Communication skills training with the transactional analysis approach developed menopausal women's marital adjustment - a quasi-experimental study.

Introduction: Communication skills help people have a better life. Due to the changes caused by menopause and their effects on interpersonal communication, it is essential to reinforce communication skills during this period. This study aimed to investigate the effect of communication skills training (CST) using the transactional analysis (TA) approach on menopausal women's marital adjustment. Material and methods: This quasi-experimental study with a parallel design was performed by the availability sampling method with participation of 46 married menopausal women. Participants were randomly assigned to two groups. The intervention group participated in eight CST sessions with a TA approach. The control group did not receive any psychosocial or educational services. Participants completed the demographic information, Queen Dam communication skills, and Spinner's marital adjustment questionnaire before, at the end of, and one month after the training period. Data were analyzed by descriptive and analytical tests with SPSS22 software. Results: There was no significant difference in demographics between the groups (p < 0.05). The mean marital adjustment scores were 53.48 ±12.24, 117.70 ±11.15, and 116.52 ±10.73 before, at the end of, and one month after the intervention, respectively. The marital adjustment scores before the intervention did not differ between the two groups but significantly increased after training and in the follow-up period (p < 0.001). Conclusions: Communication skills training with a TA approach in postmenopausal women improves marital adjustment. Therefore, it is suggested that midwives use this method in comprehensive health centers as an effective method for improving the lives of postmenopausal women.

Mindfulness-based stress reduction group training improves of sleep quality in postmenopausal women.

BACKGROUND AND PURPOSE: Sleep disorder is one of the most common problems during menopause, which affects different areas of people's lives. Today, mindfulness is one of the concepts that have attracted a lot of attention due to its desirable effects and low side effects. The present study was conducted to investigate the effect of mindfulness-based stress reduction (MBSR) group training on sleep quality of postmenopausal women. METHOD: This is a quasi-experimental parallel study. The study involved 66 eligible postmenopausal women 45-60 years' old (n = 33 in each group) during 2019-2020. The minimum score of women was 5 from Pittsburgh questionnaire. Eight sessions weekly (120-min/session) MBSR group training was conducted in the intervention group and menopausal health in the control group for two months. Pittsburgh Sleep Quality Questionnaire was used as a data collection tool. Descriptive statistics and nonparametric tests were utilized to analyze the data using SPSS software (version 25). The significance level < 0.05 was considered. RESULTS: Socio-demographic characteristics of participants were no statistically significant difference between the study groups before the intervention. The results showed that mean of overall quality of sleep score was before the intervention 10.21 ± 3.03, after the intervention 4.7 ± 2.45, and one month after the intervention 4.69 ± 2.4 respectively in intervention group (P < 0.001). While there was no significant change in the mean overall quality of sleep quality in the control group. CONCLUSION: According to the results, MBSR group training is an effective strategy for improving the sleep quality of postmenopausal women. Therefore, could be used to improve the sleep quality of postmenopausal women by midwifery consultants in health centers.

The Relationship between Health Literacy Dimensions and Perceived Risk of Cardiovascular Disease in Middle-Aged Iranian Women.

BACKGROUND: The purpose of the study was to investigate the relationship between health literacy dimensions and the perceived risk of cardiovascular disease in middle-aged Iranian women. MATERIALS AND METHODS: This is a descriptive-correlational study in which 280 women aged 40-60 years were investigated by random cluster sampling out of seven health centers in Yazd city in 2018. Data collection tools included predesigned demographic information from a standard Health Literacy for Iranian Adults (HELIA), and a standard perceived susceptibility and perceived risk components of the preventive behaviors of cardiovascular disease questionnaire. The data were analyzed using one-way ANOVA, independent t-test, Kruskal-Wallis, and Mann Whitney tests. RESULTS: A significant relationship was identified between demographic information and health literacy (p < 0.001). The mean (SD) scores of the perceived risk of cardiovascular disease and health literacy appeared to be 30.71 (5.10) and 35.62 (15.32), respectively. The perceived risk of cardiovascular disease in the participants turned out to be significantly correlated with the accessibility dimension of health literacy (r = 0.31, p < 0.001), but it failed to have any significant relationship with demographic information, especially obesity. CONCLUSIONS: As there is a significant relationship between health literacy and perceived risk of cardiovascular disease, hence increasing the health literacy of middle-aged women, especially in persons with high body mass index through the media and health centers, considered as an important source of health information, can be an appropriate task to augment the perceived risk of cardiovascular diseases.

