Effect of mindfulness on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women: a quasi-experimental study.

Background: Menopause with anatomical, physiological, and psychological changes can affect sexual satisfaction and consequently the quality of life. Aims: The study sought to evaluate the effects of mindfulness-based counseling on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women. Methods: This quasi-experimental study was conducted on 110 women who were assigned to an intervention group (n = 55) and a control group (n = 55). The intervention group received 8 sessions of mindfulness-based training and daily mindfulness exercises. Data collection tools included questionnaires of demographics and midwifery, sexual self-efficacy, and sexual satisfaction. They were completed before and 8 weeks after the intervention. The collected data were analyzed through a t test, a chi-square test, and repeated-measures analysis of variance. Outcomes: Changes in sexual self-efficacy and sexual satisfaction scores were evaluated. Results: The mindfulness-based intervention significantly improved sexual self-efficacy (F = 146.98, P = .000, ƞ2 = 0.576) and sexual satisfaction (F = 129.47, P = .000, ƞ2 = 0.545) over time. The mean scores of sexual self-efficacy (17.03 ± 2.08) and sexual satisfaction (87.94 ± 8.26) in the intervention group increased after the intervention as opposed to the mean scores of sexual self-efficacy (12.65 ± 1.70) and sexual satisfaction (76.61 ± 6.45) in the control group. Clinical Implications: Mindfulness training can improve sexual self-efficacy and sexual satisfaction in postmenopausal women. Strengths and Limitations: The intervention was implemented on a population of menopausal women in a culture in which the expression of sexual issues is taboo and has not been noticed in the past. The main limitation of this study was self-reporting, which may have affected the responses. The next limitation was the nonrandomized controlled design. Finally, the research sample included menopausal women who were heterosexual and married. Hence, the findings may not be generalizable to more diverse samples. In this study, psychological maladjustment or psychological distress was not analyzed. They should also be considered in future research. Conclusion: According to the results, it is advisable to employ mindfulness-based intervention in routine care, because it can improve different aspects of menopausal women's life.

Comparison of the effect of face-to-face training and telemedicine on self-care in adolescent pregnant women: A quasi-experimental study.

BACKGROUND: Improving self-care in adolescent pregnancy leads to improved maternal and neonatal outcomes of pregnancy. However, self-care in adolescent pregnancy is less than other women. The aim of this study was to compare the effect of face-to-face training and telemedicine on self-care in adolescent pregnant women. MATERIALS AND METHODS: The present study is a quasi-experimental study that was conducted in Zahedan in 2021 and 120 adolescent pregnant women with a gestational age of 15-20 weeks participated in it. The sampling was done in multistage, and the samples were divided into three groups: Face-to-face training, telemedicine, and control. Face-to-face training was presented in five sessions and the telemedicine group received the similar educational content through the mobile applications. The samples completed a researcher-made self-care questionnaire before the intervention and at 28 weeks of gestation. SPSS software version 21 was used for the analysis, and data were analyzed by ANOVA, Tukey post hoc, Kruskal-Wallis, and Mann-Whitney tests. RESULTS: There was no significant difference in face-to-face and telemedicine training in improving the scores of nutritional performance, smoking and narcotics use, personal hygiene, and routine pregnancy care (P > 0.05), but face-to-face training caused more improvement in the scores of sports and physical activity as compared to telemedicine group (P = 0.04). Face-to-face training and telemedicine training in all domains led to a significant improvement in scores as compared to the control group (P < 0.05). CONCLUSION: The results of this study showed that the face-to-face training and telemedicine methods were proper methods for self-care education in pregnant adolescent women. It is recommended to use these methods in promoting self-care in pregnant adolescent women.

Effect of cognitive-behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers.

