Development and psychometric evaluation of the women shift workers' reproductive health questionnaire: a sequential exploratory mixed-method study.

BACKGROUND: There is no standard and comprehensive questionnaire for reproductive health assessment among women shift workers. This study aimed at the development and psychometric evaluation of the Women Shift Workers' Reproductive Health Questionnaire. METHODS: This sequential exploratory mixed-method study was conducted in a qualitative (item generation) and a quantitative (psychometric evaluation) phase. In the qualitative phase, the primary item pool of the questionnaire was generated based on the findings of the qualitative content analysis of 21 interviews held with 21 women shift workers as well as the findings of a literature review. In the quantitative phase, the face, content, construct, convergent, and discriminant validity and the reliability of the questionnaire were assessed. For construct validity assessment through exploratory and confirmatory factor analyses, 620 women shift workers were conveniently selected to fill out the questionnaire. Reliability assessment was done through assessing internal consistency, stability, and composite reliability. RESULTS: The primary item pool contained 88 items. During face and content validity, item number was reduced to 55. Construct validity assessment through factor analysis revealed that 56.50% of the total variance was explained by five factors with 34 items. The factors were named motherhood, general health, sexual relationships, menstruation, and delivery. Confirmatory factor analysis confirmed the fit of the five-factor model. The Cronbach's alpha and the composite reliability value of the questionnaire were more than 0.7. CONCLUSION: The Women Shift Workers' Reproductive Health Questionnaire is a valid and reliable instrument and can be used for reproductive health assessment among women shift workers.

Social capital and fertility behaviors: a cross-sectional study in Iranian women health care workers.

BACKGROUND: Fertility, in addition to the biomedical aspect, is phenomena of social, economic and demographic changes. Social network were considered for understanding fertility behaviors and changes in the levels of fertility. This study was conducted to investigate the relationship between social capital and childbirth behaviors in Iranian women employees. METHODS: This cross-sectional study was conducted in 2017 on 536 women health care workers who randomly selected from health care setting Babol/Iran. Data were collected using demographic, childbearing behavior and social capital questionnaires. The SPSS-21 software was employed to analysis the data at a significant level of 0.05. RESULTS: The results of the study showed that, there was significant relationship between number of pregnancy and social capital (P = 0.039). Furthermore, social capital has a significant relationship with the time of pregnancy (P = 0.043), the time of pregnancy in women with high social capital was observed to be relatively 30% shorter compare the women with low social capital. CONCLUSION: Social capital, as one of the important factors influencing childbirth behaviors, should be considered in population planning and policy making.

Reproductive health problems among female shift workers: A qualitative study in Iran.

BACKGROUND: Shift work (i.e. working between 18:00 and 07:00) is associated with sleeplessness and fatigue and hence, can cause female shift workers different health problems. This study aimed to explore reproductive health problems among female shift workers. MATERIALS AND METHODS: This qualitative study was conducted in Amol and Babol cities, Iran, on 19 female shift workers with previous history of pregnancy and breastfeeding. Participants were selected purposively and with maximum variation respecting their age, work experience, educational level, and financial and employment status. Face-to-face semi-structured interviews were held for data collection and conventional qualitative content analysis was employed for data analysis. RESULTS: Female shift workers' reproductive health problems were categorized into fourteen subcategories and the five main categories of conflict between pregnancy and shift work, breastfeeding-related challenges, impaired sexual relationships, childbearing limitations, and gynecological problems. CONCLUSION: Impaired sexual problems are the most significant reproductive health problem among female shift workers. Their reproductive health can be promoted through periodical reproductive health assessments by midwives, reproductive health specialists, psychologists, and gynecologists.

A cross-sectional study on serum high-sensitivity C-reactive protein level and shift work among reproductive age women.

BACKGROUND: Among the inflammatory factors, high-sensitivity C-reactive protein (hs-CRP) is one of the strongest predictors of cardiovascular disease. This study aimed to evaluate the relationship of serum hs-CRP level with shift work among reproductive age women. METHODS: This cross-sectional study was conducted from September 2017 to May 2018 in three cities in Mazandaran Province, North of Iran. Through purposive sampling, 350 women (172 shift workers and 178 day workers) were recruited. The guideline recommended by the American Heart Association and the Centers for Disease Control and Prevention was used to interpret the result of hs-CRP measurement as the following: less than 1 µg/ml: low CVD risk; 1-3 µg/ml: moderate CVD risk; and more than 3 µg/ml: high CVD risk. The data were analyzed using the independent-sample t and the chi-square tests as well as the logistic regression analysis. RESULTS: 11.1% of participants had a serum hs-CRP level of more than 3 µg/ml. This rate among shift workers was significantly greater than day workers (15.6% vs. 7.0%; p=0.012). After adjusting the effects of potential confounders shift work significantly increased the odds of serum hs-CRP level of more than 3 µg/ml by 2.45 times (OR=2.45, 95% CI: 1.01-5.93, p=0.047). CONCLUSION: Shift work is a significant predictor of high serum hs-CRP level probably due to its association with sleep problems and occupational stress. Improving the knowledge of female shift workers about the importance of quality sleep can reduce their CVD risk and improve their health.

