The effect of individual counseling based on the GATHER principles on perceived stress and empowerment of the mothers with high-risk pregnancies: an experimental study.

BACKGROUND: High-risk pregnancy causes different responses, including negative emotions, feelings of vulnerability and psychological stress in the mother. The aim of this study was to investigate the effect of individual counseling on the empowerment and the perceived stress of high-risk pregnant mothers. METHODS: This study was a two-group experimental study. The study was performed on 82 high-risk pregnant women hospitalized in Fatemieh Hospital in Hamadan, Iran. Inclusion criteria were high-risk pregnancy, being literate, gestational age 24 to 36 weeks. The samples were divided into experimental and control groups using randomized block design. Data were collected using Cohen's perceived stress scale and Kameda empowerment questionnaires. For the experimental group, four sessions of individual counseling according to GATHER principles (Greet, Ask, Tell, Help, Explain, and Return) were performed for 45-60 minutes for two consecutive weeks. SPSS 25 software was used for data analysis. RESULTS: The mean score of the perceived stress after the intervention in the control and experimental groups were 27.07(5.80) and 25.30(4.95), respectively (P = 0.097). There was a substantial difference in the mean score of empowerment 84.76)9.14) and 88.75 (6.17) (P < 0.001) and different dimensions of empowerment (self-efficacy, Future image, self-esteem, Support and assurance from others) between the control and intervention groups after the intervention. CONCLUSIONS: The findings of this study indicate individual counseling is effective in empowering the mothers with high-risk pregnancy but has no significant effect on their perceived stress.

The mediating effect of ethical climate on religious orientation and ethical behavior.

BACKGROUND: Nurses' behavior in Educational-Medical centers is very important for improving the condition of patients. Ethical climate represents the ethical values and behavioral expectations. Attitude of people toward religion is both intrinsic and extrinsic. Different ethical climates and attitude toward religion could be associated with nurses' behavior. AIM: To study the mediating effect of ethical climate on religious orientation and ethical behaviors of nurses. RESEARCH DESIGN: In an exploratory analysis study, the path analysis method was used to identify the effective variables on ethical behavior. PARTICIPANTS/CONTEXT: The participants consisted of 259 Iranian nurses from Hamadan University of Medical Sciences. ETHICAL CONSIDERATIONS: This project with an ethical code and a unique ID IR.UMSHA.REC.1395.67 was approved in the Research Council of Hamadan University of Medical Sciences. FINDINGS: The beta coefficients obtained by regression analysis of perception of ethical climate of individual egoism (B = -0.202, p < 0.001), individual ethical principles (B = -0.184, p = 0.001), local egoism (B = -0.136, p = 0.003), and extrinsic religious orientation (B = -0.266, p = 0.007) were significant that they could act as predictors of ethical behavior. The summary of regression model indicated that 0.27% of ethical behaviors of nurses are justified by two variables: ethical climate and religious orientation. DISCUSSION AND CONCLUSION: Intrinsic religious orientation has the most direct impact and then, respectively, the variables of ethical climate of perceptions in the dimensions of individual egoism, individual ethical principles, local egoism, global ethical principle, and ethical behavior and extrinsic religious orientation follow. All the above, except global ethical principles and intrinsic orientation of religion have a negative effect on ethical behavior and can be predictors of ethical behavior. Therefore, applying strategies to promote theories of intrinsic religious orientation and global ethical principles in different situations of nursing is recommended.

The effect of metabolic syndrome and its components in midpregnancy on neonatal outcomes.

