related to the organizations deployed in the USA, two guidelines to the United Nations and the World Health Organization, and one guideline to the United Kingdom. The most comprehensive care coverage of pregnant women was suggested, at the first level, by Birth Champion and in the second level by the Federal Bureau of Prisons. The care recommended in the guidelines was classified into four general categories of health care, safety and security, education and counseling, as well as miscellaneous issues. Most of the care items mentioned in the guidelines were related to the issue of safety and security of pregnant women. Conclusions: There are currently gaps in the guidelines in many aspects including maternal and fetal health assessments, mental health care, and also ethical and communication issues. It is essential to upgrade the guidelines provided for imprisoned women to promote their health.

Background: The quality of prenatal care has been recognized as critical to the effectiveness of care in optimizing maternal and child health outcomes. This study examined the effect of positive psychology interventions on the quality of prenatal care offered by midwives. Materials and Methods: This field trial was conducted on 60 midwives working in community health centers in Mashhad, Iran, from September 23, 2015 to March 20, 2016. Initially, centers No. 1 and No. 3 were selected via cluster sampling from among the five healthcare centers of Mashhad. Then, all subsidiaries of these centers were listed and assigned to intervention and control groups through simple random sampling. Thus, 60 midwives were randomly assigned to two equal intervention and control groups. The intervention, based on Seligman's Well-Being Theory, was presented weekly with homework in eight 2-h sessions. Before the interventions and immediately after the intervention, the Oxford Happiness Questionnaire (OHQ) and Ryff's Scales of Psychological Well-Being (SPWB) were completed by the midwives, and the Quality of Prenatal Care Questionnaire (QPCQ) was completed by two pregnant women for each midwife. Results: After the intervention, the mean [Standard Deviation (SD)] score of the overall quality of prenatal care in the intervention group was significantly higher than that of the control group [mean (SD) = 1.51 (0.49) vs. 0.05 (0.21); t_43,12= 18.7, p < 0.001]. Conclusions: It seems that improving the well-being of midwives through positive psychology interventions is effective on the quality of prenatal care provided by them.

Background: Health Care Workers (HCWs) play a key role in the Human Immunodeficiency Virus (HIV) prevention program, care and treat People Living with HIV (PLHIV). The evaluation of the attitude and performance among HCWs is regarded as one effective method for preventing the (HIV) spreading. This study was aimed to assess the attitude and practice of HCWs about HIV in Isfahan. Materials and Methods: In a cross-sectional study, we recruited 350 eligible participants from five academic hospitals, three academics dental clinics and six health centers by the convenience multistage sampling. A standard questionnaire was used to evaluate HIV attitudes among the HCWs in Isfahan. The variables were compared between males and females by Chi-square and t-test. In addition, linear and logistic regression was utilized to investigate the factors affecting attitude. Results: Respondents had a moderate level of attitude toward PLHIV About 2.00% of the respondents had a good attitude. Marital status (β=-11.79, p = 0.048) was associated with attitude. Among women, wearing gloves was associated with attitude (β=5.96, p = 0.041). Conclusions: HIV attitude was not satisfactory among the HCWs in Isfahan. Therefore, the necessary measures and training are needed to improve the attitudes of health personnel and reduce stigma and discrimination toward PLHIV in health systems. Also, it is recommended to strongly monitor HIV infection control guidelines and instruction.