The Effectiveness of Acceptance and Commitment Therapy (ACT) on Sexual Self-Efficacy and Sexual Quality of Life in Reproductive-Age Women: A Randomized Controlled Trial.

Acceptance and commitment therapy is one of the approaches in improving sexual problems. This study aimed to investigate the effect of acceptance and commitment group counseling on sexual self-efficacy and sexual quality of life in reproductive-age women. This study was conducted on 58 women referred to selected clinics in IRAN who were randomly divided into the experimental (N = 29) and the control group (N = 29). The experimental group received eight sessions of acceptance and commitment therapy (ACT). The data was collected by sexual self-efficacy and sexual quality of life questionnaire before, after, and one month after the intervention. In the intervention group, the average score of sexual self-efficacy and sexual quality of life was significantly higher than the control group after the intervention (8th week) and follow-up period (12th week)(P > 0.005). It seems that counseling based on the ACT is effective in promoting sexual self-efficacy and the sexual quality of life of reproductive-age women.

The role of androgens in COVID-19.

BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) pandemic is a global health emergency. According to the findings, male patients with COVID-19 infection are at an increased risk for severe complications than females. The causes of this issue are unknown and are most probably multifactorial. Sexual hormones affect the immune system, so estrogen strengthens the immune system, and testosterone suppresses it. Due to the reports of the high prevalence of androgenic alopecia in hospitalized patients with COVID-19 and a higher risk of respiratory disease and increased use of allergy/asthma medications among patients with polycystic ovary syndrome (PCOS) as a hyperandrogenism condition compared with non-PCOS women, this review aimed to evaluate androgens role in COVID-19. METHODS: 42 related articles from 2008 to 2020 were reviewed with the keywords of androgens, hormonal factors, and hair loss in combination with COVID-19 in medical research databases. RESULTS: The evidence of transmembrane protease, serine 2 (TMPRSS2) expression in lung tissue, which is an androgen-regulated gene and expressed mainly in the adult prostate may interpret the increased susceptibility of the male gender to severe COVID-19 complications. Moreover, angiotensin-converting enzyme 2 (ACE-2) acts as a functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and male hormones are effective in the ACE-2 passageway and simplify SARS-CoV-2 entry into host cells. CONCLUSION: Further studies on the severity of symptoms in patients with COVID-19 in other hyperandrogenism conditions compared to the control group are recommended.

COVID-19 and self-care strategies for women with gestational diabetes mellitus.

BACKGROUND AND AIM: The outbreak of the emerging coronavirus disease 2019 (COVID-19) is a global public health emergency. According to the findings, women with gestational diabetes mellitus (GDM) are at increased risk of this virus. Due to the need for quarantine and social distancing in the current disease situation and need to receive repeated medical care in GDM patients, this review study aimed to evaluate the self-care strategies for women with GDM during COVID-19 pandemic. METHODS: 25 related articles from 2011 to 2020 and 3 guidelines were reviewed with the keywords of gestational diabetes mellitus, diabetes, pregnancy and COVID-19 in combination with self-care and self-management in PubMed, Google Scholar, Scopus, Science Direct, Elsevier, Springer, Wiley Online Library and SID. RESULTS: According to the results of the studies, face-to-face visits should be limited and instead, telemedicine services recommended. Self-care throughout telemedicine services were improved maternal and neonatal outcomes in women with GDM. CONCLUSION: Although self-care program through telemedicine services is beneficial for women with GDM, performing clinical trials are recommended to assess maternal and neonatal outcomes in this condition.

The effectiveness of counseling based on acceptance and commitment therapy on body image and self-esteem in polycystic ovary syndrome: An RCT.