BACKGROUND: Fear of childbirth is a common problem during pregnancy, which can give rise to sleep disorders and diminish sleep quality. This study aimed to determine the effect of cognitive-behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers who visited the slum health centers of Zahedan city, Iran, in 2020. MATERIALS AND METHODS: This quasi-experimental study was conducted in 2020 on 100 pregnant adolescent slum dwellers between 11 and 19 years old at 24-28 weeks pregnant. Multi-stage sampling was used and the participants were randomly divided into an intervention and a control group. The intervention group received four sessions of cognitive-behavioral training at weekly intervals. The control group only received routine care. The Wijma Delivery Expectancy/Experience Questionnaire and the Pittsburgh Sleep Quality Index were filled before and 4 weeks after the training course. The data were analyzed in SPSS 21 using independent t-test, paired t-test, Fisher's exact test, and Chi-squared test. and covariance. A P value of < 0.05 was considered significant. RESULTS: After the intervention, the fear of childbirth significantly decreased (P = 0.004), and sleep quality significantly improved (P = 0.001) in the intervention group compared with the control group. The results of analysis of covariance to control the significant effect of pre-test scores showed that the mean score of fear of childbirth (P = 0.03) and mean score of sleep quality (P = 0.001) in the two groups after the intervention was statistically significant. CONCLUSION: The results showed that in addition to reducing fear of childbirth, cognitive-behavioral training improved the sleep quality of women in the intervention group. Therefore, this training could be used as an easy and accessible method without complications to improve women's health.

The effect of motivational interviewing-based training on the rate of using mental health services and intensity of suicidal ideation in individuals with suicide attempt admitted to the emergency department.

BACKGROUND AND OBJECTIVE: Unless mental health care is provided to suicide attempters after discharge from the emergency department, suicide prevention opportunities may be lost. The purpose of this study was to determine the effect of motivational interviewing (MI)-based training on using mental health services and reducing the severity of suicidal thoughts. METHODS: This quasi-experimental study was performed on seventy suicide attempters who had been admitted to the emergency department of three university hospitals in Southeast Iran in 2019. Eligible patients were chosen through convenience sampling, and they were randomly divided into the experimental (n = 35) and control (n = 35) groups. The intervention group received three MI sessions on the day of discharge and the 1st week after discharge. Twelve weeks after the intervention, the Beck Scale for Suicidal Ideation and the using mental health services were completed in both the groups. Data were analyzed using Chi-squared test, independent t-test, and paired t-test. RESULTS: While there was no significant difference between the two groups in terms of the mean score of suicidal ideation on the pretest, the experimental group experienced a significant decrease in this respect at the end of the study; thus, this group scored 8.86 ± 5.30, which is considerably lower than that obtained in the control group (15.85 ± 6.65) (P = 0.0001). Furthermore, at the end of the study, the rate of using mental health services increased much more in the experimental group than in the control group (P = 0.01). CONCLUSION: MI training had a significant positive impact on mitigating suicidal ideation and promoting mental health services use. To improve mental health and to better serve suicidal individuals, it is recommended that short-term interventions be developed in the form of post-discharge education for suicidal patients admitted to the emergency department.

Comparing the effect of group training and telemedicine on exercise during pregnancy: An application of the health belief model.

