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1.  Comparison of Sexual Problems in Fertile and Infertile Couples 
Journal of Caring Sciences  2017;6(3):269-279.
Introduction: Infertility is known to have a negative effect on couple's life and in most cases it has a profound impact on sexual relations. Sexual problems may be the cause of infertility or may arise as a result of infertility. The aim of this study was to compare the sexual problems in fertile and infertile couples.
Methods: This cross-sectional study was performed on 110 infertile and 110 fertile couples referring to Montaserieh infertility center and five health centers in Mashhad which were selected as class clustering method and easy method. Data collection tools included demographic questionnaires and Golombok-Rust Inventory. The collected information was analyzed by SPSS software and descriptive and inferential statistics.
Results: No significant difference was found between fertile 26 (17, 37) and infertile 26(18, 37) women in terms of total score of sexual problems and other aspects of sexual problems (except infrequency). The women in the fertile group had higher infrequency than infertile women. Total score of sexual problems in fertile men was 18.5 (13, 27) and in infertile men 25 (19, 31) and the difference was statistically significant. Infertile men reported more problems in no relation, impotency and premature ejaculation compared to fertile men. Men in both fertile and infertile group reported more sexual problems than women.
Conclusion: In view of the more frequent sexual problems in infertile men than infertile women, it seems that it is necessary to pay more attention to sexual aspects of infertility in men and design the training programs for sexual and marital skills in infertility centers.
doi:10.15171/jcs.2017.026
PMCID: PMC5618951
Sexual dysfunction; Fertile; Infertile; Couples
2.  Factor structure of the Persian version of general, social, and negative self-consciousness of appearance domains of Derriford Appearance Scale 59: an application in the field of burn injuries 
Background
The Derriford Appearance Scale 59 (DAS59) is a widely used measure of the spectrum of psychological distress and dysfunction that is characteristic of disfigurement. Also, disfigurement due to burn injury leads to feeling guilty or less socially competent, avoiding social situations, suicide, poor self-esteem, sexual difficulties, and depression. Therefore, the purpose of this study was to translate and culturally adapt three subscales of DAS59 into Persian language and to investigate its factor structure for Iranian burned patients.
Method
Translation–back translation of the scale into Persian was done. The internal consistency of the translated scale was evaluated by Cronbach’s alpha. Next, construct validity of the translated instrument was assessed by exploratory factor analysis using principal components and rotation of varimax methods. This research involved a convenience sample of 189 adult burned patients with disfigurement in their face, head, ears, neck, hands, and legs.
Result
The Cronbach’s alpha for overall scale, subscales 1, 2, and 3 were 0.93, 0.93, 0.89, and 0.80, respectively. The best solution from the principal components analysis of the 40 items of the DAS59 revealed three factors corresponding to the three subscales with 20 items: factor 1 (general self-consciousness of appearance) consisted of 9 statements accounting for 33.23% of the variance (eigenvalue =9.23); factor 2 (social self-consciousness of appearance) consisted of 7 statements accounting for 22.91% of the variance (eigenvalue =1.53); and factor 3 (negative self-concept) consisted of 4 statements accounting for 14.98% of the variance (eigenvalue =1.13).
Conclusion
The factor structure of the three subscales of DAS59 provides a widely acceptable, psychometrically robust, factorial self-report scale to assess distress and dysfunction in problems of appearance among Iranian burned patients, and facilitates further research into the efficacy of treatment approaches for problems of appearance and early investigation of therapeutic outcome.
doi:10.2147/NDT.S121250
PMCID: PMC5248938  PMID: 28144145
burns; disfigurement; validity; psychological scale; appearance; Derriford (DAS59)
3.  Investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in breast cancer women under chemotherapy 
Background:
Nausea and vomiting are the worst and the most prevalent complications experienced by 70–80% of patients. Complementary treatments including therapeutic touch are cost-effective and low-risk, independent nursing interventions. Present research aims at investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in these patients.
Materials and Methods:
As a single-blind, randomized clinical trial, the present research was carried out on women with breast cancer undergoing chemotherapy in Isfahan, Iran. The subjects were divided into three groups of control, placebo, and intervention. The intervention was applied to each patient once for 20 min on the aura (human energy field) focusing on solar chakra. Data gathering instruments included demographic questionnaire and acute vomiting intensity scale.
Results:
There was a significant difference among the three groups (and also after the intervention) (P < 0.0001). Paired comparisons among the groups using Mann–Whitney test showed that there was a statistically significant difference between the control group and the intervention group and between the control group and the placebo group (P < 0.0001). However, there was no significant difference between the placebo and intervention groups (P = 0.07).