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders known with irregular menstruation, hirsutism, alopecia, obesity, infertility, and acne. These symptoms cause a negative effect on the satisfaction of body image, self-esteem, and quality of life in such patients. Recent studies emphasize the need to consider the psychological problems in these women and also the need for appropriate interventions. OBJECTIVE: The aim of this study was to determine the effectiveness of group counseling based on acceptance and commitment therapy (ACT) on body image and self-esteem in patients with PCOS. MATERIALS AND METHODS: In this randomized controlled trial, 52 women with PCOS were randomly allocated to intervention and control groups (n = 26/each) using the table of random numbers. Group counseling based on the ACT was held in eight sessions of 90 min once a week for the intervention group. The demographic questionnaire, Littleton development of the body image concern inventory and Rosenberg self-esteem scale were completed in both groups before, immediately after, and one month after the intervention. RESULTS: The mean scores of body image concern (p = 0.001) and self-esteem (p ≤ 0.001) in the intervention group after the intervention and follow-up were significantly different from the control group. CONCLUSION: Based on the findings of this study, use of cognitive-behavioral therapies in health care centers is recommended as a complementary method.

Predictors of mammography based on Health Belief Model in Khorramabad women.

BACKGROUND: Health beliefs play an important role in people's willingness to participate in health-promoting behaviors. Given the role of beliefs in women's function and the importance of the benefits of mammogram, and because the predictors of a behavior are a major prerequisite to codification of an effective prevention program, the present study was conducted with the aim of predicting mammography based on Health Belief Model (HBM) in women in Khorramabad. MATERIALS AND METHODS: In this cross-sectional study, 262 women referring to health centers in Khorramabad, Lorestan province, in 2018, were selected by randomly sampling. The data collection tool was a four-part questionnaire including demographic information, knowledge on breast cancer and mammography, Champion's Health Belief Model, and Champion's Self-Efficacy Questionnaire for Mammography. Validity and reliability of the tool were investigated and confirmed. Data were analyzed by version 16 of SPSS software using descriptive statistics, Chi-squared test, and multiple logistic regression. RESULTS: The mean (standard deviation) age of the participants was 49.26 (±7.79) years. Seventy-nine (30.85%) of the 262 participants reported mammography. Constructs' sensitivity, benefits, barriers, and perceived self-efficacy were significantly different in terms of performing mammography (P < 0.05). Participants with a history of breast cancer (odds ratio [OR] = 11.18, 95% confidence interval [CI] = [3.73-33.46]) had lower perceived barriers (OR = 3.54, 95% CI= [1.77-7.09]), were more likely to undergo mammography than women with no family history of breast cancer, and had moderate-to-high perceived barriers (P < 0.001). CONCLUSION: The results of this study indicate that health managers are required to pay more attention to training and promoting screening methods. Understanding the barriers to mammography in women by managers can help design and implement effective programs that enhance mammography in women.

Association between severity of depression and clinico-biochemical markers of polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS), as the most common endocrine disorder among reproductive-aged women may lead to psychological morbidity. OBJECTIVES: The present study set out to evaluate the severity of depression in PCOS and non-PCOS women and to evaluate correlation between depression score with body mass index, HOMA-IR, and testosterone level in every group (PCOS and non-PCOS women) in Yazd province. METHODS: In this cross-sectional study, 62 women with PCOS and 61 non- PCOS subjects (20 to 40 years) who were attending Imam-Ali Clinic in Yazd, Iran from September 2014 through March 2015 participated. These persons completed the Beck Depression Short Inventory (BDI-S) Questionnaire. Frequency of depression in PCOD and healthy persons and correlation between depression severity with body mass index, HOMA-IR, testosterone level in PCOS and non- PCOS women were evaluated by ANOVA test and independent-samples t-test and Pearson correlation. P-value of less than 0.05 was considered as statistically significant. Data analyses were performed using SPSS version 16. RESULTS: Of 62 PCOS subjects, 40 (64.5%) were verified positive for depression, determined by the BDI-S Questionnaire. In the control group, 60.7% had depression. Mean±SE score of depression for PCOS and non-PCOS women were 7.47±5.54 and 7.57±5.77 respectively. There was no statistically significant correlation between body mass index, HOMA-IR, testosterone level with depression score in either group separately or together. CONCLUSIONS: We found considerable amounts of depression in our population. There is no correlation between body mass index, HOMA-IR, and testosterone level with depression score in our study.

Self Management Behaviors in Rheumatoid Arthritis Patients and Associated Factors in Tehran 2013.

