A qualitative study on the health system-related needs in women survivors of rape.

BACKGROUND: Rape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape. METHODS: In the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method. RESULTS: After analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely "receiving services with respect for privacy and confidentiality", "non-judgmental behavior and approach", and "the need to receive empathy and the feeling of not being alone", and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely "the need to receive comprehensive and integrated services", and "establishing specialized centers for providing services to survivors". CONCLUSIONS: Overall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.

Investigating the Relationship between Early Maladaptive Schemas and Sexual Self-Confidence and Sexual Self-Efficacy in Individuals with Gender Dysphoria.

Background: Due to the negative effects of sexual identity disorder and the lack of attention from family and society, this study aimed to investigate the relationship between Young's Early Maladaptive Schemas (YEMS) and sexual self-confidence and sexual self-efficacy in individuals with gender dysphoria (GD) after surgery. Materials and Methods: This cross-sectional study was performed on 45 individuals with GD undergoing sex reassignment surgery (SRS). Three of YEMS questionnaire (YEMSQ), sexual self-confidence, and sexual self-efficacy were completed. Results: The YEMSQ score had a significant inverse relationship with sexual self-efficacy (correlation = -0.333, P-value = 0.025). In addition, dimensions of emotional deprivation, failure to achieve, dependence/incompetence, vulnerability to harm and Illness, insufficient self-control/self-discipline, and subjugation had an adverse effect on the self-confidence and sexual self-efficacy in these individuals (P-value <0.05). Conclusion: According to the results of this study, YEMSQ score, sexual self-confidence, and self-efficacy were not significantly different between the two groups of male-to-female (MF) and female-to-male (FM). Also, the formation or development of these schemas in childhood in these individuals can be influential in reducing their sexual self-efficacy.

A qualitative exploration of the psychological needs of women survivors of rape in Iran.

BACKGROUND: Rape is one of the principal forms of sexual violence leading to numerous psychological consequences for women. Providing effective psychological services to women survivors of rape requires identifying and considering their real needs. This study aimed to explore the psychological needs of women survivors of rape. METHODS: In this exploratory-descriptive qualitative study, the participants consisted of 19 women survivors of rape and 20 people with experience in providing services to survivors of rape, selected via purposive sampling method in Isfahan, Iran. In-depth individual semi-structured interviews and field notes were used to collect data, which were then analyzed using the conventional content analysis method. RESULTS: Based on the analysis of the interviews, the psychological needs of women survivors of rape were classified into three main categories: facing psychological problems, attention to emotional reactions, and the need to accept and adapt to reality. CONCLUSIONS: The results revealed that women survivors of rape have different psychological needs. Thus, to meet these needs, supportive and psychological interventions can be considered at both individual and environmental levels. Also, eliminating gender stereotypes affecting the occurrence of rape in the dimensions of Iranian culture can lead to the liberation of the society from the culture of rape.

Development and psychometric evaluation of the need assessment tool for women survivors of rape: Protocol for a mixed methods study.

BACKGROUND: Rape can lead to various physical and psychological consequences. Thus, survivors should receive immediate interventions and need-based care. The present study aims to design and psychometric evaluation of needs in women survivors of rape. MATERIALS AND METHODS: This mixed methods study is conducted using a sequential exploratory approach. In the first phase, the participants (women survivors of rape and healthcare providers) are selected through purposive sampling in Isfahan. Data are collected through in-depth semi-structured interviews and field notes and are analyzed using conventional qualitative content analysis. The draft of the questionnaire is prepared based on the findings of the qualitative phase and literature review. Then, the face validity, content validity, and reliability of the questionnaire are assessed. Construct validity is assessed using the exploratory factor analysis through a descriptive cross-sectional study on women survivors of rape in the quantitative phase. Using a convenience sampling method, the data are collected in the research environment and analyzed via descriptive and inferential statistical methods. Cronbach's alpha coefficient is used to assess the internal correlation of the questionnaire. CONCLUSION: The valid and reliable questionnaire that is developed in this study can be used by planners to provide services and care according to the needs of women survivors of rape.

The relationship between sexual self-concept and contraception sexual behavior in 15 to 49 years old women covered by community health centers.

BACKGROUND: One of the most important goals of sexual intercourse is to arouse the psychological effects of intercourse and to increase sexual self-concept, which changes following sexual behaviors such as the use of contraception methods. This study was performed to investigate the relationship between sexual self-concept and contraception sexual behavior in 15-49-year-old women covered by community health centers. MATERIALS AND METHODS: The present descriptive correlational study was performed on 297 married women referring to Isfahan community health centers in 2020 who were selected as cluster that randomly classified. The tools included demographic information and the Snell's Multidimensional Sexual Self-Concept Questionnaire, the data of which were analyzed via SPSS version 22 software by Mann-Whitney U test and Pearson correlation. RESULTS: Among a total of 297 women, 5.4% of the samples used hormonal methods and 94.6% used non-hormonal methods, which was the most common intermittent method. The results also showed that the mean score of negative sexual self-concept in women using the hormonal level method was significantly higher (P = 0.012). Positive and positive sexual self-concept score was significantly higher in women using non-hormonal methods (P = 0.048 and P = 0.002). Therefore, there was a significant relationship between sexual self-concept and contraception method. CONCLUSION: Due to the relationship between contraception and sexual self-concept, it is recommended to pay attention to the aspects of sexual self-concept and contraception during reproductive health counselling sessions so that if there is a disorder, useful advice can be provided or referred, if necessary.