Background: The prevalence of metabolic syndrome has been rising worldwide in recent decades. Determining the associations between metabolic syndrome and its components in midpregnancy with neonatal anthropometric indices and outcomes is a major challenge in both public health and clinical care. Methods: This prospective cohort study was performed on 238 pregnant women at 24-28 weeks of gestation. Metabolic syndrome was recognized with 3 or more of the following criteria: triglyceride ≥ 247 mg/dL; HDL < 61 mg/dL; GCT ≥ 140 mg/dL; prepregnancy body mass index ≥ 30 kg/m2; and blood pressure ≥ 130/85 mmHg. Statistical analysis was performed through descriptive statistics, including mean, standard deviation, frequency, and percentage, Mann-Whitney test, Chi-square test, Fisher's exact test, linear and logistic regression in SPSS 21.0. P values < 0.05 were considered significant. Results: There was a significant association between blood hypertriglyceridemia in weeks 24-28 and anthropometric indices, including weight, height, and jaundice, in the first 24 hours of birth. Metabolic syndrome also had a significant relationship with jaundice (P=0.002). The results of linear regression analysis revealed that metabolic syndrome was positively associated with birth weight (B=0.18, P=0.003) and height (B=0.18, P=0.009). Among the components of metabolic syndrome, the results showed a direct relationship between increased blood triglyceride of the mother and newborn's weight (B=0.11, P=0.011) and height (B=0.14, P=0.007). Also, increased BMI had a significant direct relationship with the newborn's weight (B=0.11, P=0.023) and height (B=0.12, P=0.023). Moreover, decreased HDL had a significant reverse relationship with the newborn's weight (B=0.09, P=0.042). Conclusion: Presence of metabolic syndrome and its components in midpregnancy may influence neonatal outcomes, especially anthropometric indices. However, more studies should be conducted to further investigate these relationships.

Comparison of the Effects of Dill Seed, Grape Seed and Date Extracts on Postpartum Hemorrhage Rates in the Fourth Stage of Labor: A Randomized Clinical Trial.

BACKGROUND: Postpartum hemorrhage (PPH) is one of the three leading causes of maternal mortality. Herbal medicine is one of the well-known methods of treatment in the world. OBJECTIVE: This study was conducted to determine and compare the effect of dates, grape seed and dill seed extracts on the PPH rate in women in the fourth stage of labor. METHODS: Two hundred eligible multiparous women visiting the maternity ward in Hamadan for normal delivery participated in this double-blind parallel-group clinical trial. They were randomly divided into four 50-member groups of experiment (3 groups) and control (1 group). The data were collected using a researcher-made questionnaire. In the experimental groups, in addition to routine care and oxytocin administration, the mothers received a capsule containing 15 mg of dill seeds extract or 20 mg of grape seed extract or 5 g of dates extract immediately after the delivery, and then their hemorrhage rates were measured one and two hours after delivery. The control group received routine care, oxytocin, and placebo. Data were analyzed in SPSS 21. RESULTS: The hemorrhage changes in the placebo group were much less than the intervention groups at 1 and 2 hours after delivery, and the four groups had a significant difference in terms of hemorrhage in both hours (p <0.001). The overall difference between the dates extract group and the placebo and grape seed groups was also statistically significant (p <0.05). CONCLUSION: All three extracts of dates, grape seed and dill seeds, especially dates, can be effective in PPH reduction. CLINICAL TRIAL REGISTRATION NUMBER: IRCT20120215009014N300.

Investigating the Relationship between the Attitude Towards Infertility and Stress Coping Strategies among Couples undergoing Assisted Reproduction Treatment.

INTRODUCTION: Infertility and its treatment methods among couples have psychological and social consequences. To encounter these consequences, coping strategies are commonly used, which are influenced by various factors, such as the attitude of couples toward infertility. OBJECTIVE: This study aims to determine the relationship between attitudes toward infertility and stress-coping strategies among couples undergoing Assisted Reproduction Treatment, referring to the infertility clinic of Al-Zahra Educational Center. METHODS: This study was a cross-sectional study performed on 153 couples referred to Al-Zahra Infertility Clinic in Rasht. Three instruments (demographic questionnaire, attitude, and Lazarus coping strategies questionnaire) were used with regard to the inclusion restrictions. RESULTS: Between the two variables of individual and social information factors and the attitude of couples toward infertility, only the duration of infertility factor revealed a significant relationship (p <0.05); and in explaining the relationship between individual and social variables and coping strategies, the lack of insurance in both genders with an emotion-oriented strategy, the female infertility factor in women with the confrontational adjustment domain, and treatment in a discontinuous way in both genders have a significant relationship with the problem-oriented domain (p <0.05). Accountability and problem-solving strategies in women and an escapeavoidance strategy in infertile men have been identified as the most important predictors of attitude toward infertility. CONCLUSION: There is a relationship between attitudes toward infertility and coping strategies. However, the impact of community culture on the type of coping strategies used in this study has led to different results in some cases from other studies.