INTRODUCTION: Many women refuse to exercise during pregnancy due to lack of awareness and not receiving training. The aim of this study was to investigate and compare the effect of group and telemedicine education on exercise during pregnancy by using the health belief model (HBM). MATERIALS AND METHODS: This quasi-experimental study was carried out in 2019 in Zahedan, and a total of 135 pregnant women participated in it. Samples were randomly assigned to the following three groups: group training (n = 45), telemedicine (n = 45), and control (n = 45). Group training was presented in three sessions, and the telemedicine group received the educational content through mobile applications. The samples completed the HBM questionnaire before and 6 weeks after the intervention. In addition, within 6 weeks after the intervention, they completed the exercise activity schedule. SPSS software Ver. 16 (IBM Corp, Armonk, NY, USA) was used for analysis, and data were analyzed by ANOVA, Tukey's post-hoc test, Kruskal-Wallis test, and Mann-Whitney test. RESULTS: After intervention, the scores of HBM constructs and exercise levels in group training, telemedicine group, and control group, respectively, were as follows: perceived susceptibility 25.91 ± 3.24, 25.51 ± 1.97, and 22.55 ± 3.78; perceived severity 27.48 ± 2.27, 25.13 ± 2.29, and 22.51 ± 3.88; perceived benefits 27.28 ± 2.97, 25.68 ± 3, and 22.8 ± 3.05; perceived barriers 10.69 ± 2.69, 10.66 ± 3.19, and 14.17 ± 3.14; cues to action 24.71 ± 4.35, 23.9 ± 2.48, and 22.84 ± 3.02; self-efficacy 26.17 ± 3.05, 25.2 ± 2.82, and 22.51 ± 3.38; and exercise levels 70.99 ± 20.43, 56.51 ± 21.99, and 37.62 ± 29.66. Group training and telemedicine led to significant improvement in all HBM constructs and exercise levels (P < 0.05, P < 0.0001, and P = 0.003, respectively). Group training provided more improvement than telemedicine in the scores of perceived severity (P < 0.0001), perceived benefits (P = 0.001), cues to action (P = 0.02), and mean exercise time (P = 0.001). CONCLUSION: The results of this study showed that the HBM is a proper model for exercise education in pregnant women. It is recommended to use HBM as a group training and telehealth in promoting the rate of exercise in pregnant women.

Effect of sexual health education on sexual function and resumption of sexual intercourse after childbirth in primiparous women.

INTRODUCTION: A large number of women experience sexual health problems during the postpartum period. This study aimed to evaluate the effect of sexual health education on sexual function and time of sexual intercourse resumption after childbirth in primiparous women in Southeast Iran. MATERIALS AND METHODS: This randomized clinical trial was conducted on 94 primiparous women randomly divided into two groups of intervention and control. The intervention group was subjected to three training sessions 3-5, 10-14, and 30-45 days after childbirth (first session lasting 20 min and other sessions 60 min). On the other hand, the participants in the control group only received the routine postpartum training. The Female Sexual Function Index (FSFI) was completed by all participants before and 8 weeks after the intervention. Data were analyzed in SPSS software (version 22) using descriptive and inferential statistics, such as Chi-square test, independent t-test, and paired sample t-test. P < 0.05 was considered statistically significant. RESULTS: The mean score of FSFI in the intervention group was increased from 12.70 ± 6.166 before the onset of the intervention to 17.36 ± 5.407 after 8 weeks (P = 0.01). In the control group, the mean score of FSFI was decreased from 13.09 ± 4.306 to 12.29 ± 3.511 on the 8th week postpartum (P = 0.06). The mean times of sexual intercourse resumption in the intervention and control groups were 5.82 ± 0.17 and 5.81 ± 0.22 weeks, respectively, which were not significantly different between the two groups (P = 0.879). CONCLUSION: Sexual health education for women in the postpartum period could improve their sexual function after childbirth. However, it is recommended to use sexual health education programs in women during the postpartum period to promote female sexual function.

The Effect of Motivational Interviewing on Self-Efficacy and Continuation of Exclusive Breastfeeding Rates: A Quasi-Experimental Study.

Background: Self-efficacy is a decisive psychological and motivational factor in maintaining exclusive breastfeeding (EBF). The aim of this study was to explore the impact of motivational interviewing (MI) on EBF self-efficacy and EBF in primiparous women. Materials and Methods: This quasi-experimental study was conducted on 140 primiparous women admitted to a number of comprehensive health centers in Zahedan in 2019. The health centers were determined through multistage random sampling, and the subjects were selected from each center using convenience sampling. The selected women were equally divided into the intervention and control groups. The two groups took the pretest by filling out a demographic questionnaire and a breastfeeding self-efficacy questionnaire. The intervention group attended four 45- to 60-minute MI sessions on breastfeeding. The EBF continuation sheet and the breastfeeding self-efficacy questionnaire were filled out 6 months postpartum. Data were analyzed in SPSS 22 using paired t-test, independent t-test, chi-square test, and covariance analysis. Results: Based on the results, the mean and standard deviation of the number of EBF days were significantly higher in the intervention group (137.68 ± 65.50) compared with that of the control group (99.51 ± 80.62). In addition, the mean score of breastfeeding self-efficacy after MI was significantly different between the two groups (p = 0.0001). Conclusion: Because of the significantly positive impact of MI on enhancing EBF self-efficacy and continuation, it is recommended to integrate this counseling strategy into the care programs designed for women in pregnancy and even postpartum period.

