Cognitive behavioral counselling in post abortion grief: A randomized controlled trial.

BACKGROUND: Abortion is can led to certain psychological problems that may decreased self-esteem, and concerns about future fertility. Abortions have multiple psychological consequences such as grief, anxiety, depression, and post-traumatic stress. The purpose of this study is to examine the effect of cognitive behavioral counseling intervention on women in post-abortion period. MATERIAL AND METHODS: This research was a randomized, controlled trial study that was conducted on 168 women during the post-abortion period at the Khalill Azad Center of Larestan (Iran), where the women were selected randomly from February 2019 to January 2020. Data were collected using post-abortion grief questionnaire. All women in the post-abortion period answered the perinatal grief scale questions at the beginning of the intervention, immediately after the intervention and three months after the end of the intervention. Data were analyzed through descriptive statistics and repeated measures analysis of variance (ANOVA) with time and group were used to evaluate the effect of intervention. RESULTS: By using repeated measures ANOVA, the comparison of the mean score of grief in the two groups indicated that the scores decreased over time and it was lower in the intervention group. The mean score of grief between the intervention and control groups at the end of the intervention was 67.59 ± 13.21 and 75.42 ± 12.7, respectively (P < 0.001). Mean post-abortion grief score in the intervention and control groups three months after the intervention were 59.41 ± 13.71 and 69.32 ± 12.45, respectively (P < 0.001). CONCLUSION: According to results of this study, it can be concluded that the use of cognitive behavioral counselling can reduce post-abortion grief intensity or prevent the occurrence of complicated grief. Therefore, this method can be used as a preventive or therapeutic approach to control post-abortion grief and other psychological disorders.

Men's knowledge of preconception health: A systematic review.

Preconception health is defined as the physical and psychological well-being of women and men throughout their reproductive life. It is a method that raises healthy fertility and focuses on activities that persons can take to minimize risks, raise healthy lifestyles, and increase preparation for pregnancy. The purpose of this systematic review study was to assess men's knowledge of preconception health. Electronic databases, including Web of Science, PubMed, Scopus, Sciencedirect, ProQuest, Cochrane, SAGE, Springer, Google Scholar, were searched for published studies from 2000 to March 2021 to identify the studies carried out on men's knowledge of preconception health. The quality assessment was done using the critical appraisal skills program tool for qualitative studies and the Newcastle-Ottawa scale for cross-sectional studies. Of the 1195 references identified in the initial search, 11 studies met the inclusion criteria. Because of the diversity in the study design and the data collection tools used in studies, meta-analysis was impossible. All the studies of the present systematic review found that men's preconception health knowledge is poor. This systematic review showed that men's preconception health knowledge is low. Due to the limited studies of men's knowledge about the importance of optimizing their health before pregnancy, further study of the issue is still required.

Exploring the reproductive health needs of men in the preconception period: A qualitative study.

BACKGROUND: Male reproductive health is a necessary pillar of childbearing. If a reproductive health assessment is conducted in the preconception period, the chance of a healthy pregnancy can increase. This qualitative study aimed to explore men's reproductive health needs before conception in Iran. MATERIALS AND METHODS: This research was a qualitative study conducted in Bushehr city, Iran to explore men's reproductive health needs from April 2021 to November 2021. 30 semistructured interviews were conducted with married men, women, healthcare providers, and specialists individually in the health centers. The sampling method used in this study was purpose-based with maximum variety. All interviews were digitally recorded and transcribed verbatim in Persian and analyzed using directional content analysis. MAXQDA software version 12 was used to facilitate data analysis. RESULTS: From the data analysis, 2 themes, 15 categories, and 38 subcategories emerged. The themes included evaluation and health promotion recommendations. It consisted of 10 categories: reproductive life plan evaluation, medical history evaluation, family and genetic history evaluation, social history evaluation, sexual health evaluation, medication evaluation, laboratory evaluation, physical examination, lifestyle evaluation, and mental health evaluation. Health promotion recommendations included five categories: nutritional recommendations, stress management, avoiding harmful behaviors, protective measures against harmful exposure, and need for education. CONCLUSIONS: Our results showed that men need a comprehensive evaluation of reproductive health and recommendations to improve their health in the preconception period. Our study findings can inform healthcare providers to increase men's participation in reproductive health.

