SinaWebMedical Education Bulletin2783-18091220201201Effect of Acupressure Point (LI4) on Anxiety Levels of Pregnant Women during Labor: A Systematic Review and Meta-Analysis657213400110.22034/meb.2021.296308.1017ENFarzaneh FazeliAnesthesiologist, Assistant Professor of Intensive Care, North Khorasan University of Medical Sciences, Bojnord, Iran.0000-0002-4841-2325Somayeh MoeindarbaryAssistant Professor, Department of Obstetrics and Gynecology, Neonatal and Maternal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0003-2421-2203Reza AhmadiAssistant Professor of Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0003-4921-976XNeda DehghaniNeda Dehghani: Department of Midwifery, Firoozabad Branch, Islamic Azad University,Firoozabad, Iran.Journal Article20210722<strong><em>Background: </em></strong>Using medication to reduce pain has adverse effects. It is, therefore, better to use non-pharmacological methods for pain relief. One of these methods is acupressure. The present study aimed to investigate the effect of acupressure point (LI4)<strong> </strong>on the anxiety levels of pregnant women during labor.
<strong><em>Materials and Methods: </em></strong>In this systematic review and meta-analyses, online databases, including Medline, Cochrane Library, EMBASE, and Scopus were searched up to November 2020 using keywords such as (Anxiety) AND (Acupressure). The final version of the Jadad scale, which comprises three important items, was used for evaluating the quality of trials.
<strong><em>Results: </em></strong>Results showed that the patients in the acupressure with ice group were not different from patients in touch group [SMD= -1.26; 95% CI: -2.86 to 0.614; p=0.205; heterogeneity; I<sup>2</sup>: 96.58%; p<0.001; 2 trials]. Women in the group of acupressure without ice [SMD= -0.83; 95% CI: -1.147 to -0.520; p<0.001; heterogeneity; I<sup>2</sup>:0%; 2 trials] reported significantly lower anxiety than those in the control group. Also, the meta-analysis showed that acupressure without ice was more effective than acupressure with ice in decreasing anxiety levels [SMD=-0.86; 95% CI: -1.18 to -0. 55; p<0.001; heterogeneity; I<sup>2</sup>:64.47%; p=0.09; 2 trials].
<strong><em>Conclusion</em></strong>: Based on the results, acupressure point (LI4) with ice was not different from touch, but acupressure without ice resulted in significantly lower anxiety than the control group. However, these findings should be interpreted with caution due to the small sample size and the low number of studies.SinaWebMedical Education Bulletin2783-18091220201201Pain Management after Surgery: An Educational Study with the Purpose of Reviewing and Comparing Analgesics for Medical Providers738213914010.22034/meb.2021.311704.1030ENMohammadhadi Mohammadzadeh RezaeiUrologist, Department of urology, Mashhad University of Medical Science, Mashhad, Iran.0000-0002-0870-4913Mahdieh JafariAssistant professor of Anesthesiology, Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-1416-196XShima ImannezhadPediatric Neurologist, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Rahele RahimiFellowship of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Sina SezavarDepartment of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran.0000-0002-0485-2740Forough RakhshanizadehDepartment of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20211023<strong><em>Background: </em></strong>The purpose of the present study is to review and compare the effect of analgesics after surgery on children, adults, and the elderly.
<strong><em>Materials and Methods: </em></strong>This review was conducted through a systematic search of electronic resources in English, including Medline, Scopus, Web of Science, Cochrane Library, and EMBASE, SID, Magiran, CIVILICA, and Google Scholar search engine with no time limit from inception up to March 2020, using the following keywords on their own or in combination: "Pain management", "Pain", "Advantage", "Disadvantage", "Drugs", and "Analgesic".
<strong><em>Results: </em></strong>Three studies were found that compared the effects of pethidine and morphine on postsurgical pain. The findings demonstrated that in pediatric surgery, pain intensity in those who received morphine was significantly lower than those who received meperidine. On the other hand, the results of one study did not find a significant difference between the two drugs in post-operative sedation and satisfaction of patients who underwent cesarean section. Of the two studies comparing the effects of pethidine and paracetamol on postsurgical pain, one study reported that pethidine reduced the pain score significantly more than paracetamol. In contrast, the other study found that pain intensity in patients who received intravenous acetaminophen was significantly lower than those who received meperidine after six hours (P<0.001). According to one study, ketorolac was more effective than intravenous pethidine in reducing the pain score, and in another study, a mixture of pethidine and bupivacaine was able to aggravate the effects of each drug alone.
