Journal of Education and Health Promotion

Abstract INTRODUCTION: Reporting medical errors is one of the common methods for identifying and
preventing mistakes in‑hospital care. This study was conducted to identify the status of reporting
and related factors in two groups of midwives and midwifery students.
METHODOLOGY: This research was analytic correlational; it was conducted among all the midwives
working in the midwifery and labor departments and midwifery students in Isfahan University of
Medical Sciences. The data collection tool included a checklist of errors and the researcher‑construed
questionnaires of awareness and attitude toward reporting errors. The results were examined using
descriptive and inferential statistics (ANOVA, Pearson and Spearman correlation coefficient, and
independent t‑test) by SPSS software version 20.
RESULTS: In this research, the error reporting in midwifery staff was 79.1% and the most frequent
error was related to the patient’s process of testing; the error reporting among the students was
90% and the most frequent error occurred in the labor processes. The present study also showed
that there was a direct relationship between awareness and attitude toward reporting medical
errors (P < 0.001), while there was not a significant relationship between the midwifery students’
awareness and attitude toward reporting the medical errors (P = 0.31).
CONCLUSION: According to the study, hospital midwives reporting is less than midwifery students.
Accordingly, it is recommended to focus on the error and risk management committee to strengthen
the reporting system.

Abstract INTRODUCTION: Prenatal care refers to proper and principled implementation aimed at maintaining
a healthy pregnancy in terms of physical health and favorable psychological outcomes for the
mother, infant, and family. The adequacy of prenatal care is an important indicator in predicting infant
and maternal mortality. Mental health components such as hope and happiness can influence the
quality of prenatal care. The aim of this study was to determine the relationship between hope and
happiness with prenatal care.
METHODS: This is a cross‑sectional study that was performed on 200 pregnant mothers referred
to Isfahan, Iran, comprehensive health centers in 2018 using an available sampling method. The
research instrument was a questionnaire of hope, happiness, and quality of prenatal care that was
completed by qualified people. The data were analyzed by descriptive and analytical statistical
methods (Pearson correlation).
RESULTS: The results of this study showed that there is a significant relationship between the
adequacy of care and overall hope score (P = 0.032). There was also a positive and significant
relationship between the adequacy of care and the subscales of hope (thinking [P = 0.002] and
path [P = 0.004]). There was a positive and significant relationship between the adequacy of prenatal
care and overall happiness score (P = 0.03). Positive emotion subscale (P = 0.033) had a significant
positive correlation and negative emotion subscale (P = 0.001) had a significant negative relationship
with the adequacy of prenatal care.
CONCLUSION: According to the results, mental health can affect the quality of prenatal care. As a
result, health providers to pregnant mothers can improve the adequacy of prenatal care by examining
pregnant women in terms of these two issues, thereby improving the health of themselves and their
children, and ultimately, community health.

Abstract INTRODUCTION: Investigating severe maternal morbidity and near‑miss cases are applied
internationally as a new indicator to examine the quality of maternal care and as an effective strategy
to reduce maternal mortality. This study aimed to determine the root causes of severe maternal
morbidity in order to improve maternal health.
MATERIALS AND METHODS: The present research is a descriptive case series study. The data was
obtained from the hospital and health records of mothers admitted to hospitals affiliated to Isfahan
University of Medical Sciences due to severe morbidity in the first 6 months of 2018, which were
selected randomly. The data collection was completed by interviews with the mentioned mothers and
14 related health‑care staffs and that led to the development of the morbidity story. The compiled
story of each case was evaluated by the root analysis team’s opinion. Causes of morbidity were
determined according to a root cause analysis checklist composing of factors such as health‑care
services (human and structural factors), family‑social status, and disease status of maternal morbidity.
RESULTS: The findings indicated that human factors related to the health system led to severe
maternal morbidity more than any cause. Inadequate knowledge and skills of service providers,
disregard for guidelines and protocols, lack of teamworking, and lack of considering competency
were the most important human factors. Disease condition, family, and social status were the other
related factors, respectively.
CONCLUSION: Human factors are the most important cause of maternal morbidity based on the
results of this study. Therefore, modifying the health structure can be one of the most important
reducing factors for maternal mortality in order to improve the services for these individuals.

Abstract INTRODUCTION: Mental health is very important during pregnancy, and perfectionism, body image,
and eating disorder are three important factors in mental health. Given that eating disorders are very
dangerous in pregnancy, the aim of this study was to determine the relationship between perfectionism
and body image with eating disorder in pregnancy.
METHODS: This descriptive study was performed on 200 pregnant women referred to Isfahan Health
Centers in 2017. The research units, if met the inclusion criteria, completed the Eating Attitudes
Questionnaire, Multidimensional Relationships of their Body Questionnaire, and Perfectionism
Questionnaire. Finally, the data were analyzed by SPSS software version 22, with a significance
level of 0.05.
RESULTS: The results showed that there was a significant negative relationship between positive
perfectionism with symptoms of eating disorder, anorexia nervosa, and nervous longing to eat.
There was a significant positive correlation between negative perfectionism with symptoms of eating
disorder, anorexia nervosa, and nervous longing to eat. The results also showed a significant negative
relationship between body image and its dimensions with symptoms of eating disorder, anorexia
nervosa, and neurasthenia.
CONCLUSION: Perfectionism and body image and its dimensions are psychological problems related
to eating disorder in pregnancy. For this reason, it seems that taking classes for pregnant women
and their spouses can reduce the incidence of this disorder.