Design and psychometric properties of a questionnaire for assessing sexual and reproductive health needs of married adolescent women: an exploratory sequential mixed methods study.

To date, there is no valid and reliable instrument to specifically evaluate married adolescent women's sexual and reproductive health (SRH) needs. Hence, the aim of this study was to develop and evaluate the psychometric properties of a questionnaire for assessing married adolescent women (MAW)'s SRH needs. The current exploratory sequential mixed method study was performed in two phases. In the first phase, a preliminary questionnaire was developed based on in-depth interviews with 34 MAW and four key informants as well as a comprehensive literature review. In the second phase, validity of the questionnaire was assessed using face, content, and construct validity and reliability of the questionnaire was assessed using internal consistency and test-retest reliability. Based on qualitative content analysis and literature review, 137 items were extracted. After several modifications of the generated items, a 108-item questionnaire was prepared for the psychometric process. After checking face and content validity, 85 items remained in the study. In the exploratory factor analysis, 11 items were removed and the remaining 74 items were categorised into nine factors. Cronbach's alpha coefficient and the intraclass correlation coefficient were found to be 0.878 and 0.99 for the whole scale, respectively.Impact StatementWhat is already known on this subject? Sexual and reproductive health (SRH) needs of married adolescent women (MAW) are different from those of married adult women or unmarried, sexually active adolescents. However, there are to date no valid and reliable instruments to specifically evaluate the SRH needs of this group of women.What do the results of this study add? The final version of questionnaire consists of 74 items in nine domains including need to improve MAW's sexual quality of life, promote MAW's SRH self-care, improve MAW's SRH self-efficacy, increase MAW's SRH knowledge, increase husband's involvement in MAW's SRH, improve the performance of health care providers, strengthen the family support to married adolescent women, improve family involvement in SRH education of MAW, and provide specific premarital counselling to MAW.What are the implications of these findings for clinical practice and/or future research? The 74-item questionnaire has acceptable validity and reliability. Therefore, it can be used by researchers and policymakers as an appropriate instrument for assessing MAW's SRH needs.

Effectiveness of aromatherapy in reducing duration of labour: a systematic review.

Childbirth is one of the most important events in woman's life. Different methods are typically used for labour augmentation. Aromatherapy is one of the complementary methods. The present systematic review evaluated the efficacy of aromatherapy in reducing the duration of labour. A systematic search of all clinical trials studies on Cochrane, Scopus, Web of Science, PubMed, ProQuest, Google scholar, Irandoc, Science direct, Magiran and Sid was performed up to September 2021. A total of 22 articles met the inclusion criteria and 3234 women used a variety of aromatherapies. Results showed that some aromatherapies, such as lavender was almost effective in reducing length of labour. Results suggest that some aromatherapy can be an effective, inexpensive and holistic method of reducing the duration of labour but it should be used with caution.

The solutions to increase the participation of men in sexual and reproductive health of women in Iran: an analytic hierarchy process (AHP) analysis.

Ever since the Cairo Declaration in 1994, women's Sexual and Reproductive Health (SRH) has become a priority and substantial efforts have been made to improve it. Men's contribution to promote the SRH of women is essential. Therefore, this study aimed to identify the best solutions to increase the men's participation in the SRH of women in Iran, using an analytic hierarchy process (AHP) approach. A cross-sectional study was conducted among 150 married men in Iran. The data was collected using a questionnaire. To determine the best solutions to improve the men's participation in women's SRH, the opinions of an expert group from academia, Ministry of Health (MOH) were employed and the best solution were selected based on the scores, applying analytic hierarchy process (AHP) approach. The statistical analysis was performed using SPSS V.20 and Expert Choice software. In the final analysis 'Well-oriented sex education focused on men's involvement', 'Well-trained professional employment' and 'Sex education in society, schools, and universities' were the solutions with highest coefficients, respectively.Impact statementWhat is already known on this subject? SRH of women, is a major part of primary efforts regarding the increase of SRH's quality; among which, the role and place of men is of utmost importance. Struggling to participate men in issues related to the health of women can not only promote inter family relationships, but also can affect the quality of relationship between man and woman in the society.What do the results of this study add? According to results of the study, one of the main obstacles of men participation was educational and information barriers, regarding which, having adjusted and improved educational systems, opportunity could be prepared for men participation. Current centres for educating those who are already getting married are the first and main places where men can be educated to meet their educational needs in their marriage life such as SRH. Through integrating three selected approaches in the experts' meetings in the educational program of before marriage, men participation can be increased in SRH.What are the implications of these findings for clinical practice and/or future research? The findings could inform and guide the policies in formulating effective solutions to improve the men's participation in SRH in Iran.