Background: Empathy is an important component of the nurse-client relationship and nursing care. The current study aimed to compare nurses' level of empathy with patients in critical care units, psychiatric, and emergency wards. Materials and Methods: The present cross-sectional study was conducted on 112 nurses selected by convenience sampling in three educational hospitals affiliated with Isfahan University of Medical Sciences, Iran from June to September 2017. Data collection tool was a two-part questionnaire consisting of sociodemographic data (such as age, gender, and work experience) and Jefferson Scale of Empathy (JSE) containing 20 items, scored according to Likert scale from totally agree (7 points) to totally disagree (1 point). In total, the maximum score was 140 and the minimum score was 20. Data were analyzed using SPSS version 16 as well as descriptive and analytical statistical tests (multiple regression). Results: The mean (SD) empathy score of nurses working in critical care units, emergency, and psychiatric wards was 87.51 (6.65), 87.59 (4.90), and 90.71 (7.12), respectively. Regarding the regression models, it was observed that only the work experience was a significant predictor for empathy (β = 0.19, p = 0.04). This model predicted 3.50% of variances in the nurses' empathy. Conclusions: Nurses' level of empathy in this study was above average with equal scores in different wards. Therefore, increasing the nurses' level of empathy is essential in interventional studies.

Background: Child visual impairment is one of the disabilities that influence the Health Related Quality of Life (HRQOL) of mothers. Therefore, it is necessary to establish appropriate interventions for enhancing their HRQOL. This study was conducted to assess the efficiency of a Health-Centered Life Skills Training (HCLST) program on the HRQOL of mothers with visually impaired children aged 7 to 12 years. Materials and Methods: The present study was a nonblinded, randomized, controlled trial on 52 mothers with visually impaired children studying at an educational complex. The participants were selected using convenience sampling method and were randomly divided into intervention and control groups using balanced block randomization method. The intervention group participated in a HCLST program, but the control group did not. Data were collected using a demographic questionnaire and the 36-item Short Form (SF-36) Health Survey, which were completed by the participants of both groups before, immediately after, and 3 months after the intervention. Results: There was no significant difference between the intervention and control groups in terms of total mean score of HRQOL before the intervention; however, it increased significantly immediately (Z = −5.73, p < 0.001) and 3 months (Z = −5.84, p < 0.001) after the intervention in the intervention group. A statistically significant increase was observed in the mean scores of the two main domains of the HRQOL, which were physical health (Z = −3.61, p < 0.001) and emotional health (Z = −6.19, p < 0.001) domains, only in the intervention group. Conclusions: HCLST program can be used as an effective technique for the improvement of the HRQOL in mothers with blind children.

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.

Background: Perineal lacerations resulting from vaginal delivery may cause short and long complications, which lead to some problems in women after the delivery. Ostrich oil is safe for use in skincare and beauty products. The aim of this study was to examine the effect of perineal massage with Ostrich oil on the episiotomy and lacerations in nulliparous women. Materials and Methods: This single-blind randomized controlled trial was conducted on 77 nulliparous women referred to Razi Hospital in Qazvin (Iran) from May to December 2018. After screening of potential participants, 80 out of 105 pregnant women were selected by convenience sampling and were assigned into the intervention and control groups by block randomization technique. In the intervention group, participants received a perineal massage with Ostrich oil in the active phase and the second stage of labor. The rates of episiotomy and perineal laceration were compared between the two groups. Data were analyzed using Chi-square, t-test and Mann-Whitney. Results: Perineal massage with Ostrich oil in the intervention group significantly decreased the rate of episiotomy compared to the control group (χ² = 18.32, df = 1, p < 0.001). However, there was no statistically significant difference in perineal lacerations between the two groups. Conclusions: The results revealed that perineal massage with Ostrich oil could be recommended as an effective, safe, and inexpensive method to improve the rate of episiotomy in vaginal delivery. Perineal massage can be performed by midwives in the first and second stages of labor.

