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Background & Aim: Many changes occur during and after pregnancy which affect physical, psychological and social health and generally women's quality of life. This study aims to explore the relationship between quality of life and sexual dysfunction after delivery.
Methods & Materials: This cohort study was designed to compare the relation of mode of delivery to quality of life and sexual satisfaction in 330 pregnant women referred to hospitals of Tehran University of Medical Sciences. Sexual function questionnaire including 20 questions and quality of life questionnaire including 26 questions were developed based on Female Sexual Function Index (FSFI) and World Health  Organization life quality (WHOQOL- BREF) questionnaire,  respectively. Data were analyzed through SPSS version 15 software using descriptive and analytical methods (t-test, X2 test, Fisher's exact test and analysis of variance).
Results: The mean sexual function score in the vaginal delivery and Cesarean section groups were 45.25±5.59 and 45.50±6.03, respectively, which shows no significant difference. No significant difference was seen regarding the mean score of quality of life between vaginal delivery group (87.8±10.70) and Cesarean section group (88.25±11.29). Also no significant difference was seen between two groups of study, considering different aspects of life (physical, psychological, environmental and social).
Conclusion: Quality of life was similar in both groups of vaginal delivery and Cesarean section. Therefore, authorities in charge of health programs can have a leading role in changing people's concept of delivery and developing a positive attitude towards vaginal delivery. This could be achieved through effective public training schedules.

Background & Aim: Heart failure is one of the most common cardiovascular diseases which decreases the quality of life. Most of the factors influencing quality of life can be modified with ongoing educational interventions. Inadequate teaching is one of the causes of low health outcomes. Therefore, this study examined the effects of a Roy’s Adaptation Model (RAM) based on quality of life of patients with heart failure.
Methods & Materials: This randomized clinical trial study was conducted during May to August 2011. From patients with heart failure referred to Tabriz Shahid Madani policlinics, 44 subjects were conveniently selected and randomly allocated to two groups. The intervention group (n=22) received ongoing one-to-one teaching and counseling sessions and phone calls based on RAM over 3 months. The control group (n=22) received routine teaching. Data were collected using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), Interpersonal Support Evaluation List (ISEL) and the 6-Minute Walk Test (6MWT) at first as well as three months later, and analyzed through SPSS (v.13).
Results: The statistical tests showed significant differences in the physical, emotional and total dimensions of quality of life (p<0.001) in intervention group. But in control group, no significant differences were obtained. In addition there was significant differences in interpersonal support between two groups after intervention (p<.001). Also there was a statistically significant increase in 6MWT between baseline and after 3 months for intervention (p<.001) group.
Conclusions: This result showed that teaching program based on RAM was effective in improving the quality of life and in interpersonal support for patients with heart failure.

Background & Aim: Primary Dysmenorrhea (PD) is the most common genital disease among adults which can disrupt daily activities and reduce quality of life. Acupressure was recommended for relief of PD and the aim of this study was to compare the maximum pain intensity (MPI) and duration of PD after acupressure on third liver (LIV3) and placebo points.
Methods & Materials: Students who were suffering from PD were studied for three menstrual cycles between March and June 2012. In the first cycle, intensity and duration of dysmenorrhea (DPD) were assessed and students with pain score≥4 according to visual analogue scale for MPI were selected. Randomized block allocation was performed based on pain intensity with 1:1 allocation ratio. Students, data analyzer and allocation were blind. Students applied acupressure themselves, on LIV3 or placebo points in the second and third cycles, only on first day of menstrual cycles in the beginning of bleeding. Acupressure was performed 4 times intermittently, (2 minutes pressure followed by 2 minutes rest, twice on each leg and 16 minutes in total). Chi-square, Mann –Whitney, Wilcoxon, Sign test and ordinal regression analysis were used.
Results: In LIV3 group 27 and in control group 32 students were analyzed. MPI in each group decreased after intervention but decrease in DPD was not significant. There were not significant differences between groups based on ordinal regression test for MPI and DPD (p>0.05).
Conclusion: Pressure at LIV3 point decreased MPI but was not significantly effective in reducing DPD. Further studies in more menstrual cycles and other techniques are recommended.