The Effect of Regular Family Appointments on Hope of Hospitalized Depressed Patients: a Randomized Clinical Trial.

Introduction: Depression is one of the most common psychological disorders in the world. Many depressed patients are being hospitalized in psychiatric centers every year, which can lead to hopelessness and indifference. Considering the role of family as a support system in caring for depressed patients, the goal of the present study is to assess the effects of regular family appointments on the hope of hospitalized depressed patients. Methods: This was a randomized clinical trial on 70 hospitalized depressed patients in the Baharan psychiatric hospital of Zahedan. Block Randomization was used to categorize the participants continuously into two groups intervention (n=35) and control groups (n=35). The data collection tools were demographic characteristics questionnaire and Schneider hope scale. The patients in the interventions group received 6 sessions of regular family appointments with first- degree relatives. The control group received freely and without any planning appointments. Hope level was measured and compared before and after the intervention for two groups. The data were analyzed by SPSS using the chi-square test, the independent t-test and the paired t-test. Results: The results showed that both groups were homogeneous in terms of socio- demographic differences. The hope scores of patients in the intervention group significantly increased compared to those of the control group. Conclusion: Encouraging family cooperation and using patient's choice in selecting visitors is recommended.

El efecto del entrenamiento grupal en asertividad sexual sobre la asertividad sexual de las alumnas: Un estudio cuasi-experimental / The Effect of Group sexual assertiveness training on Sexual assertiveness of Female Students: A quasi-experimental study

Sexual relation is a very important part of the marital relationship. Any problem in the marital relationship affects the family and society cohesion. This study aim to determine the effect of Group sexual assertiveness training on Sexual assertiveness of Female Students. This quasi-experimental pre and posttest study was conducted on 80 married female students of Sistan and Baluchestan University (southeast of Iran), from 1 July 2018 to 30 March 2019.Students were selected and randomly allocated in the two intervention and control groups. The intervention group received group sexual assertiveness training in the 4 two-hourly sessions over a period of two weeks. The control group did not receive any training. The data were collected before and 12 weeks after the intervention by Hurlbert's sexual assertiveness questionnaire, and then were analyzed. After the implementation of group sexual assertiveness training, the mean score of sexual assertiveness significantly increased in the intervention group compared to the control group (p=0.01). It is recommended to add sexual assertive training to the pre-marriage education, especially in cultures in which women have a low level of sexual assertiveness

Investigating the effect of education on man immunodeficiency virus/acquired immune deficiency syndrome preventive behaviors in vulnerable women living in peripheral neighborhoods: Applications of the health belief model.

