No abstract

Childbirth is a great moment in a woman's life and is inevitably influenced by emotional, social, and psychological stress. This study aimed to assess the anxiety and pain level of nulliparous women giving birth using physiological methods (without doula support) during labor and those women supported by a doula at Towhid Hospital of Jam, Bushehr, Iran in 2015. In this interventional study, 150 women were randomly assigned to either an intervention (with doula support) or a control group (with no doula support). The intrapartum, postpartum, and hidden anxiety levels were measured using Spielberger standard questionnaire used for assessing anxiety. The labor pain rate was evaluated using McGill questionnaire. Results showed that the average rate of obvious anxiety during labor was 57.76 ± 9.57 in physiological delivery (without doula) and 48.04 ± 9.61 in doula-supported delivery. The difference between mean scores of obvious anxiety during labor was significant. The mean anxiety of the control group (who did not receive doula support) was higher (P = .000). Also, the difference between the mean labor pain scores of the 2 groups was statistically significant. The results of the study showed that doula's presence has positive significant effects on labor pain and anxiety reduction; also, doula-supported mothers reported considerably lower pain and anxiety compared with those experiencing physiological delivery (without doula). Thus, the increased use of doula in hospitals all over the country is recommended.

Nurses are the largest group and an important part of the providers in the health care systems that who a key role in hospitals. Any defect and deficiency in their work can result in irreversible outcomes. This study aimed to determine the effect of supervisors' support and mediating factors on the job performance (JOBPER) of 400 nurses working in the teaching hospitals affiliated to Shiraz University of Medical Sciences, using structural equation modeling. The results showed that the supervisor's support had a significant negative effect on work-family conflict (t = -2.57) and a positive effect on organizational commitment (t = 4.03); Work-family conflict had a significant positive effect on job stress (t = 11.24) and a negative effect on organizational commitment (t = -3.35) and JOBPER (t = -2.29). Family-work conflict had a positive effect on job stress (t = 4.48) and a negative effect on organizational commitment (t = -2.54). Finally, job stress had a negative effect (t = -3.30), and organizational commitment showed a positive effect (t = 5.96) on the studied nurses' JOBPER. According to the results, supervisor's support could influence JOBPER through reducing work-family conflict and increasing organizational commitment. Therefore, to improve the nurses' JOBPER in the hospitals, some strategies are recommended.