INTRODUCTION: Rheumatoid Arthritis (RA) is a systemic, autoimmune and inflammatory disease with an unknown etiology that is associated with progressive joint degeneration, limitation of physical activity and disability. The aim of the study was to evaluate self-management behaviors and their associated factors in RA patients. MATERIAL & METHOD: This cross-sectional study was performed in 2013 on185 patients in Iran. Data were selected through convenient sampling. The collected data included demographic variables, disease related variables, Arthritis Impact Measurement Scale 2 (AIMS-2SF), and Self-Management Behaviors (SMB). Data were analyzed by SPSS17 using Spearman correlation and logistic regression test. RESULT: In this study drug management, regular follow-up, and food supplement were used as the most frequently applied SMB and aquatic exercise, diet, massage therapy, and relaxation were the least common SMBs. Age, education, health status, occupation, marital status, sex, DAS28 (Disease Activity Score 28 joints), and PGA (Physician Global Assessment) were significantly related with SMB. CONCLUSION: The result of the study highlight the influence of demographic variables, health status, and disease related data on SMB. Thus, more studies are required to find factors influencing SMB in order to improve SMB.

Factors Affecting Cervical Cancer Screening Behaviors Based On the Precaution Adoption Process Model: A Qualitative Study.

One of the most preventable cancers in women is cervical cancer. Pap smear test is an effective screening program; however, it is not conducted very frequently. The aim of this study is explaining the determinants affecting women's participation in the Pap smear test based on precaution adoption process model with a qualitative approach. This study was a qualitative approach using a Directed Content Analysis methodology which was conducted in 2014. Participants were 30 rural women who participated in this study voluntarily in sarvabad, Iran. Purposive sampling was initiated and continued until data saturation. Semi-structured interviews were the primary method of data collection. Data were analyzed using qualitative content analysis and continuous comparisons. Women`s information and awareness about cervical cancer and Pap smear is insufficient and most of them believed that they were not at risk; however, they perceived the severity of the disease. Some of them had no adequate understanding of the test benefits. They pointed to the lack of time, financial difficulties, fear of test result and lack of awareness as the main barriers against the Pap smear test; however, they did not say that they were not willing to do the test. Findings could help health policy makers to find the right area and purpose to facilitate the participation of women in the Pap smear test.

Risk Perception of Nonspecific Low Back Pain among Nurses: A Qualitative Approach.

BACKGROUND: Low back pain (LBP) is a common medical problem among nurses. A better understanding of nurses' experiences about LBP may help to develop preventative approaches. The study aimed to explore risk perceptions of nonspecific LBP among nurses in Bandar Abbas City, southern Iran. METHODS: This qualitative study conducted as directed content analysis in 2013. Private semi-structured interviews were conducted with a convenience sample of 30 nurses with minimum of 1-year working experience in hospital. The interview questions were based on perceived severity and vulnerability structures of Protection Motivation Theory. All interviews were transcribed and analyzed using thematic analysis. RESULTS: Perceived Severity had the following sub-themes: developing disorders in one's own life and profession, psychical and mental consequences, conflicts and problems in family life, and financial problems. Two sub-themes (problems and limitations in hospital's working system, nature of nursing profession) were identified in relation to perceived vulnerability. CONCLUSION: Nurses reflected their concerns about the impact of LBP on their job security and their considerations about how their back pain might be interpreted by their employers and co-workers. Importance of transparent medical diagnostic procedure and clinical evidence to justify degree of LBP and its burden on the nurses' performance was also addressed.

Oral fennel (Foeniculum vulgare) drop effect on primary dysmenorrhea: Effectiveness of herbal drug.

BACKGROUND: Primary dysmenorrhea refers to the occurrence of painful menstrual cramps of uterus and is considered as a gynecological complaint. The common treatment for this problem is medical therapy such as mefenamic acid [non-steroidal anti-inflammatory drugs (NSAIDs)] and oral contraceptive pills, both of which work by reducing myometrial activity. Fennel contains an antispasmodic and anethol agents and may be helpful for management of primary dysmenorrhea. MATERIAL AND METHODS: The aim of this study was to evaluate the effects of oral fennel drop for treating primary dysmenorrhea. Sixty college students suffering from primary dysmenorrhea were randomly assigned to two groups and followed up for two cycles. Statistical analysis was performed using SPSS version 16. P < 0.05 was considered to be statistically significant. Parametric and non-parametric tests were adopted. RESULTS: Comparison of pain intensity in the two groups showed that there was no significant difference in pain relief between the two groups. Comparison of bleeding severity in the study group before and after intervention was demonstrated from the first day to the fifth day (PV on first day, second day, third day, fourth day, and fifth day 0.948, 0.330, 0.508, 0.583, 0.890, respectively). CONCLUSION: It seems that fennel can be effective in reducing the severity of dysmenorrhea, but it has an unpleasant taste in view of most of the volunteers.