Health information needs, sources of information, and barriers to accessing health information among pregnant women: a systematic review of research.

INTRODUCTION: Awareness of health information needs, sources of health information, and barriers to accessing health information among pregnant women is critical for the development of health interventions and provides high-quality prenatal care for them. Hence, the aim of this review study was to summarize evidence from studies evaluating health information needs, sources of information and barriers to accessing health information of women during pregnancy. METHODS: A systematic literature search was conducted using Web of Science, Scopus, PubMed, ScienceDirect, and Google Scholar for relevant studies published between 1 January 2000 and 24 May 2018. The methodological quality of cross-sectional studies was assessed using the STROBE checklist. The Critical Appraisal Skills Programme (CASP, 2018) was used to appraise the qualitative studies. Data were analyzed descriptively. RESULTS: Thirty-one studies from 14 countries met criteria for inclusion in this review. The majority of articles focused on information needs and sources of information used by women during pregnancy. The most common information needs among women during pregnancy were information about unborn child, nutrition, and labor/delivery. The most frequent information source used by women during pregnancy was health professionals followed by informal source (family and friends), and Internet. The most prominent barriers to information access included the following: feeling ashamed or embarrassed to talk about pregnancy-related issues, long waiting times at clinic to see a health provider, and lack of adequate information resources. CONCLUSIONS: Due to the limited number of studies examining barriers to health information seeking among pregnant women, further research is warranted. Further qualitative research is also recommended to explore pregnant women's perceptions of, and satisfaction with the use of health information sources.

Perceived Barriers to Accessing Pregnancy-Related Health Information Among Married Adolescent Women: A Qualitative Study in Iran.

STUDY OBJECTIVE: To date, no study has reported barriers to accessing pregnancy-related health information among married women younger than the age of 19 years. Indeed, the voice of the girls being married is absent in the literature. We sought to explore the barriers to accessing pregnancy-related health information from the perspective of Iranian married adolescent women. DESIGN: Qualitative study. SETTING: The research was conducted in Mashhad city (health care centers) and Shahrood County (a maternity teaching hospital, and urban/rural health care centers) in Iran. PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Twenty-four married adolescent women aged 14-19 years were recruited through purposive sampling. Individual in-depth interviews were tape-recorded, transcribed verbatim, and analyzed using conventional content analysis. Prolonged engagement with participants, maximum-variation sampling, member checking, peer deferring, and external audit were used to enhance the rigor of the study. RESULTS: The results showed 3 categories: "structural barriers," "individual barriers," and "sociocultural barriers." The structural barriers category consisted of 2 subcategories, namely, poor quality of education and counseling in the health care centers, and transportation barriers. The 2 subcategories of the individual barriers category consisted of affective barriers and cognitive barriers. The sociocultural barriers category included the following 2 subcategories: husband's decision-making power and fear of being labeled infertile. CONCLUSION: The barriers identified in this study should be considered when designing educational interventions for married adolescent women. Moreover, further research is needed to enhance current knowledge on this topic.

A Systematic Review on the Anxiolytic Effect of Aromatherapy during the First Stage of Labor.