Conclusions:
Therapeutic touch was effective in reducing vomiting in the intervention group. However, the patients experienced lower-intensity vomiting which may be because of presence of a therapist and probably the reduced anxiety related to an additional intervention. So, further research is recommended considering the placebo group and employing another person in addition to the therapist, who is not skilled for this technique.
doi:10.4103/1735-9066.180373
PMCID: PMC4857659  PMID: 27186202
Breast cancer; chemotherapy; nursing; therapeutic touch; vomiting
4.  Sexual dysfunction in infertile women 
Background:
Sexual problems have different effects on the life of people by influencing their interpersonal and marital relationships and satisfaction. Relationship between sexual dysfunctions and infertility can be mutual. Sexual dysfunction may cause difficulty conceiving but also attempts to conceive, may cause sexual dysfunction.
Objective:
This paper compares sexual dysfunction in fertile and infertile women.
Materials and Methods:
In this cross-sectional study, 110 infertile couples referring to Montasarieh Infertility Clinic and 110 fertile couples referring to five healthcare centers in Mashhad were selected by class cluster sampling method. Data collection tools included demographic questionnaire and Glombok-Rust Inventory of Sexual Satisfaction. Data were analyzed through descriptive and analytical statistical methods by SPSS.
Results:
There was no significant difference in total score of sexual problems and other dimensions of sexual problems (except infrequency) in fertile 28.9 (15.5) and infertile 29.0 (15.4) women. Fertile women had more infrequency than infertile women (p=0.002).
Conclusion:
There was no significant difference between fertile and infertile women in terms of sexual problems. Paying attention to sexual aspects of infertility and presence of programs for training of sexual skills seems necessary for couples.
PMCID: PMC4869159  PMID: 27200422
Sexual problems; Fertile; Infertile; Couples
5.  Effect of self-care education on the quality of life in patients with breast cancer 
Context:
Breast cancer is the most common cancer among Iranian women. Although survival rate of breast cancer patients has been increased some distresses affect the patients’ quality of life negatively. the effectiveness of self-care education, particularly in the sociocultural context of Iran, has not been adequately investigated.
Aims:
This study aims at evaluating the effectiveness of nurse-led self-care education program on quality of life in this patients.
Settings and Design:
A controlled trial as pretest and posttest design was conducted in Sayyed-Al-Shohada Hospital in Isfahan in 2012.
Materials and Methods:
Sixty patients with breast cancer were assigned to either the nurse-led self-care education program (n = 30), or to routine care (n = 30). Quality of life was measured at the time of recruitment and also 3 months after the intervention by the instrument of the National Medical Center and Beckman Research Institute.
Statistical Analysis Used:
Data were analyzed by SPSS (version 16) software using T-independent, T-paired and χ2, and Fisher's exact tests.
Results:
The intervention group had significantly greater improvements in quality of life status (P < 0.05). Furthermore, self-care education caused a significant increase in the quality of life score related to physical (P = 0.00), psychological (P = 0.00), social (P = 0.00), and emotional (P = 0.00) dimensions.
Conclusions:
Quality of life in patients with breast cancer can be improved by participating in a nurse-led self-care education program. It is suggested that self-care education to be added to the routine nursing care delivered to these patients.
doi:10.4103/2277-9531.171782
PMCID: PMC4944611  PMID: 27462612
Breast cancer; quality of life; self-care education
6.  An investigation of the effects of therapeutic touch plan on acute chemotherapy-induced nausea in women with breast cancer in Isfahan, Iran, 2012–2013 
Introduction:
Nausea is the worst and most prevalent chemotherapy-induced complication experienced by 70–80% of patients despite mediation therapy. Reduction of nausea is one of the most important roles of oncologist nurses. Today, complementary therapies in addition to classic medicine, because of their lower costs, receive much attention. Nonetheless, their safety and effectiveness are not yet proven. The purpose of this research was to investigate the effect of therapeutic touch plan as a complementary therapy on acute nausea in women with breast cancer in 2012–2013 in Isfahan, Iran.
Materials and Methods:
A quasi-experimental, single-blind, randomized control trial with three groups (control, placebo and intervention) was performed at the Isfahan Seyedolshohada (AS) Teaching Hospital, Isfahan, in 2012–2013. The intervention was therapeutic touch plan on women with breast cancer, with the three groups receiving the same medicine regimen. Information was recorded by a checklist after infusion of chemotherapy drugs. Data analysis was performed by SPSS, ANOVA and Kruskal–Wallis tests.