Relationship of social capital with overweight and obesity among female health care workers.

BACKGROUND: The epidemic of obesity has turned into a major global health challenge. Environmental and social factors such as social capital, can significantly affect obesity. This study aimed to evaluate the relationship of social capital with overweight and obesity among female health-care workers. METHODS: This cross-sectional study was conducted in 2018 on 680 female health-care workers who were randomly selected from healthcare settings affiliated to Babol University of Medical Sciences, Babol, Iran. Data were collected using a demographic questionnaire and the Workplace Social Capital (WSC) questionnaire. The SPSS Version 21 was employed to analyze the data through conducting the independent-sample t and the chi-square tests as well as the linear and the logistic regression analyses at a significance level of less than 0.05. RESULTS: Linear regression analysis revealed that age, marital status, satisfaction with economic status, and structural social capital were significant predictors of body mass index (P<0.05). Moreover, logistic regression analysis indicated that weak social capital increased the odds of overweight/ obesity by 1.3 times (OR=1.345; 95% CI: 0.643-2.812) and weak structural social capital significantly increased the odds of overweight /obesity by almost four times (OR=3.757; 95% CI: 1.628-8.671; P=0.002). CONCLUSION: Social capital, particularly structural social capital, is a significant predictor of body mass index and a protective factor against obesity among female health-care workers. Further studies are needed to determine the paths through which social capital affects obesity- and overweight-related behaviors.

Erratum: Shift work and metabolic syndrome: A multi-center cross-sectional study on females of reproductive age.

[This corrects the article DOI: 10.3892/br.2019.1205.].

Shift work and metabolic syndrome: A multi-center cross-sectional study on females of reproductive age.

Shift work during reproductive age can be a risk factor for metabolic syndrome. The present study evaluated the association between shift work and metabolic syndrome during reproductive age. This multi-center cross-sectional correlational study was performed between September 2017 and May 2018. A total of 419 female shift and day workers were purposively recruited to the study from three central cities in Mazandaran, Iran. To diagnose metabolic syndrome based on the National Cholesterol Education Program Adult Treatment Panel III guidelines, the anthropometric measures, blood pressure, and levels of serum triglyceride, high-density lipoprotein and fasting blood sugar were taken. Data were analyzed using the independent-sample t, Chi-square and the Fisher's exact tests as well as the logistic regression analysis. Among the 419 participants, 28 were excluded during the study. The total prevalence of metabolic syndrome was 16.3%, and its prevalence among shift workers and day workers was 17.3 and 14.9%, respectively. The most prevalent components of metabolic syndrome were low serum level of high-density lipoprotein and abdominal obesity. Following adjustments for the effects of potential cofounders, the logistic regression analysis revealed that the odds of metabolic syndrome among shift workers was ~2 times greater than day workers (odds ratio, 1.83; 95% confidence interval, 0.088-3.79), although this association was statistically insignificant (P=0.10). The results of the current study suggest that shift work is associated with a greater risk of metabolic syndrome for women. The most important components of metabolic syndrome are low serum level of high-density lipoprotein and abdominal obesity, which are attributable to limited physical activity and high occupational stress. The risk of metabolic syndrome among female shift workers of reproductive age may be reduced through strategies, including awareness raising, dietary educations and provision of physical activity facilities in the workplace.

The status of international collaborations in compilation of Iranian scientific articles on environmental health engineering.