Background & Aim: Stress is a common phenomenon in nursing profession, but novice nurses usually experience more stress. This stress can result in job dissatisfaction and quitting the occupation. This study aimed to explore the novice nurses’ experience of stress at the beginning of their clinical practice.
Methods & Materials: This study was conducted using a qualitative content analysis. The study population consisted of 17 novice nurses working in hospitals affiliated to Tehran University of Medical Sciences in Iran, selected through purposive sampling. Data were collected through semi-structured interviews.
Results: Four themes and 7 categories emerged during data analysis. The extracted themes and categories consisted of (I) insufficient competency (inadequate knowledge, inadequate practical skills, inappropriate communication skills), (II) clinical workplace (workplace environment, workplace climate), (III) clients’ challenges (patient's physical and psychological status, family and relatives’ behavior), and (IV) colleagues' behaviors.
Conclusion: Novice nurses expressed that they had high levels of stress in their first months of employment. The study showed various factors causing stress among participants which may result in quitting their work. Considering novice nurses’ experience of stress, and underlying factors, nursing managers can help to reduce novice nurses' stress and increase their motivation to continue their work.

Background & Aim: The causes of increased rate of Cesarean section (C-section) are not completely known. The repeated C-sections are frequently reported in studies conducted in Iran. This study aimed to determine the frequency of, and indications for the first time Csection (FCS) in Zanjan, Iran in 2012-2013.
Methods & Materials: A cross-sectional study was conducted and systematic random sampling was used to select medical records of delivered women. We provided a selfstructured short questionnaire. Data were collected from the medical records and analyzed using independent sample t-test, and Chi-square test.
Results: A total of 4563 women have been delivered during the period of the study from which 1928 cases (42.25%) underwent C-section. Among women who had C-section, 1144 cases (59.3%) underwent first time C-section. The three most frequent indications for FCS were prolonged labor (35.2%), meconium staining (22.2%), and fetal distress (21.9%).
Conclusion: The frequency of FCS is high in Zanjan, Iran. Adequate following of programs to diminish the percentage of first time C-section and increase the number of vaginal birth would significantly reduce the prevalence of C-sections.

Background & Aim: Increasing students’ academic stress especially during taking final exams may result in sleep  disorders, fatigue, poor academic performance and low functional efficiency. The aim of this study was to determine the relationship between sleep quality with fatigue severity and academic performance of nursing students.
Methods & Materials: In a cross-sectional study, the sleep quality and fatigue of nursing students (n=138) of AJA University of Medical Sciences in Tehran, Iran were assessed using Pittsburgh Sleep Quality Index and Fatigue Severity Scale within last week of exams of second semester in 2013. Subjects filled demographic questionnaires and the response rate was 86.8%. The data were analyzed using SPSS software with descriptive and analytic statistics including Chi square, Pearson and Spearman’s rho correlation coefficients.
Results: Sleep quality in 64.4% of students was poor. About 77% of students suffered from fatigue in moderate to severe levels. The mean of total scores of lessens was 16.16. Chi-square test and Pearson correlation coefficient did not indicate significant relationship between sleep quality and age, gender, education semester and educational level, material status, habitancy location, caffeine consuming, smoking, experience of suffering from chronic and psychological diseases, working and also experience of major stress (p>0.05).Spearman’s rho correlation coefficient indicated significant relationship between sleep quality and fatigue severity (p≤0.0000), whereas Pearson correlation coefficient did not show significant relationship between sleep quality and academic performance and also between fatigue severity and academic performance (p>0.05).
Conclusion: Prevalence of poor sleep quality and fatigue during final exams in nursing students is high. Considering importance of sleep quality and quantity and its effect on academic performances, creating suitable conditions for improving sleep quality is suggested.

Background & Aim: Although the literature provides evidence-based guidance for bathing infants, it is important to be aware of cultural differences what may arise when caring for infants with a diverse family background. The aim of this study was to examine the correlation between social support and state anxiety in mothers’ practices in newborn baby bathing.
Methods & Materials: The descriptive and correlation study was conducted in 256 mothers. The data collection forms and scales were administered by the researcher to the mothers using a face to face interview technique when they presented to FHCs.
Results: Majority (97.7%) of the mothers said that they bathed their babies at home for the first time and these mothers’ mean scores obtained from the PSS- Fa Scale was 15.54±4.63.
Conclusion: The study showed that mothers’ perceived social support level from the family was satisfactory and their state anxiety was moderate. Mothers’ past experiences related to baby bath showed that it decreased their state anxiety levels meaningfully and statistically. Mothers’ perceived social support levels from the family related to baby bath increased and their state anxiety levels decreased.