Background: Adherence to rehabilitation regimens is a major issue in the treatment of stroke. Despite the agreement on the importance of adherence, there is still no clear definition of this concept in rehabilitation. The aim of this study was the concept analysis of the concept of adherence to rehabilitation regimens in stroke patients. Materials and Methods: This qualitative concept analysis was performed using Walker and Avant's method. English and Persian articles were searched using keywords such as “adherence”, “compliance”, “rehabilitation”, “stroke”, and other related keywords among articles published from 1997 to 2018 in PubMed, Scopus, Web of Science, Google Scholar, Iranmedex, Magiran, and Scientific Information Database (SID). Related textbooks were also searched and all articles containing definitions, attributes, antecedents, and consequences of the concept were included in the study. Results: The attributes of the concept included complex, multidimensional, and dynamic behavior in the treatment process, personal experience, and adaptive behavior in patients, changeable, situational, voluntary, and collaborative behavior, and active communication between the patient and the healthcare provider. Common antecedents of the concept of adherence to the rehabilitation regimen were classified into patient-related and environmental-related categories and the consequences were classified into the three categories of patient-related, healthcare professional-related, and healthcare system-related. Conclusions: This concept analysis can be useful in eliminating any ambiguity of the concept of adherence to rehabilitation regimens. It helps clarify the vague concepts used in nursing rehabilitation instead of adherence. The results of this study can be helpful for researchers for further studies in this context.

Background: Women's beliefs regarding breast cancer and its screening approaches were considered antecedents of their behavioral changes. Understanding of these beliefs in women requires a valid and reliable instrument. The present study seeks to translate the English version of the Champion's Revised Health Belief Model Scale (CRHBMS) into the Persian language and assess its psychometric properties. Materials and Methods: The study was conducted on 334 students at Urmia University of Medical Sciences, Iran, 2016. The 57-item CRHBMS was translated to Persian language, back translated, and tested. To test the face and content validity of the Persian version; item analysis, Content Validity Ratio (CVR), and Content Validity Index (CVI) were applied, respectively. Construct validity of the Persian scale was performed by Exploratory and Confirmatory Factor Analyses (EFA, CFA) using Kaiser-Meyer-Olkin and Bartlett's tests in SPSS 16 and LISREL8.72 software. The reliability of the translated scale was evaluated using Cronbach's alpha and test-retest approaches. Results: In the EFA, eight factors were extracted concerning breast cancer screening, and each item was loaded on its specific factor. These factors were self-efficacy, health motivation, benefits-mammography, benefits-Breast Self-Examination (BSE), barriers-mammography, barriers-BSE, susceptibility, and severity. The final 42-item scale was confirmed by the CFA, and all goodness of fit indices showed a proper fit of the model. Cronbach's alpha coefficient and test-retest correlation of the subscales ranged from 0.72–0.89 and 0.67–0.93, respectively. Conclusions: The study suggests that the Persian version of CRHBMS is a feasible scale for evaluating women's health beliefs regarding breast cancer and its screening behaviors.

Background: Understanding the needs of families of hospital patients, especially those in intensive care units is key to providing comprehensive, effective support. The aim of this study is to determine the needs of families of Intensive Care Unit (ICU) patients in four Palestinian hospitals. Materials and Methods: This was a cross-sectional, analytic study including 240 participants selected using convenience sampling. Data was obtained from participants from September 2016 to April 2018. The Critical Care Family Needs Inventory (CCFNI) was distributed to examine their needs. Descriptive analysis, t-tests, and Analysis of Variance (ANOVA) were conducted to analyze relationships between demographic characteristics of respondents and their needs. Differences were considered significant at p < 0.05. Results: The results revealed that the assurance domain was the most important, but participants had some unmet needs from the support domain. Parents reported higher levels of importance of all needs than other types of relatives of patients. In addition, participants with a higher level of education reported a significantly higher level of importance in the dimensions of assurance (F_3,236= 2.85, p = 0.038), proximity (F_3,236= 4.36, p = 0.006), and support (F_3,236= 4.13, p = 0.007). Also, married participants had a higher need for all dimensions. Family members of patients who stayed more than 7 days had higher needs for support (F_2,237= 3.39, p = 0.035) and comfort (F_2,237= 3.92, p = 0.021). Conclusions: Family members of ICU patients have certain unmet needs, which require attention from healthcare professionals and administration in Palestinian hospitals. In addition, sociodemographic variables influence family member needs.