Effect of Evening Primrose Vaginal Capsule on Cervix Preparation and Duration of First Stage of Labor in Nulliparous Women Referred to Fatemieh Hospital in Hamadan, Iran: A Single-blind Randomized Controlled Trial.

BACKGROUND: Cervix preparation is one of the main steps in the onset of labor and is very important for success in initiating or inducing labor. OBJECTIVE: The present study aimed at investigating the effect of evening primrose vaginal capsule on the preparation of cervix and the consequences of labor in nulliparous women. METHODS: This randomized clinical trial study was conducted in 2018 on 100 nulliparous women referred to Fatemieh Hospital in Hamadan. In intervention group (50 people), one evening primrose capsule (500 mg) was used vaginally and then two hours later, another capsule was used, and placebo was used in the control group (50 people). Then, the dilatation, effacement, Bishop scores and duration of the first stage of the labor were compared in two groups after 4 hours. Statistical analysis was performed with SPSS 21. The significance level was considered to be 0.05. RESULTS: There was a statistically significant difference in the mean score and standard deviation of dilatation, effacement of cervix, bi-shop scores and duration of the first stage of labor four hours after the intervention in the intervention and Placebo groups by controlling the effect of potential confounding factors (P <0.001). CONCLUSION: The results showed that the use of evening primrose vaginal capsules can reduce the length of the first stage of labor, improve Bishop score, and soften and ripen the cervix.

The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial.

OBJECTIVES: Menopause is associated with complications that could decline women's health during this period. Therefore, some of its complications, such as hot flashes and night sweats, must be treated or alleviated. METHODS: This randomized controlled trial included postmenopausal women who were referred to health centers in Hamadan from May 2018 to April 2019. The hot flash and night sweat questionnaires were completed by the researcher a week before and 8 weeks after the intervention. The intervention group took one capsule (1,000 mg) of evening primrose oil twice daily, while the control group received the same amount of placebo. Finally, the results were analyzed using Stata 13. RESULTS: The mean scores of duration, frequency, and severity of hot flashes did not significantly decrease in both groups after the intervention compared with before the intervention, and no statistically significant difference was observed (P > 0.05). However, the intervention group had lower frequency and severity of night sweats after the intervention than the control group, with statistically significant differences (P < 0.05). CONCLUSION: Evening primrose oil effectively decreased the frequency and severity of night sweats.

Comparison of the Effects of Nika Vaginal Cream with Clotrimazole Cream on Vaginal Candidiasis Symptoms: A Randomized Single-Blind Clinical Trial.

BACKGROUND: The prevalence of vaginal candidiasis is high in women and proper treatment is essential in this regard. MATERIALS AND METHODS: This single-blind randomized controlled clinical trial was conducted on 120 women who were referred to Hamadan health centers in 2019. The patients were randomly divided into Clotrimazole cream and Nika vaginal cream groups each including 60 cases. The intervention group received Nika vaginal cream once a day for a week and those in the control group were given Clotrimazole vaginal cream in the same way. The clinical symptoms were studied by clinical examinations and the culture of vaginal discharge before and 7 days after the treatment to confirm the diagnosis of Candida albicans. The results were analyzed by SPSS 21.0 using an independent t test, Mann-Whitney U test, and Chi-square, Fisher's exact, and McNemar's tests, the significance level was set at 0.05. RESULTS: Most patients in both groups reported no clinical symptoms after the intervention, and no significant difference was observed between the two groups in this regard (χ2 = 2.23, p = 0.566). Conversely, a significant difference was found in Nika and Clotrimazole groups before and after the intervention regarding improving Vulvovaginal Candidiasis (VVC) symptoms χ2 = 86.01, χ2 = 99.41, respectively (p < 0.001). Finally, 84.48% and 75.86% of women in the Nika χ2 = 45.02 (p < 0.001) and Clotrimazole cream χ2 = 40.02 (p < 0.001) groups had negative culture results after the intervention. CONCLUSIONS: In general, the Nika and Clotrimazole vaginal creams have the same effects concerning improving the symptoms of vaginal candidiasis and thus can be used to treat VVC.

Designing and Executing a Checklist for Evaluating Midwifery Students' Practical Skills.