<strong><em>Conclusion: </em></strong>Intravenous acetaminophen, pethidine, morphine, ketorolac, and paracetamol are effective in reducing postoperative pain in children and adults. Due to the methodological limitations of the included studies, these results should be interpreted with caution.SinaWebMedical Education Bulletin2783-18091220201201Evaluation of the Physical Activity of Health Volunteers Using the Planned Behavior Theory and the Stages of Change Structure838913612710.22034/meb.2021.302642.1024ENMansoure Alipour-AnbaraniPh.D Student, Student Research Committee, Department of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.0000-0002-9563-7383Mohammad Vahedian ShahroudiAssociate Professor, Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-5402-1646Hamed TabeshDepartment of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0003-3081-0488Masumeh NooriMashhad University of Medical Sciences, Mashhad, Iran.Ali TaghipourProfessor, Department of Epidemiology, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0001-7594-0097Journal Article20210901<strong><em>Background: </em></strong>Lack of physical activity is the leading cause of many diseases such as obesity, weakness of the cardiovascular and respiratory systems, and threatens human health. In this study, the physical activity of healthy volunteers was examined using the planned behavior theory and the stages of change structure.
<strong><em>Materials and Methods: </em></strong>In this cross-sectional study, 262 female healthy volunteers were selected using a simple random sampling method. A questionnaire with three sections addressing demographic information, structures of the Planned Behavior Theory, and the stages of change structure was used to collect the required data. Moreover, the International Physical Activity Questionnaire (IPAQ) was used to assess the healthy volunteers’ physical activity. Data analysis was performed with SPSS software (version 16.0). To this end, descriptive statistical tests, Spearman correlation, and Chi-square tests were run.
<strong><em>Results: </em></strong>The healthy participants’ mean age was 40.9±88.66 years. According to IPAQ, 41.6%, 55.7%, and 2.7% of the participants revealed low, moderate, and moderate-high levels of physical activity, respectively. There was a direct and significant correlation between the structures of attitude, mental norms, and control of perceived behavior with physical activity (p <0.05). However, there was no significant correlation between the structures of behavioral intention and physical activity (p>0.05). Furthermore, a significant structural difference was noticed between the stages of change and the level of education among the participants (p <0.001).
<strong><em>Conclusion: </em></strong>The present study highlighted the need to consider a set of effective factors in converting the healthy volunteers’ behaviors to physical activity. The factors can provide the grounds for the development of theory-based educational interventions aimed at promoting physical activity.SinaWebMedical Education Bulletin2783-18091220201201Investigating the Awareness of Patient Rights based on the Patient's Rights Charter among Patients Referring to Teaching Hospitals of Mashhad University of Medical Sciences, Mashhad, Iran9110213407510.22034/meb.2021.296569.1018ENMohammad Ali KianiFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Gholamali MaamouriFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Masumeh NooriMashhad University of Medical Sciences, Mashhad, Iran.Elham RoudiFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Lida JarahiDepartment of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Hamidreza KianifarFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Mohsen ZakerianSchool of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20210724<strong><em>Background: </em></strong>In order to ensure the quality of healthcare services, it is inevitable to observe medical ethical standards and patient rights. We aimed to determine the level of awareness of patients' rights based on PRC among patients referred to the teaching hospitals of Mashhad University of Medical Sciences, Iran.
<strong><em>Materials and Methods: </em></strong>This cross-sectional study was performed on 43 patients admitted to two teaching hospitals in Mashhad, Iran. Data were collected using a two-part questionnaire including demographic characteristics and the inventory of patients’ rights observance. Statistical analysis was performed using descriptive statistics and independent t-test, chi-square, Spearman correlation coefficient and ANOVA in SPSS ver. 16.
<strong><em>Results: </em></strong>The mean ± SD of the age of the research subject was 26.5 ± 9.83 years. A total of 37.2% of the participants had moderate awareness of patient rights. The highest observance of the patient's rights was related to the area of respecting the patient’s privacy and confidentiality, which was evaluated as excellent by 41.9% of research subjects. The lowest observance of the patient's rights was related to the optimal provision of health services to patients, which was poor in 39.2% of the research subjects. There was no significant relationship between demographic characteristics (age, gender, education, number of hospitalization days, and patients’ place of residence) with observance of patient rights (P>0.05).