Results:
The ANOVA test showed that the therapeutic touch plan was significantly effective in reducing the duration of nausea compared with the control and placebo groups (P < 0.001). The Kruskal–Wallis test showed that the frequency of occurrence of nausea was also reduced in the intervention and placebo groups compared with the control group (P < 0.001). The therapeutic touch plan was significantly effective in delaying the onset of nausea compared with the control and placebo groups (P < 0.001).
Conclusion:
This research showed that the therapeutic touch plan is effective in reducing acute chemotherapy-induced nausea; thus, education and implementation of the therapeutic touch plan is proposed for clinical nurses.
doi:10.4103/2277-9531.162380
PMCID: PMC4579769  PMID: 26430688
Acute nausea; breast cancer; chemotherapy; therapeutic touch
7.  Relationship of Elongated Styloid Process in Digital Panoramic Radiography with Carotid Intima Thickness and Carotid Atheroma in Doppler Ultrasonography in Osteoporotic Females 
Journal of Dentistry  2015;16(2):93-99.
Statement of the Problem
Cardiovascular disease and osteoporosis are major health dilemmas. Osteoporotic patients frequently display vascular calcification that consequently increases the cardiovascular morbidity and mortality.
Purpose
This study aimed to investigate the relation of osteoporosis, vascular calcification (atheroma, intima-media thickness (IMT)) and elongated styloid process (ESP) in a sample of osteoporotic and normal female individuals.
Materials and Method
This study recruited 78 women who were assessed for bone mass density (BMD). Sample included individuals with normal BMD (n=13, 17 %), osteopenia (n=36, 46 %), and osteoporosis (n=29, 37%). The presence of atheroma and IMT was examined using color Doppler ultrasonography (CD-US). In addition, digital panoramic radiographs (PRs) were obtained to assess ESP.
Results
In this study, 55 subjects (70%) with low BMD exhibited at least one side ESP. Femoral BMD decreased significantly in subjects with ESP (p= 0.03). Bilateral ESP was correlated with the presence of atheroma (p= 0.029). The CIMT was greater in patients with ESP, although the relation was not significant.
Conclusion
The obtained data suggest referring the aged individuals with ESP for BMD assessment and individuals with low bone mass and ESP for more cardiovascular risk assessment.
PMCID: PMC4445858  PMID: 26046104
Digital radiography; Panoramic radiography; Carotid intima thickness; Doppler ultrasonography; Carotid atheroma
8.  The effect of pelvic floor muscle exercises program on sexual self-efficacy in primiparous women after delivery 
Background:
Selection and acceptance of appropriate sexual behavior and sexual function are made difficult by low sexual self-efficacy in the postpartum period. The general purpose of this research is to define the effects of an 8-week pelvic floor muscle exercise program on sexual self-efficacy in primiparous women after childbirth.
Materials and Methods:
This clinical trial was performed on 79 primiparous women who referred to health care centers, Mashhad, Iran in 2013, 8 weeks after delivery, to receive health care services. They were selected by easy sampling. The samples were randomly assigned to either intervention or control group. The intervention group was trained in Kegel exercises for 8 weeks. Both groups were evaluated at 4 and 8 weeks. Data collection tools included: Demographic information, sexual self-efficacy, and Brink scale. Data were analyzed using repeated measures, Friedman test, t-test, and Mann–Whitney test.
Results:
The results showed significant increase in pelvic floor muscle strength in the intervention group at 4 and 8 weeks after exercises (P < 0.0001), but no significant difference was observed in the control group (P = 0.368). There was a significant increase in sexual self-efficacy in the intervention (P < 0.0001) and control groups (P = 0.001) at 4 and 8 weeks after the start of the study. Comparison of the two groups showed a significant difference in sexual self-efficacy after they performed these exercises (P = 0.001).
Conclusions:
The findings showed that 8-week pelvic muscle exercises increase the sexual self-efficacy in women after delivery.
PMCID: PMC4462060  PMID: 26120335
Exercises; Iran; pelvic floor; postpartum; self-efficacy; sexual
9.  Management of Epilepsy in Resource-Limited Areas: Establishing an Epilepsy Surgery Program in Iran 
Background Of about 40 million people with epilepsy, who live in developing countries, the majority do not receive appropriate treatment. Nonetheless, there are striking disparities among the so-called developing countries, however generally speaking, access to and availability of epilepsy management programs in developing countries are very limited and therefore, the issue of developing epilepsy centers in resource-limited settings in a large scale is very essential. The surgery for epilepsy, including temporal lobotomy, lesionectomy and corpus colostomy, for patients with medically-refractory seizures, defined as failure of adequate trials of two tolerated, appropriately chosen and using antiepileptic drug to achieve sustained freedom, from seizure has been proved to be feasible and cost-effective in developing countries. However, the success of epilepsy surgery depends upon the accurate identification of good surgical candidates based on the available resources and technologies without jeopardizing safety. In the current paper, we will share our experiences of establishing an epilepsy surgery program in Iran, despite all short-comings and limitations and try to provide some answers to those challenges, which helped us establish our program.