INTRODUCTION: Acquired immune deficiency syndrome (AIDS) is a pervasive disease, and its epidemic is spreading around the world. The only way to effectively fight against human immunodeficiency virus (HIV)/AIDS is good-quality health. The present study aimed to investigate the effect of an educational intervention program on HIV/AIDS preventive behaviors based on the Health Belief Model (HBM) in vulnerable women residing in peripheral neighborhoods. MATERIALS AND METHODS: This study was a quasi-experimental research conducted among 200 vulnerable women, randomly selected from four community health centers in peripheral neighborhoods in 2019 in Zahedan, Iran. The data were collected using a researcher-made questionnaire, containing demographic information, HIV knowledge, and the HBM constructs. Besides, the data were collected before, immediately after, and 1 month after the intervention in both groups. Data analysis was performed in SPSS (version 24) using descriptive statistics, Chi-square test, independent t-test, repeated-measures analysis of variance, and multivariate linear regression. RESULTS: The findings revealed no significant difference in the mean scores of knowledge and the HBM constructs before the educational intervention (P > 0.05). However, after the intervention, this difference was significant in three time intervals (P < 0.05). Despite the effectiveness of the educational intervention in the mean scores of knowledge and the HBM constructs in the intervention group compared with the controls, the largest effect size was observed, respectively, in knowledge (d = 0.762) and perceived barriers (d = 0.612), and the smallest effect size was reported in cues to action (d = 0.421). As well, the F-statistic ratio (0.847) demonstrated that the selected demographic variables had failed to explain variations in knowledge mean scores (P = 0.497). CONCLUSION: HBM-based training interventions were positive for HIV/AIDS prevention behaviors. However, training alone does not seem to have enough effect on behavior persistence. Therefore, further research is recommended to investigate the role of predictive factors, especially social determinants of health and their relationship to different parts of the model, to take more effective measures for behavioral stability at the same time as training.

Assessing the effect of self-care education on anxiety and depression among pregnant women with a history of spontaneous abortion.

INTRODUCTION: Abortion is one of the most common complications of early pregnancy, which emerges as a physically and mentally devastating experience. Due to the prevalence and importance of postabortion mental health problems and their adverse effects on subsequent pregnancies, some interventions should be made to reduce the resultant anxiety and depression. The present study aimed to determine the effect of self-care education on anxiety and depression among pregnant women with a history of spontaneous abortion. METHODS: This randomized quasi-experimental study was performed on ninety pregnant women with a history of spontaneous abortion who referred to health centers in Zahedan in 2019. The samples were selected by convenience sampling method and randomly assigned to two intervention and control groups. Between 6 and 16 weeks of gestation, the participants in the intervention group received four sessions of 60-min self-care training over 2 weeks. On the other hand, the control group received routine pregnancy care. Data collection tools included a demographic and fertility evaluation questionnaire, a 6-item short-form of the state scale of the Spielberger State-Trait Anxiety Inventory, and a short form of Beck Depression Inventory. Posttest was performed 4 weeks after the end of the intervention. The data were analyzed in SPSS software (version 21) using statistical tests of independent t-pair, paired t-pair, Chi-square, and Fisher's exact test. RESULTS: Based on the obtained results, there was no significant difference between the two groups in terms of anxiety and depression scores before the intervention. Nonetheless, after the intervention, the mean scores of anxiety and depression in the intervention group were calculated at 7.31 ± 1.31 and 4.71 ± 1.90, respectively. However, these scores were reported as 1.87 ± 13.46 and 9.31 ± 1.59 in the control group, respectively (P = 0.0001). CONCLUSION: As evidenced by the obtained results, self-care education is effective in the reduction of anxiety and depression in pregnant women with a history of spontaneous abortion. Therefore, health professionals and health-care providers should enrich prenatal care programs with these training sessions and provide women with peace of mind and comfort during pregnancy.

The Effect of Cognitive-Behavioral Training Versus Conventional Training on Self-care and Depression Severity in Heart Failure Patients with Depression: A Randomized Clinical Trial.

Introduction: Psychological factors including depression and anxiety are the most critical risk factors in the treatment and prognosis of heart failure which should be addressed in treatment and care programs. The purpose of this study was to examine the effect of cognitive-behavioral training (CBT) on depression severity and self-care ability of patients with heart failure. Methods: This study was a randomized clinical trial that carried out on 80 patients with heart failure who had been hospitalized in 2018. The participants were divided into the CBT group (n= 40) and the conventional training (CT) group (n= 40), randomly. Data were collected using Beck Depression Inventory (BDI) and the Self-Care of Heart Failure Index (SCHFI) version 6.2 before and 8 weeks after the educational interventions. Data were analyzed in SPSS 21 using paired t-test, independent t-test, chi-square test, and covariance analysis. Results: The mean score of self-care in the CBT group turned out to be significantly higher than the CT group after receiving the intervention. Also, the mean depression score of the CBT group 26.95 (5.53) after intervention was significantly lower than the CT group 36.04 (8.45). Conclusion: Cognitive-behavioral intervention, compared with conventional training, had a greater positive impact on improving self-care and alleviating the severity of depression symptoms. Therefore, it is recommended that the principles of cognitive-behavioral therapy be integrated into routine educational programs.

