Background: The World Health Organization (WHO) has considered the ideal rate for cesarean sections to be 10 - 15%. The Iran Ministry of Health introduced the promoting natural childbirth program (PNCP) in 2014 to lower cesarean sections. Objectives: This study presents a model for the implementation of the PNCP. Methods: A mixed study was conducted to determine and prioritize the factors affecting the implementation of PNCP and present a model. We conducted a qualitative study to determine the effective factors of the program by examining the views of 15 gynecologists, anesthesiologists, midwives, and managers in 2019 at Zabol Medical Sciences University. Semi-structured individual and group interviews were used and analyzed with MAXQDA16. In the quantitative phase, a questionnaire of themes was prepared and ranked by 10 experts based on the Likert scale. Then, we used the technique for order performance by similarity to ideal solution with BT TOPSIS solver software to confirm and rank the themes and design a model. Results: The model included six main themes extracted from the qualitative phase. In the quantitative phase, they were approved and prioritized by experts in the following order: 1- Creating a culture for natural childbirth; 2- Strong and committed leadership; 3- Empowerment; 4- Education; 5- Comprehensive support; and 6- Optimization. Conclusions: The model can provide useful insight for policymakers and care providers to make more qualified decisions, determine the status quo, allocate resources, and enforce policies.
Introduction: Given the role of the family in decisions related to the patient’s health, their role in educating the patient should be considered in the health care program. Therefore, the present study was conducted to determine the effect of family-centered education on the care burden of family caregivers of the elderly with cancer. Methods: In this quasi-experimental study, 30 elderly caregivers with cancer were selected and randomly divided into two groups of 15 intervention and 15 control from 1 March 2020 to 1 July 2021. Data collection tools were demographic characteristics questionnaire and care burden questionnaire. The intervention was performed as individual training to caregivers in two one-hour sessions. 6 weeks after the intervention, care burden was measured in both groups. Data were collected and analyzed using PSSS software version 23. Results: According to the independent t-test, before the intervention, there was no significant difference between the mean score of care burden in the intervention and control groups, but after the intervention, the mean score of care burden in the intervention group decreased from 56.93 ±11.08 to 42.93 ± 9.78 and in the control group It changed from 54.27 ± 11.38 to 56.80 ± 11.43 and there was a statistically significant difference in the mean scores of the two groups (P <0.001). Conclusion: Based on the findings of the present study, family-centered education intervention can be effective in reducing the care burden of caregivers of the elderly with cancer in a sample of Iranian society. Therefore, it is predicted that providing such educational services in the health care delivery system is absolutely necessary and effective, and the use of this type of training in nursing activities is recommended.
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