PMCID: PMC4154273  PMID: 25250284
Epilepsy surgery; Developing country; Limited resources; Iran
10.  Iranian Effective Clinical Nurse Instructor evaluation tool: Development and psychometric testing 
Background:
Clinical education is the heart of the nursing education program. Effective nursing clinical instructors are needed for graduating the future qualified nurses. There is a well-developed body of knowledge about the effectiveness of clinical teaching and the instructors. However, translating this knowledge into a context-based evaluation tool for measuring the effectiveness of Iranian clinical nursing instructors remains a deficiency. The purpose of this study is to describe the development and psychometric testing process of an instrument to evaluate the characteristics of Iranian effective clinical nurse instructor.
Materials and Methods:
Following a precise review of Iranian literatures and expert consultation, 83 statements about the characteristics that make clinical nurse instructors effective were extracted. In the next phase, the psychometric properties of the instrument were established by looking at the content validity, face validity, and internal consistency. Content validity of the instrument was assessed based on the comments of an expert panel including 10 nursing faculty members. During this phase, 30 items of the instrument were omitted or merged. Face validity of the instrument was assured based on the advices of 10 nursing students and 10 nursing faculty members. Finally, in the pilot test, the data of 168 filled questionnaires were gathered and analyzed by an exploratory factor analysis to reduce the items and identify the factor structure of the instrument.
Results:
Through subsequent analyses, of the 83 items, 31 items were merged or omitted. At last, 52 retained items were divided into four subscales including student-centric behaviors, clinical performances, planning ability, and personality traits. The Cronbach's alpha level of the inventory was 0.96, with the value for each domain ranging from 0.87 to 0.94.
Conclusions:
Iranian Effective Clinical Nurse Instructor evaluation tool has acceptable psychometric properties and can be used in evaluating the effectiveness of clinical nursing instructors.
PMCID: PMC4020021  PMID: 24834081
Clinical education; effective instructor; evaluation tool; Iran; nursing
11.  Proposing a syllabus for the operation room B.S. courses in Iran 
BACKGROUND:
Education is based upon the knowledge, skills, and attitudes that are required for an occupation, and the changes occurring in the occupations and duties as well as in the ideals and values necessitate constant needs analysis. Furthermore, owing to the transformations in sciences, especially medical sciences, the current syllabus for the operation room courses at associate level will not meet the requirements for operation room personnel in future. Therefore, the syllabus for operation room B.S. was developed and proposed in a research project entitled “Study of the international syllabus for the operation room courses and proposing an appropriate syllabus for the courses in Iran.” Since the operation room courses at B.S. level are supposed to be introduced in Iranian universities, we intended to learn about the opinions of other people related to this subject in Iran.
METHODS:
In this research, a questionnaire was used that contained the syllabus proposed for the operation room B.S. courses, which was the result of a research project entitled “Study of the international syllabus for the operation room courses and proposing an appropriate syllabus for the courses in Iran.” To develop this syllabus, 12 heads of the operation room departments in universities across Iran in which the subject matter was being taught at associate level were consulted.
RESULTS:
The study showed that 14 out of the 53 courses proposed in the syllabus had a desirability level of 100%, 22 courses were desirable at levels of 91-100%, 19 were 75-90% desirable, and no courses had a desirability level less than 75%. After carrying out some modifications to the syllabus, the problems were resolved and the opinions were again asked. When a consensus of greater than 70% was reached, the syllabus for the operation room courses at B.S. level was finalized and proposed. The regulations from the Development, Planning, and Evaluation Office of the Ministry of Health were also followed.
CONCLUSIONS:
Although all the courses showed a desirability level of greater than 70%, receiving appropriate suggestions about some courses led the research team to carry out major or minor modifications to some of the courses.
PMCID: PMC3208936  PMID: 22069405
Syllabus; surgery technologist; Delphi technique
12.  Comparing the effects of reflexology methods and Ibuprofen administration on dysmenorrhea in female students of Isfahan University of Medical Sciences 
BACKGROUND:
Dysmenorrhea or menstrual pain is one of the most common disorders experienced by 50% of women in their reproductive age. Adverse effects of medical treatments and its failure rate of 20-25% have caused many women to seek other complementary and alternative treatment methods for primary dysmenorrhea. Hence, this study aimed to compare and determine the efficacy of reflexology and Ibuprofen on reduction of pain intensity and duration of menstrual pain.