Introduction: Anxiety is the most common psychological response of women to labor. The aim of the present systematic review was to evaluate and summarize the available clinical evidence on the anxiolytic effects of aromatherapy during the first stage of labor. Methods: Electronic databases including: Cochrane Library, MEDLINE/ PubMed, Scopus, CINAHL, SID, Iran Doc, ProQuest, and Google Scholar were searched up to Sep10, 2017 with the keywords of 'aroma*', 'aromatherapy', 'essential oil', 'anxiety', and ' labor '. The risk of bias in the included studies was assessed using the Cochrane Collaboration's 'Risk of bias' tool. The results were reported qualitatively. Results: A total of 14 published papers and 2 unpublished papers were retrieved which met the inclusion criteria. The studies were conducted in Iran, Egypt, Korea, and Italy. Essential oils had been used were lavender in 5 articles, rose, clary sage, geranium and frankincense in 3 articles, chamomile, bitter orange, sweet orange and peppermint in 2 articles, mandarin orange, jasmine and clove in 1 article. A majority of the studies suggested a positive effect of aromatherapy in reducing women's anxiety during the first stage of labor. Conclusion: It is recommended that aromatherapy could be applied as a complementary therapy for reducing anxiety during the first stage of labor, but methodologically rigorous studies should be conducted in this area.

The relationship between semen parameters in processed and unprocessed semen with intrauterine insemination success rates

Objective: To evaluate the relationship between semen parameters and intrauterine insemination (IUI) success rates. Material and Methods: This retrospective study was conducted during a 4-year period (2011-2015) on the medical records of 350 couples admitted to the infertility center of Beast Hospital in Tehran. The participants' data such as age, duration of infertility, semen parameters [including volume, concentration, motility, normal morphology and total motile sperm count (TMSC)] before and after sperm processing, as well as the IUI results were extracted from the patients' records. Only the first IUI cycle of the couples was considered. The main outcome criterion for the IUI success was serum positive beta human chorionic gonadtotropin 14 days after IUI. The collected data were analyzed using the Mann-Whitney U test, chi-square, and Fisher's exact tests. Results: The overall pregnancy rate for each couple was reported as 23.42% (82/350). There was no significant difference in the mean age of the couple and infertility duration between the groups who achieved pregnancy and those who failed. The two groups showed no significant differences in pre and post processing of semen parameters (including volume, concentration and TMSC). Sperm motility and normal sperm morphology before and after sperm processing were significantly different between the two groups, respectively (p=0.023 before sperm processing and p=0.032 after) (p=0.032 before sperm processing and p=0.007 after). Conclusion: Sperm motility and normal sperm morphology have an effect in IUI success.

The effect of gender-role orientation on attitudes towards menstruation in a sample of female university students

Objective: To examine the effect of gender role orientation on attitudes towards menstruation in a sample of Iranian female students of medical sciences. Material and Methods: Three hundred female university students (94%; response rate: 282) were enrolled in the study via stratified random sampling. Data were collected using a demographic questionnaire, the Menstrual Attitude Questionnaire (MAQ), and the short version of the Bem Sex Role Inventory (BSRI). Data were analyzed using SPSS v.18. Analyses were performed using the Kruskal-Wallis test and the Mann-Whitney U test. Results: The mean scores of the MAQ subscales ranged from 3.7±1.35 to 5.6±1.3, indicating that most of the respondents had natural to moderate attitudes toward menstruation. When participants were classified into one of four gender-role categories of BSRI, the results showed that the undifferentiated group with 33.7% was higher than other gender-role groups. The undifferentiated group was significantly less likely than the other groups to perceive "menstruation as a natural event". Conclusion: The study shows an association between gender-role orientation and attitudes toward menstruation in female university students. However, further research is still necessary in this issue.

Do Breathing Techniques Enhance the Effect of Massage Therapy in Reducing the Length of Labor or not? a Randomized Clinical Trial.