<strong><em>Conclusion: </em></strong>In the present study, patients did not have an optimal awareness of PRC in most related areas. Therefore, it is suggested that more detailed regulatory policies be developed and implemented to ensure the provisions of the Patients’ Rights Charter as well as educational programs to promote patient awareness in this area.SinaWebMedical Education Bulletin2783-18091220201201Investigating the Level of Learning Motivation in Clinical Nurses of Mashhad University of Medical Sciences, Mashhad, Iran10311114001510.22034/meb.2021.313972.1037ENNaeem Al-shoelyMSN, Al-Rashad Training Hospital for Psychiatric and Mental Illnesses (Al-Shama'a), Baghdad, Iraq. AND MSN, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.Seyed Reza MazlomInstructor of Pediatrics Department, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0001-6722-8411Amir Reza Saleh MoghaddamInstructor of Nursing, Department of Community Health and Psychiatric Nursing, School of Nursing and Midwifery Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20211109<strong><em>Background: </em></strong>Nurses are important healthcare providers in providing high-quality health services. It is therefore recommended to measure their level of learning motivation towards achieving the goals of healthcare organizations. The present study aimed to determine the level of learning motivation in clinical nurses in health centers in Iran.
<strong><em>Materials and Methods: </em></strong>This quantitative descriptive research was conducted at hospitals affiliated to the Mashhad University of Medical Sciences in 2020. Sampling was done by the random categorical cluster sampling method. A total of 300 nurses were selected to complete the demographic information form and the learning motivation questionnaire made by the researchers. Data analysis was performed by SPSS software version 25.0 and descriptive and inferential statistical tests.
<strong><em>Results: </em></strong>Mean score of nurse's learning motivation was at the average level (104.6±11.1). Female nurses (104.8±11.4), head nurses (109.0±2.7), married nurses (109.0±11.8), evening shifts workers (107.0±10.4), nurses with master degree (107.5±10.0), nurses with a company employment status (105.2±10.2), nurses with a monthly income more than living expenses (106.6±11.5), and nurses with willingness to work in their current department (209.0±21.9) had the highest motivation scores (P<0.05). The Pearson correlation coefficient test showed that there was a significant relationship between motivation and work shifts per month (r=0.004, P<0.05). In other cases, no significant relationship was seen (P>0.05).
<strong><em>Conclusion: </em></strong>Based on the results, nurses' learning motivation was at a moderate level and characteristics related to the profession (job position, work shift, employment status, financial situation, willingness to work), and individuals (gender, marital status, education level) had the highest means. Therefore, health system employers and managers should pay careful attention to these issues to encourage nurses participating in the in-service training courses.SinaWebMedical Education Bulletin2783-18091220201201Explaining the Challenges of Sex Education in Midwives and General Practitioners: a Qualitative Study11312313860310.22034/meb.2021.310024.1028ENTalat KhadivzadehNursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-7422-65Robab Latifnejad RoudsariNursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-1438-88Masumeh GhazanfarpourStudent Research Committee, Kerman University of Medical Sciences, Kerman, Iran.0000-0003-4639-3711Journal Article20211011<strong><em>Background: </em></strong>Although sexual health assessment is required for health care providers and sexual rights are a human right, only 2% of general practitioners pay attention to the sexual issues of their patients. Most international studies have reported a lack of clinical knowledge and skills in sexual conversations among treatment workers. This study aimed to explore the challenges of sexual education to midwives and general practitioners.
<strong><em>Materials and Methods: </em></strong>This study is qualitatively based. For data analysis, a combination of Hsieh, Shannon, Graneheim, and Lundman methods was used. As part of this study, 14 midwives and 13 general practitioners at the Mashhad University of Medical Sciences were selected through targeted sampling. The data collection methodology was carried out through in-depth, one-on-one, and in-person interviews. The MAXQDA software version 10.0 was used in the data analysis.
<strong><em>Results: </em></strong>In an inductive process, 38 codes were revealed in nine sub-categories, two categories, and a theme. The theme "lack of clinical knowledge and skills regarding women and sex" emerged from the conclusions of the study. Most of the participants indicated a lack of adequate training or poor formal or informal training programs. The participants' experiences in this area consisted of two sub-categories: "inefficiency of informal education programs", and "inefficiency of formal clinical education programs for women and sex".
<strong><em>Conclusion: </em></strong>Barriers to sexual conversation among midwives and general practitioners are associated with inadequate access to effective education programs and ineffective formal education programs at universities.