The Needs of Women Survivors of Rape: A Narrative Review.

Background: Rape is a serious global problem linked to long-term physical health complications in women. Women survivors of rape have different needs, the identification of which ensures optimal services and improves their health conditions. This study aimed to explore the needs of women survivors of rape through a narrative review. Materials and Methods: This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), Iranian Research Institute for Information Science and Technology (IranDoc), Iranian Medical Articles Database (IranMedex), and the Google Scholar engine. All English and Persian articles published from January 2000 to August 2022 were searched using the keywords rape, sexual assault, sexual violence, victim, survivor, demands, and needs. Two independent researchers conducted all steps of article extraction and review to avoid possible bias, and a third person reviewed the articles in the case of disagreement between the two researchers. The final related articles were selected and evaluated using a pre-prepared checklist. Results: Out of 112 articles, 26 articles were selected for final evaluation. The needs of women survivors of rape were divided into six categories, including sociocultural, educational, legal and judicial, psychological, spiritual and religious, and healthcare. Conclusions: Women survivors of rape need survivor-centered, culturally appropriate services, necessitating careful planning and policymaking to address health and judicial issues from different dimensions considering their real-world needs.

The effectiveness of sexual health counseling based on cognitive-behavioral therapy on sexual satisfaction and inefficient sexual beliefs of primigravida women.

BACKGROUND: Pregnancy may change sex life, this period may be associated with decreased sex, and this is due to fear of miscarriage, nausea and vomiting, fear of harm to the fetus, fatigue, and fear of ruptured membranes. Midwives could help them to improve their sexual life during this period. One of the important approaches to improving sexual life during pregnancy is cognitive-behavioral therapy (CBT). This nonmedical approach could improve misconceptions about sex during pregnancy. The aim of this study was the effect of sexual health counseling based on CBT on sexual satisfaction and inefficient sexual beliefs of primigravida women. MATERIALS AND METHODS: This was a randomized clinical trial study, the research population being 52 pregnant women who were randomly divided into groups, the experimental (26) and the control (26). Before the sexual health counseling based on CBT, the Sexual Satisfaction Questionnaire and the Inefficient Sexual Beliefs Questionnaire were filled by both the groups. These standard questionnaires were completed three times (before, immediately, and 4 weeks after intervention). After pretest, eight sexual health counseling sessions (90 min) were performed for the experimental group. The control group received routine care. Data analysis was performed by using descriptive statistics tests, ANOVA, and post hoc tests by Bonferroni method in SPSS version 22. P < 0.05 was considered statistically significant. RESULTS: The mean score of inefficient sexual beliefs in the interventional group before intervention, immediately after the intervention, and 1 month later was obtained 22.85 ± 9.57, 12.92 ± 7.25, and 7.86 ± 13.88, respectively (P < 0.001). The mean score of sexual satisfaction before the study, immediately after the intervention, and 1 month later was 88.77 ± 11.89, 95.62 ± 9.27, and 94.65 ± 8.28, respectively, in the experimental group (P < 0.001). CONCLUSION: Sexual health counseling based on CBT could reduce inefficient sexual beliefs and increase the sexual satisfaction of the primigravida women during pregnancy, but most participants preferred fewer sessions.

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.

Parenting Styles and Psychiatric Disorders in Children of Bipolar Parents.

BACKGROUND: Bipolar disorders (BD) in parents can have different effects on children and perhaps as a reason of the incidence of various psychiatric disorders in them and they may show a particular parenting style due to features of their disease. Given a crucial role of parenting style in upbringing children, this study aimed to evaluate different styles of parenting and its relationship with psychiatric disorders in children of parents with bipolar disorder (PBD) compared with controls. MATERIALS AND METHODS: In this case-control study, 500 parents with children aged 6-17 years were included that 250 of them with BD were selected as the case group and 250 of them were healthy as control group. The parents were selected according to the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) by a physician. Psychiatric disorders in children were assessed by The Kiddie Schedule for Affective Disorders and Schizophrenia for school-age children (KSADS). The collected data were analyzed with SPSS (version 20). RESULTS: According to KSADS, there was significant difference between two groups of children in depression, mania, attention-deficit hyperactivity disorder, and posttraumatic stress disorder (P < 0.05). In authoritative dimension, parenting styles were effective in the incidence of psychosis (odds ratio [OR] [95% confidence interval (CI)]: 0.775 [0.63-0.95]) and led to a decrease of 0.320 times in the chance of oppositional defiant disorder incidence (OR [95% CI]: 0.320 [0.21-0.74]; P = 0.043) but an increase of 1.129 times in the chance of cigarette/tobacco use (OR [95% CI]: 1.129 [1.02-1.25]; P = 0.016). CONCLUSION: The chance of psychiatric disorder's incidence in children of PBD was so far more than children of healthy parents. Hence, the incidence of some psychiatric disorders in children can be associated with parenting styles.