Health Promoting Behaviors in a Population-based Sample of Middle-aged Women and its Relevant Factors in Yazd, Iran.

OBJECTIVES: This study is carried out with the aim of describing the pattern of health-promoting behaviors (HPBs) among middle-aged women and its relevant factors in Iran as a Muslim developing country. METHODS: In a cross-sectional study, 483 middle-aged women were selected using cluster random sampling from Yazd city in Central Iran. An adjusted Persian version of Health Promoting Lifestyle Profile II was used for measuring HPBs. The demographic data were collected too. RESULTS: The average score of middle-aged women HPBs was 2.73 ± 0.36 (2.69 ± 2.76, %95). Spiritual growth and physical activity had the highest and the lowest score in HPBs' dimensions, respectively. HPBs had a positive significant correlation with age (p=0.02) and education level (p=0.001) and a negative significant correlation with number of children (p=0.005). HPBs had a higher level in retired women than employees and housewives. CONCLUSIONS: In spite of a desirable level of HPBs in spiritual growth and interpersonal relationship dimensions among this group, their level of HPBs in physical activity and health responsibility dimensions was undesirable. It means that the feature of health among Iranian middle-aged women in a Muslim developing country is different from the industrialized developed and also the non-Muslim countries; hence, they need a different intervention programs.

Barriers of child adoption in infertile couples: Iranian's views.

BACKGROUND: There are many reasons why some couples do not become parents. Some are infertile, some do not want kids, children can be in a social context unacceptable and for others different life goals are more important. OBJECTIVE: This study was designed to determine barriers of child adoption in infertile couples in Iran. MATERIALS AND METHODS: This cross-sectional study was carried out at Iran from April 2010 to June 2011. The research program was comprised consecutively in 240 infertile couples. Experts in Guidance and Counseling vetted the instrument and set that it has content validity. Test re-test reliability was conducted by the investigators using a sample of 20 couples who have filled questionnaire. RESULTS: Although 230 (96%) of the respondents heard of child adoption, only 89 (37.3%) of couples knew correct meaning of child adoption. Fifty four women (24%) knew how to adopt a baby while the rest did not; 196 (82%) respondents expressed their unwillingness to adopt a baby. Hoping of childbearing (78%) was the main barrier to adopt a child. CONCLUSION: The barriers mentioned were cultural practices, stigmatization, financial implications, and technical problems. Most of the infertile Iranian couples prefer to stay even so without children or think about new treatment.

Internal motivations and barriers effective on the healthy lifestyle of middle-aged women: A qualitative approach.

BACKGROUND: A healthy lifestyle is one of the basic health-promotion strategies. Several factors are involved in shaping health-promotion behaviors. The internal barriers are the opinion and feelings that surround the individual and are the reasons that complicate the change of behavior. The aim of this study was to identify internal motivations and barriers effective on the healthy lifestyle in middle-aged Iranian women. MATERIALS AND METHODS: This was a qualitative study based on content analysis of in-depth semi-structured interviews with 21 middle-aged women in the city of Yazd, who were selected using purposeful sampling approach. The interviews continued until data saturation was reached; and the interviews were audio-recorded and transcribed exactly. The transcripts were analyzed. RESULTS: FIVE MAIN THEMES EMERGED FROM THE ANALYSIS OF THE INTERVIEWS: Women's knowledge of health-promoting behaviors, importance of health and healthy behavior of women, affliction or fear of affliction to chronic disease and its consequences, responsibilities of women in the family and society, and skills of life management in women. CONCLUSION: The findings suggest that empowering individual participants in health promotion is the most important factor determining their health. Thus, designing appropriate programs for education and empowerment of people is essential to promoting health. Health policy makers, with knowledge of these factors, can design comprehensive, socialization programs to promote women's health.