Background: Social support perceived by the elderly can reduce mental health problems including depression. In Iranian society, some elderly people spend their elderly years in senior day care centers established to promote social protection for the elderly. Therefore, the purpose of this study was to assess perceived social support and depression in the elderly members of senior day care centers and compare the results with that of elderly individuals living at nursing homes and at home. Materials and Methods: This descriptive, cross-sectional study was conducted on 315 elderly people. The participants were selected using stratified random sampling method and a random number table. The data collection tools used consisted of a demographic characteristics questionnaire, the Barthel index for assessing Activities of Daily Living (ADL), Social Support Appraisals (SSS-As) scale, and Geriatric Depression Scale short form (GDS-15). ANOVA, Chi-square, the Pearson correlation coefficient, and linear regression analysis were used to examine the hypotheses. Results: The results showed that with increasing social support, depression decreased in all three groups, which was statistically significant in the two elderly groups living in nursing homes (r = −0.19, p = 0.044) and elderly members of senior day centers (r = −0.18, p = 0.049). Conclusions: According to the results, it can be concluded that senior day care centers have been able to promote perceived social support in the elderly through their participation in daily activities and social activities, and thus were able to reduce depression significantly compared to the other two groups.

Background: To provide excellent nursing care services, nursing standards should be considered; one of these standards is being socially responsible. Regarding the lack of appropriate instruments in Iran for measuring social responsibility, the design of an instrument in accordance with Iranian culture seems to be necessary. So, the present study aimed to design a valid and reliable tool for measuring the social responsibility of nurses. Materials and Methods: In this sequential exploratory mixed-method study, designing and psychometric evaluation of nurses' social responsibility instrument were performed in qualitative and quantitative phases. In the qualitative phase, the concept of nurses' social responsibility was explored and its characteristics and dimensions were identified using a hybrid concept analysis model. In the quantitative phase, validity (face, content, and construct), and reliability (Cronbach's α and interclass correlation) were examined a sample of nurses in Tehran, Iran (n = 280). The construct validity of the scale was determined using exploratory factor analysis. Results: The findings supported 23 items in four factors: dedicated to others, efforts to improve social conditions, holistic vision, and favorable relationship. A total of 44.40% of the variance was explained by these four factors. Scale-Content Validity Index/Average (S-CVI/AVE) was calculated 0.91 and it was found that the Cronbach's alpha was 0.88. Conclusions: The researchers focused on designing and psychometric evaluation of nursing social responsibility tools based on nurses' opinions and prepared a native, valid, and reliable tool, which seems to be a good tool for measuring the social responsibility of nurses.

Background: Professional Self-Concept (PSC) affects one's way of thinking, role evolution, professional behavior, and performance. The present study aimed to determine the effect of Pilates exercises on PSC in nurses working in Intensive Care Units (ICU) and emergency departments. Materials and Methods: This quantitative study was a randomized controlled field trial. The study population consisted of all nurses working in ICUs and emergency departments from 2016 to 2017. Based on the inclusion and exclusion criteria, 110 nurses were assigned to intervention and control groups using a permuted block randomization method. The Nurses' Self-Concept Questionnaire (NSCQ) was completed by both groups. The intervention group performed Pilates 30 min each session at home for 8 weeks. The Chi-squared test, Mann–Whitney U, Kruskal–Wallis test, and t-test were employed to analyze the collected data. Results: Mean and standard deviation of the PSC score was 223.73 (23.35) in the intervention group and 215.75 (34.54) in the control group at baseline; it reached 229.17 (23.36) in the intervention group and 217.77 (34.44) in the control group at the end of the study. The difference was not significant. The paired-samples t-test showed that the score of PSC was increased by 5.45 points on average in the intervention group after the Pilates exercises, which was statistically significant (t₅₄= 25.80, p < 0.001). Conclusions: Pilates enhances the score of PSC in nurses working in ICUs and emergency departments. The designing and implementation of these easy and safe exercises may prove beneficial for nurses.