BACKGROUND: Scientific cooperation is one of the effective methods to access current knowledge and technologies and also to use successful experiences of researchers in developed countries by academicians living in developing countries. This study aimed to determine the level of international contribution in compilation of scientific articles in Iranian journals published in the field of environmental health engineering. METHODS: This descriptive and retrospective study was conducted within a 10-year period (2008-2017), in which all articles published in five specialized Iranian journals of environmental health engineering were reviewed using a researcher-made checklist. The information collected in the checklist included: the year of publication, number of issues and articles, information about the status of authors' participation in terms of number of authors, sex, institutional affiliation, country, continents, and research centers. Descriptive and inferential statistics such as index of dispersion, measures of central tendency, and Chi-square and t tests were used to statistically analyze the data. Besides, VOSviewer software was used to visualize the data. RESULTS: The review of 1276 articles published in 102 issues of the five journals of environmental health engineering in Iran showed that 184 articles were written with the participation of researchers from other countries. Most articles with the participation of international authors during the last decade were published in 2014. Chi-square test indicated a significant difference in the publication of these articles within 2014-2015 than other years (P = 0.001). Among the five journals, the best participation of international researchers was observed in J Environ Health Sci Engineer (168 articles, 91.3%). Considering the number of joint articles with Iran, the top continents were Asia, Europe, and Africa each with 117, 52, and 32 articles, respectively. India, Turkey, and Malaysia had the highest level of cooperation with Iranian researchers with 53, 16, and 14 articles, respectively. 637 authors contributed in 184 articles, of whom 469 (73.6%) were male and 121 (18.9%) were female. T test was used to compare the mean number of male and female authors in the articles with or without the participation of international researchers, which showed no significant difference. CONCLUSION: International contribution of researchers in compilation of specialized environmental health articles was good. Given the low level of cooperation between researchers from developed European and American countries and their Iranian counterparts, it seems necessary to adopt different methods to attract more collaboration from researchers working in developed countries considering their significant role in health-related areas.

Self-citation in Iran in Comparison with Other Countries.

INTRODUCTION: Self-citation is a debate in citation analysis and evaluating research performance. AIM: This study aimed to investigate the self-citation rate of Iranian scholars in comparison with scholars of other countries in the World. METHODS: The scientific output of 238 countries in the time span of 1996-2017(two recent decades) was studied from perspective of some bibliometric indicators, using "country ranking" section in SJR database for data collection. RESULTS: Regarding self-citation rate, Iran ranked third in the world, second in Asia and first in the Middle East. However, Iran ranked 22nd in the World, second in Asia and Middle East in scientific production. Iran has self-citation rate of 36.57%, which is higher than World standard level. CONCLUSION: It is needed that Iranian researchers consider their research quality as well as making the appropriate context for more visibility of their works by receiving more citations from other researchers and taking other scientific visibility modes into account. Science policy-makers in Iran should consider some approaches to decreasing the self-citation rate in Iranian publications.

Psychometric Properties of Persian Version of the Short-Form Workplace Social Capital Questionnaire for Female Health Workers.

BACKGROUND: The workplace social capital is one of the important features of clinical work environment that improves the productivity and quality of services and safety through trust and social participation. Evaluation of workplace social capital requires a valid and reliable scale. The short-form workplace social capital questionnaire developed by Kouvonen has long been used to evaluate the workplace social capital. OBJECTIVE: To evaluate the psychometric properties of the Persian version of the questionnaire among a group of female Iranian health care workers. METHODS: The Persian version of the short-form questionnaire of workplace social capital was finalized after translation and back-translation. 500 female health care workers completed the questionnaire. Then, the content validity and the construct validity of the questionnaire were assessed. The reliability of the questionnaire was assessed by Cronbach's α, θ, and McDonald's Ω. The construct reliability and ICC were also evaluated. RESULTS: Based on the maximum likelihood exploratory factor analysis (n=250) and confirmatory factor analysis (n=250), two factors were identified. The factors could explain 65% of the total variance observed. The model had an acceptable fit: GFI=0.953, CFI=0.973, IFI=0.974, NFI=0.953, PNFI=0.522, RAMSEA=0.090, CMIN/DF=2.751, RMR=0.042. Convergent and divergent validity as well as internal consistency and construct reliability of the questionnaire were confirmed. CONCLUSION: The Persian version of Kouvonen workplace social capital has acceptable validity and reliability. The questionnaire can thus be used in future studies to assess the workplace social capital in Iranian health care workers.

Workplace social capital and mental health: a cross-sectional study among Iranian workers.

BACKGROUND: The psychosocial environment of the workplace has received less attention in terms of occupational health. Trust, social network and social cohesion at the workplace (that is, factors related to social capital) may have effects on employee health. Thus, the objective of this study was to examine the association between workplace social capital and mental health among Iranian workers. METHODS: In this cross-sectional study, data were obtained from 5 factories in Babol, Northern Iran, in 2016, where 280 workers responded to a survey on social capital at work and psychosocial distress. RESULTS: Approximately 23.6% of the workers had psychological distress, and 23.4% had low social capital in the workplace. There was a significant relationship between mental health and individual workplace social capital (p = 0.025) and aggregated workplace social capital (p = 0.027). After controlling for each individual's characteristics, the prevalence ratio of psychological distress was 2.11 (95% CI: 1.43-3.17) times higher among workers with low individual social capital, and low aggregated workplace social capital was associated with 2.64 (95% CI: 1.28-5.45) times higher odds of psychological distress. CONCLUSION: Higher social capital is associated with a reduced risk of psychological distress. The promotion of social capital can be considered as a means to increase workplace mental health among workers.