The Effect of Cognitive-Emotional Intervention on Growth and Posttraumatic Stress in Mothers of Children With Cancer: A Randomized Clinical Trial.

BACKGROUND: To diminish the negative impact and improve the positive outcomes on the parents of children with cancer, it is crucial to attend to their problems. This is especially significant in the case of mothers as the main caregivers. The present study aimed at evaluating the efficiency of cognitive-emotional intervention on growth and posttraumatic stress in mothers of children with cancer hospitalized in the chemotherapy ward. PROCEDURE: This randomized clinical trial was conducted on 100 mothers of children with cancer who presented to the chemotherapy ward of a hospital located in southeastern Iran in 2018. The eligible mothers were chosen and randomly assigned to intervention and control groups. Mothers in the intervention group as a whole received 5 sessions of cognitive-emotional intervention. The sessions were held twice a week, each lasting 60 to 90 minutes. Sixteen weeks after the intervention, posttest data were collected through the Posttraumatic Stress Disorder Checklist and Posttraumatic Growth Inventory. The data were then analyzed using SPSS 21 utilizing statistical tests including independent and paired t tests, χ, and covariance analysis. RESULTS: The results show that the mean value of posttraumatic stress in mothers of children with cancer after cognitive-emotional training in the intervention group (25.92±5.29) was significantly lower than that in the control group (44.94±11.92; P=0.0001). Moreover, in the posttest, the mean value of posttraumatic growth in the intervention group (92.06±5.50) was significantly more than that in the control group (62.98±15.08; P=0.0001). CONCLUSIONS: Alleviating posttraumatic stress, the cognitive-emotional intervention proposed in this research had a significant and positive impact on posttraumatic growth in mothers of children diagnosed with cancer. Therefore, implementing this intervention in the chemotherapy department and throughout the course of the children's treatment is highly recommended for their caregivers, especially mothers of children diagnosed with cancer.

The Effect of Psycho-Education Intervention Based on Relaxation Methods and Guided Imagery on Nausea and Vomiting of Pregnant Women.

Objective: The present study aims at evaluating the effects of psycho-education based on relaxation methods on Hyperemesis Gravidarum (HG). Materials and methods: This is a quasi-experimental study, with pretest and posttest design, which was carried out on 100 pregnant women with complaints of nausea and vomiting who had referred to general health centers to receive pregnancy care. In accordance with the specified content, women in the intervention group received 3 sessions of psycho-education based on relaxation methods for a week. Four weeks after the end of education and before the 16th week of pregnancy, data were gathered from both the intervention and control groups using the Pregnancy-Unique Quantification of Vomiting and Nausea (PUQEN) scale. Data were analyzed with the aid of statistical tests. Results: There was no significant difference between the average values of HG in the intervention group and the control group prior to the intervention. However, after receiving psycho-education, the average value of nausea and vomiting in pregnant women of the intervention group (5.11 ± 1.60) was significantly lower than that in the control group (6.00 ± 1.66) (p = 0.035). Conclusion: The psycho-education based on relaxation methods of this study had a positive and significant effect on reducing the intensity of HG. It is helpful to integrate the educational content of this intervention in the caring programs of pregnant women with nausea and vomiting.

The Effect of Group Counseling Based on Quality of Life Therapy on Stress and Life Satisfaction in Family Caregivers of Individuals with Substance Use Problem: A Randomized Controlled Trial.