METHODS:
This was a quasi-experimental clinical trial study on 68 students with primary dysmenorrhea living in Isfahan University of Medical Sciences’ dormitories. Simple random sampling was done considering the inclusion criteria and then the students were randomly divided into two groups. In the reflexology group, the subjects received 10 reflexology sessions (40 minutes each) in two consecutive mense cycles. The Ibuprofen group received Ibuprofen (400 mg), once every eight hours for 3 days during 3 consecutive mense cycles. To assess the severity of dysmenorrhea, Standard McGill Pain Questionnaire, visual analog scale (VAS) and pain rating index (PRI) were used in this study.
RESULTS:
Findings of the study showed that the two groups had no statistically significant difference in terms of demographic characteristics (p > 0.05). Reflexology method was associated with more reduction of intensity and duration of menstrual pain in comparison with Ibuprofen therapy. Independent and Paired t-test showed that there was a significant difference in the two groups between intensity and duration of menstrual pain using VAS and PRI in each of the 3 cycles between reflexology and Ibuprofen groups (p < 0.05).
CONCLUSIONS:
Considering the results of the study, reflexology was superior to Ibuprofen on reducing dysmenorrhea and its treatment effect continued even after discontinuing the intervention in the third cycle. Therefore, considering that reflexology is a non-invasive, easy and cheap technique, it seems that it can replace anti-inflammatory drugs (NSAIDs) to avoid their adverse side effects.
PMCID: PMC3208937  PMID: 22069413
Primary dysmenorrhea; reflexology; ibuprofen; McGill pain questionnaire scale
13.  Effects of two educational method of lecturing and role playing on knowledge and performance of high school students in first aid at emergency scene 
BACKGROUND:
This study aimed to investigate the effects of two educational methods on students' knowledge and performance regarding first aid at emergency scenes.
METHODS:
In this semi-experimental study, the sample was selected randomly among male and female public high school students of Isfahan. Each group included 60 students. At first the knowledge and performance of students in first aid at emergency scene was assessed using a researcher-made questionnaire. Then necessary education was provided to the students within 10 sessions of two hours by lecturing and role playing. The students' knowledge and performance was as-sessed again and the results were compared.
RESULTS:
It was no significant relationship between the frequency distribution of students' age, major and knowledge and performance before the educational course in the two groups. The score of knowledge in performing CPR, using proper way to bandage, immobilizing the injured area, and proper ways of carrying injured person after the education was significantly increased in both groups. Moreover, the performance in proper way to bandage, immobilizing injured area and proper ways of carrying injured person after educational course was significantly higher in playing role group compared to lecturing group after education.
CONCLUSIONS:
Iran is a developing country with a young generation and it is a country with high risk of natural disasters; so, providing necessary education with more effective methods can be effective in reducing mortality and morbidity due to lack of first aid care in crucial moments. Training with playing role is suggested for this purpose.
PMCID: PMC3093028  PMID: 21589743
Speech; role playing; accidents; emergencies
14.  Effects of therapeutic touch on the vital signs of patients before coronary artery bypass graft surgery 
BACKGROUND:
Currently healthy heart word considered to be the objective of community health applications in many countries of the world because cardiovascular diseases are the most important factor in mortality of humans, worldwide. Coronary artery bypass graft surgery is one of the most common surgery procedures for these patients. The purpose of this study is to assess the impact of therapeutic touch on medical vital signs of patients before coronary artery bypass graft surgery.
METHODS:
The present study is a clinical trial with 44 samples that were selected by easy sampling method and based on two separate lists of random numbers for both men and women; they were divided into two groups. In the therapeutic touch group, intervention therapy was applied on patents for 20 minutes. Data was analyzed using descriptive and inferential statistics.
RESULTS:
Test results showed that there was a significant difference between the mean pulse rate before and after intervention in both groups (p < 0.001). Results also showed that there was a significant difference between the average number of breathing before and after intervention in both groups (p < 0.001).
CONCLUSIONS:
Considering the effects of therapeutic touch therapy as a safe and effective intervention on the patients which were revealed in this study, this technique can be used as a simple, cheap and applicable technique in all health care centers to help these patients.
PMCID: PMC3093033  PMID: 21589748
Blood pressure; coronary artery bypass; pulse; therapeutic touch

Results 1-14 (14)