Abstract INTRODUCTION: The healthcare program has opponents and supporters with its multiple policies
and also its difficult implementation, which requires that its barriers and problems be addressed
comprehensively and extensively. This study was conducted aimed to determine the service
provision challenges by healthcare providers, from their point of view, in selected comprehensive
health centers of Isfahan.
MATERIALS AND METHODS: The present study is a descriptive‑analytic one. One‑hundred
and ninety‑seven healthcare providers were selected by census sampling method from the
population of female healthcare providers in Isfahan comprehensive health centers in 2017. The
data collection tool was a researcher‑made questionnaire in the field of individual–professional,
managerial–organizational, and executive challenges. Data analysis was done by repeated measures
ANOVA and post hoc test.
RESULTS: The findings indicated that there was a significant difference between the mean score
of individual–professional, managerial–organizational, and executive challenges (P < 0.001) from
the point of view of healthcare providers. According to least significant difference post hoc test, the
mean score of individual challenges was significantly lower than that of managerial and executive
challenges (P < 0.001). However, there was no significant difference between the mean score of
managerial–organizational and executive challenges (P = 0.46).
CONCLUSION: Based on the results, healthcare providers have put forward several challenges during
the implementation of the healthcare program. Meanwhile, executive and managerial challenges
have been considered more than individual challenges. Considering that this could lead to improper
service provision to the clients, the role of policymakers in this program to remove obstacles and to
provide satisfaction to healthcare providers is emphasized.

Abstract INTRODUCTION: Mental health is one of the focuses of the health assessment of different
communities and plays an important role in ensuring the dynamism and efficiency of each community.
Pregnancy is one of the most sensitive periods, in which mental health is effective. The mental health
of individuals is the result of the interaction of cognitive‑emotional ordering strategies and proper
evaluation of stressful situations. The aim of this study was to determine the relationship between
cognitive emotion regulation and the health of pregnant women.
MATERIALS AND METHODS: This is a descriptive and cross‑sectional study that was carried out on
200 pregnant women who were covered by Navab, Amir Hamzeh and Motahari centers in Isfahan in
2017 by available sampling method. The instrument was the Beck Depression Inventory, Goldenberg
Health, and Emotional Cognitive Order. Finally, the data were analyzed using the SPSS software.
RESULTS: The mean age of pregnant mothers participating in the study was 26.66 ±6.09 years. The results
of data analysis showed a significant positive correlation in relation to blaming others and disaster with
physical health, blaming others and rumination and catastrophes with anxiety, disaster with social health,
blaming others and rumination and catastrophes with depression, and also blaming others and rumination,
catastrophizing, and positive re‑focusing have a significant positive correlation with total health score.
CONCLUSION: Regarding the relationship between mental health and cognitive dysmenorrhea
during pregnancy, pregnant women carers can help with pregnant women by conducting educational
programs on health promotion and strive to maintain mental health and improve their quality of life.
Consequently, they will ensure the mental health of their future children.

Abstract BACKGROUND AND OBJECTIVES: Hypertension in pregnancy is one of the most important
unsolved problems in midwifery, and since it is the main cause of maternal death, preventive
intervention measures are essential to control this serious complication. This study aimed to determine
the effect of walking on gestational hypertension disorders in women prone to hypertension.
MATERIALS AND METHODS: This randomized clinical trial was conducted on 72 pregnant women
susceptible to gestational hypertension who were randomly (through a random number table)
assigned into two groups of 36. The pregnant women in the experimental group had walking program
for 20–30 min from weeks 14–34, four times a week. Data were analyzed, via independent t‑test,
Fisher’s exact test, and Chi‑square test.
RESULTS: The results indicated that in the experimental group, 2 cases with transient gestational
hypertension and 1 case of preeclampsia existed, and in the control group, 9 pregnant women
were with gestational hypertension and 4 pregnant women were with preeclampsia. Therefore, the
incidence of these two complications in the experimental group was significantly lower than the control
group (P < 0.05). Moreover, the mean systolic and diastolic blood pressures in the experimental
group were significantly lower than the control group (P < 0.05).
CONCLUSION: Based on the results, the moderate walking, as an easy physical activity, is
recommended for pregnant women susceptible to pregnancy hypertension.