Family caregivers of people with substance abuse are exposed to psychological problems that diminish their life quality and satisfaction. The purpose of this study was to diagnose the efficacy of quality-of-life intervention on stress and life satisfaction of family caregivers of individuals with substance use problem. This is a randomized controlled trial conducted on 80 family caregivers of individuals with substance use problem in the process of withdrawal who were referred to a psychiatric center in southeastern Iran (2018). The intervention group received seven sessions of quality-of-life group counseling every other day based on predetermined content. Twelve weeks post-intervention, data were collected from the control and intervention groups using the Depression Anxiety and Stress Scales (DASS-21) and the Satisfaction with Life Scale (SWLS). The results were analyzed through statistical tests. After group counseling based on quality of life, the mean stress score in the family caregivers of the intervention group (11.50 ± 4.36) was significantly lower than in those of the control group (14.67 ± 4.93) (p = 0.003). Also, in the posttest, the mean score of life satisfaction in the intervention group (24.75 ± 4.28) was significantly higher than that of the control group (19.57 ± 7.33) (p = 0.001). Group counseling based on quality of life exerted a significantly positive impact on reducing the severity of stress and improving life satisfaction among family caregivers of individuals with substance use problem. Therefore, it is highly recommended that healthcare service providers incorporate this counseling approach in substance use withdrawal programs so as to increase the well-being and mental health of family caregivers.

Impact of group assertiveness-based sexual training on the quality of marital relationships among female university students.

BACKGROUND: Sexual assertiveness plays a crucial role in the quality of sex, as well as in investigating and treating sexual problems. The purpose of this study was to determine the impact of assertiveness-based sexual training on the quality of marital relationships of married female students. METHODS: This quasi-experimental study was done in southeastern Iran in the academic year of 2017. A total of 80 married women were chosen from university students through convenience sampling, and they were assigned to the intervention (n = 40) and control (n = 40) groups. Data were collected using the Perceived Relationship Quality Components Inventory. For the intervention group, assertiveness-based sexual counseling was provided in four sessions (90-120 min each session). The posttest was performed 12 weeks after the last counseling session. Independent t-test and covariance analysis were employed to analyze data using SPSS version 21 software. RESULTS: After the intervention, the two groups revealed a significant difference in their respective mean total score of the quality of various dimensions of marital relationships (P = 0.0001). This indicates that assertiveness-based sexual counseling has improved this mean total score in the intervention group compared to the control group. CONCLUSION: Given the positive impact of assertiveness-based sexual training on the quality of students' marital relationships, the integration of sexual training with focus on assertiveness in usual sexual counseling will help therapists to improve the quality of marital relationship from the perspective of women.

Effectiveness of stress inoculation training on occupational stress of midwives in healthcare centers of Zahedan in Health Transformation Plan in 2017.

INTRODUCTION: Occupational stress is a main problem of healthcare workers, which significantly affects their professional and personal performance. The aim of this study was to determine the impact of a stress immunization program on occupational stress of midwives working in health centers. MATERIALS AND METHODS: In this quasi-experimental study, 80 midwives working in health centers of Zahedan (2017) were divided into test and control groups based on random allocation. The intervention involved a stress immunization program consisting of two workshops (each lasting 4 h) in two consecutive weeks, which was implemented for the intervention group. As data collection tool, Health and Safety Executive Occupational Stress Questionnaire was completed in three steps before, immediately after, and 1 month after the intervention. Data were analyzed using descriptive and analytical statistics, independent t-test, and repeated measures ANOVA. RESULTS: The findings showed that mean stress score in the intervention group was increased from 79.5 ± 9.7 before intervention to 104.5 ± 17.3 immediately after it, which was increased to 110.5 ± 18.3 1 month after intervention (P < 0.001). In the control group, mean stress score was decreased immediately after as well as 1 month after the intervention, which was statistically significant after the intervention and 1 month after it (P > 0.023). CONCLUSION: The stress immunization program is an inexpensive and effective way to reduce the stress of midwives; therefore, it is suggested to be used to effectively handle occupational stress among midwives and to improve their quality of care.