Introduction: Prolonged labor is a common birth complication that is associated with some negative maternal and fetal effects. The aims of this study were 1) to evaluate the effect of effleurage abdominal massage and 2) to assess the effects size of breathing techniques with massage on the length of labor. Methods: This study was a randomized trial with concealed allocation, assessor blinding for some outcomes and intent-to-treat analysis. Primiparous women (n=117) age 18-35 years who were randomly assigned to three groups; abdominal massage (n=37), abdominal massage with breathing technique (n=38) and control (n=42). Although it was randomized block design with the allocation ratio 1:1:1 but soon after the sample was withdrawn in labor, another was replaced. Experimental groups' participants received a 30-min effleurage abdominal massage during the active and transitional phases of labor. Particular breathing techniques in each stage of labor were done. Data were analyzed using SPSS ver.13. Results: Duration of the active phase was 244.89(83.30) min in the massage, 254(68.55) min in massage with breathing and 312.07(67.17) min in control group, which was significantly different between the massage and control groups (P<0.001, Min Diff; -67.18), as well as massage with breathing and control groups (P=0.003, Min Diff; -9.63). The Scheffe test showed no significant difference between the two experimental groups. Conclusion: Effleurage abdominal massages decrease length of active phase on labor, but the learning of breathing techniques in labor couldn't enhance this effect of massage, so it is likely that breathing exercises may be considered during pregnancy.

The Role of Lifestyle in Developing and Maintaining Vasomotor Symptoms: A Cross-Sectional Study among Iranian Postmenopausal Women.

OBJECTIVE: Lifestyle patterns are not only related to healthy life but also could be related to modifying menopausal symptoms. Considering the lack of data, the present study aimed to evaluate the relationship between lifestyle and vasomotor symptoms among Iranian postmenopausal women. MATERIALS AND METHODS: The present cross-sectional questionnaire-based study was conducted among 302 eligible postmenopausal women referring to Shahroud health centers (Shahroud, Iran) during June 2017 and October 2018. The Iranian standard questionnaire on women health project (Saba questionnaire) was used for data collection. Our data were analyzed using the SPSS software (version 18). Descriptive statistics, Chi-square test, Fisher's exact test, and multiple logistic regression were used to address sociodemographic characteristics among our participants and the relations between lifestyle and vasomotor symptoms. RESULTS: We found a significant relation between daily dairy units (P = 0.05), daily vegetable units (P = 0.01), weekly use of solid oils (0.01), and hot flush. The relation between daily vegetable units and urinary incontinence was also statistically significant (P = 0.02). When we use multiple logistic regression, we found significant predictive relations between daily vegetable unit status (P = 0.01), weekly use of solid oils (P = 0.04), body mass index (P = 0.03), and hot flush. CONCLUSION: The study provided findings to support the probable relation between some of lifestyle-related variables and vasomotor symptoms in postmenopausal women.

The Effect of Listening to Holy Quran Recitation on Anxiety: A Systematic Review.

BACKGROUND: Among all mental health disorders in the general population, anxiety is the most frequent. Both pharmacological and non-pharmacological interventions are used to manage anxiety in various settings. There is a growing interest among researchers on religion therapy as a non-pharmacological intervention for anxiety management. Hence, due to the importance of Holy Quran in Muslims' lives, this systematic review was performed to assess the studies that evaluated the effect of Quran recitation on anxiety in various settings. MATERIALS AND METHODS: This systematic review study was performed on articles published between January 1990 and September 2017. Several online databases including SID, Iranmedex, Magiran, IranDoc, PubMed, Scopus, and Google Scholar were searched with the keywords of "Quran," "anxiety," "clinical trial." The risk of bias across all included studies was assessed using the Cochrane Collaboration's risk of bias tool. RESULTS: Of the 973 articles found in the initial search, 28 randomized controlled trials and quasi-experiments were selected for the systematic review. In most studies, State-Trait Anxiety Inventory was used to measure participants' anxiety. Findings of this review revealed a positive effect of listening to Holy Quran recitation in reducing anxiety in various settings. Only one study had reported that anxiety level in Holy Quran recitation group was less than that of the control group, but it was not statistically significant. CONCLUSIONS: Based on the available researches, Quran recitation can be used as a useful non-pharmacological treatment to reduce anxiety. However, methodologically strong randomized controlled trials are needed in this area.