Social capital and fertility behaviors among female workers in healthcare settings: study protocol of a sequential explanatory mixed methods study.

BACKGROUND: Fertility rate in Iran has decreased by more than 70% in the last three decades. Continuous decrease in fertility rate will create socioeconomic crises for the country in a near future. A significant factor behind fertility behaviors is women's attitudes towards maternal and spousal roles. Such attitudes are mainly determined by social capital. This study aims to determine and explore of relationship between social capital and fertility behavior among female healthcare workers. METHODS: This sequential explanatory mixed methods study will be conducted using the follow-up explanations model in two phases. In the first phase, a population-based cross-sectional survey will be conducted on 500 female workers recruited through multistage cluster sampling from healthcare settings located in Babol, Iran, and the relationship of social capital with fertility behaviors will be assessed. In the second phase, a qualitative study will be done to explain the findings of the first phase. Finally, the findings of the first phase will be explained using the findings of the second phase. DISCUSSION: Understanding the relationship of social capital with fertility behaviors is essential to effective planning for the management of population decline. The findings of the present study will provide population policy-makers with helpful information.

Development and psychometric evaluation of a women shift workers' reproductive health questionnaire: study protocol for a sequential exploratory mixed-method study.

BACKGROUND: Although shift works is a certain treat for female reproductive health, but currently, there is no standardized instrument for measuring reproductive health among female shift workers. This study aims to develop and evaluate the psychometric properties of a Women Shift Workers' Reproductive Health Questionnaire (WSW-RHQ). METHODS: This is a sequential exploratory mixed-method study with a qualitative and a quantitative phase. In the qualitative phase, semi-structured interviews will be held with female shift workers who live in Mazandaran Province, Iran, additionally, the literature review will be performed by searching electronic databases. Sampling will be done in different workplaces and with maximum variation respecting female shift workers' age and job and educational and different economic situation. Interview data will be analyzed using conventional content analysis and then, the primary item pool for the questionnaire will be developed. In the quantitative phase, we will evaluate the psychometric properties of the questionnaire, i.e. its face, content, construct as well as reliability via the internal consistency, stability. Finally, a scoring system will be developed for the questionnaire. DISCUSSION: The development of WSW-RHQ will facilitate the promotion and implementation of reproductive health interventions and assessment of their effectiveness. Other scholars can cross-culturally adapt and use the questionnaire according to their immediate contexts.

Musculoskeletal disorders among a group of Iranian general dental practitioners.

BACKGROUND: Dentists have to remain in a fixed position during dental practices for the accuracy required, therefore they are susceptible to musculoskeletal disorders (MSDs). OBJECTIVES: Considering the infrequency of ergonomics studies in general dental practitioners (GDPs), especially in cervical region, this study aimed to reviews MSDs in the neck region among GDPs. METHODS: An analytic cross-sectional study was carried out among the GDPs in 2011. A total of 60 dentists (40 males and 20 females) were examined through a combination of questionnaires (concerning their demographic information) such as the Nordic standardized musculoskeletal disorder questionnaire (NMQ) and Body Discomfort Assessment questionnaire (BDA). Each dentist's working posture was assessed using Rapid Upper Limb Assessment (RULA) and deep cervical flexor muscle endurance through a Craniocervical Flexion test (CCFT). Descriptive statistical indexes and Chi-square test were used for statistical analysis, while considering p< 0.05. RESULTS: The mean dental practice experience was 16.9 ± 5.6 years with average 41.2 ± 13.4 working hours per week. About 45% of dentists took regular exercises weekly. Some 83.3% of these dentists expressed to be suffering from the cervical pain, whereas, 56.7% complained about back pains and 41% shoulder problems. Female dentists were found more at risk of neckache, discomfort and pain in shoulder and hand than males. Greater pain frequency in knee was found in more experienced and older age dentists (P= 0.07). Results from the CCF test showed that the deep cervical flexor muscles endurance increased with regular exercise and decreased with aging. CONCLUSION: Many dentists experience the MSDs, especially in cervical region, as a consequence of occupational stresses. Therefore, detecting occupational risk factors, standards of work position, regular exercise and following ergonomic policy are intensely recommended.