The Effect of Cognitive-Emotional Training on Post-traumatic Growth in Women with Breast Cancer in Middle East.

Overcoming distresses and negative consequences of serious crises such as cancers can lead to perception of positive changes in the patients. It is necessary to design and test the psychological interventions that can improve post-traumatic growth. The objective of this study was to determine the effect of cognitive-emotional training on post-traumatic growth in women with breast cancer referred to the department of chemotherapy. This is a quasi-experimental study and it was performed on 85 patients with breast cancer who referred to an educational hospital in southeastern of Iran in 2017. The eligible patients were selected through convenience method sampling among the patients and they randomly allocated into intervention and control groups. The intervention group received five sessions of emotional-cognitive training in two sessions per week. Each session lasted 60-90 min. The posttest data were collected by post-traumatic growth inventory (PTGI) 20 weeks after the end of the last intervention session. Collected data were analyzed by SPSS software version 21.00 using independent t test, paired t test, and Chi-square tests for demographic analysis. The results indicated that there is no significant difference in both groups in terms of individual variables such as age, marriage, duration of disease, and degree progression of cancer. Although the mean of PTG scores in posttest and the mean of variations in the PTG scores in the intervention group were 77.48 ± 11.18 and 25.81 ± 12.24, respectively, and it was significantly higher than the control group, 53.95 ± 14.86 and 7.69 ± 9, respectively (mean scores of PTG: p < .0001; mean changes of PTG: p < .001). According to the results of this study, cognitive-behavioral intervention had a positive and significant effect on post-traumatic growth in women with breast cancer. If intervention is found to be effective, cognitive and emotional strategies of such interventions could be integrated into daily clinical practice as a way to promote PTG in women who are being treated for breast cancer.

The effect of couples education on marital satisfaction in menopausal women.

Inviting husbands to come to terms with women's adaptation to the phenomenon of menopause is beneficial. The aim of this research was to uncover the effect of couples education on marital satisfaction. This study was performed on 80 menopausal women accompanied by their husbands. The intervention group received four sessions of couples education. The results showed that the mean increase in the rate of marital satisfaction after couples education in the intervention group was significantly higher than the control. Short-term couples education has a significant positive effect on marital satisfaction. Therefore, this counseling strategy can be integrated into health-care programs.

The Effect of a Date Consumption-Based Nutritional Program on Iron Deficiency Anemia in Primary School Girls Aged 8 to 10 Years Old in Zahedan (Iran).

AIM: Iron deficiency anemia (IDA) is one of the most common nutritional problems in students. The best and most cost-effective ways to prevent IDA are changes in people's dietary habits and their nutrition education. The purpose of this study was to determine the effect of nutritional program based on dates consumption on IDA in primary schoolgirls. MATERIALS AND METHODS: This was a semi-experimental study. The study population consisted of primary school girl students of Zahedan, Iran, during the academic year of 2018-2019. The sampling method was a combination of stratified sampling and multi-stage cluster sampling. Then, 31 female primary school children with IDA were fed with dates for 2 months. Before the intervention and after 2 months of date consumption, hemoglobin, hematocrit, and ferritin blood parameters were measured. Both paired t-test and chi-square test were used to analyze the data using SPSS version 21. RESULTS: The results were meaningful. The hemoglobin levels at the beginning and the end of the study were 11.19 ± 0.38 and 12.05 ± 0.81 g/dL, respectively (P = 0.001), the hematocrit levels were 34.24 ± 0.41% and 37.17 ±2.36%, respectively, P = 0.001, and the ferritin levels were 47.07 ± 21.89 µg/dL and 53.98 ± 19.77 µg/dL, respectively, P= 0.001. CONCLUSION: The consumption of date fruit increased hemoglobin, hematocrit, and serum ferritin levels in primary school girl students with IDA; therefore, it is recommended to give dates to school girls.