BACKGROUND: This study aimed to design and execute a reliable checklist for evaluating midwifery students' clinical skills. MATERIALS AND METHODS: In this cross-sectional study, 8 checklists were designed and validated for midwifery procedures. The students' performances were compared using this method and two other evaluation methods. RESULTS: The face and content validity of all questions were approved (content validity ratio and content validity index >0.80, inter-rater reliability >0.50, and Cronbach's alpha >0.70). The rate of the students' satisfaction was 19%, 14%, and 76% with the nonchecklist method, the general checklist, and the designed checklist, respectively. Furthermore, both students (F2,60= 107.07, p < 0.004) and evaluators (F2,9 = 152.23, p < 0.001) gained significantly higher attitude scores towards the new checklist compared to the two other methods. CONCLUSIONS: The designed checklist was quite reliable and valid for evaluating the midwifery students' clinical skills.

Effect of Combined Herbal Capsule Menohelp on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial.

OBJECTIVES: Hot flashes and night sweats are the most common and annoying consequences of menopause. The present study aimed to investigate the effect of a combined herbal capsule (black cohosh, soy, potato, chaste tree, and burdock) on hot flashes and night sweats in postmenopausal women. METHODS: The present study was a randomized clinical trial conducted on postmenopausal women who were referred to Hamadan health centers in 2018-2019. The patients were distributed randomly in two groups of 85 individuals using the permuted block technique. The intervention group received the Menohelp capsule 550 mg twice daily for eight weeks and those in the control group received placebo. Data was obtained using a demographic questionnaire and a night sweat checklist one week before and eight weeks after the intervention. Data analysis was done using Stata 13. RESULTS: Data analysis revealed that means of hot flashes duration, frequency and intensity did not significantly decrease in the postintervention phase as compared to the pre-intervention phase in both the groups (P > 0.05). Comparative analyses of frequency and intensity of night sweats in the two groups revealed that both variables decreased after intervention with the Menohelp capsule (P < 0.05). CONCLUSIONS: This study revealed that combined herbal medicine (Menohelp) was effective in reducing the frequency and intensity of night sweats. Therefore, it can be used to reduce night sweats in postmenopausal women.

Evaluating Clinical Course and Risk Factors of Infection and Demographic Characteristics of Pregnant Women with COVID-19 in Hamadan Province, West of Iran.

BACKGROUND: COVID-19 is a new viral disease with a rapid outbreak. Pregnant women are at a higher risk of contracting viral infections including COVID-19. We aimed to evaluate the clinical course and risk factors of pregnant women diagnosed with COVID 19 in Hamadan Province, west of Iran. STUDY DESIGN: A retrospective cohort study. METHODS: The convenience sampling was performed using 50 papers and electronic files of pregnant women diagnosed with COVID-19 according to the WHO's temporary guidelines. They were hospitalized in health centers and clinics of Hamadan Province. The data-collecting tool employed was a researcher-made questionnaire. The data were analyzed via SPSS software version 19. RESULTS: The mean age of pregnant women with COVID 19 was estimated to be 29.20 ± 5.8 yr and their average gestational age estimated to be 28.8 ± 8.20 weeks. About 32% of them had an underlying disease, 32% a history of influenza, and 40% recently traveled to infected areas. The most common findings were CT scans and multiple mottling and ground-glass opacity chest radiology. The most common symptoms were fever, cough, and shortness of breath. About 8% of the women required ICU hospitalization and the average length of hospital stay was 4.04 ± 2.38 and 29% had premature births. Moreover, 28% of infected mothers had a normal delivery and 20% had a cesarean section. CONCLUSION: Early diagnosis of Covid-19 disease is essential in pregnant women. Because there is a possibility of worsening complications in the mother and fetus.

The Effect of Self-learning Module on Nursing Students' Clinical Competency: A Pilot Study.

BACKGROUND: Self-learning module (SLM) is designed for independent learning. In this study, the hypothesis that SLM is effective to some extent in improving clinical competence in nursing students was tested. MATERIALS AND METHODS: The study employed a randomized controlled design. In this study, 46 nursing students were randomized into the control or intervention group. Study tools included a demographic information form and nursing skills checklist. Unlike the control group, the intervention group received clinical SLM. Nursing students' clinical competency was measured at the end of the intervention through objective structured clinical examination. Statistical analysis was performed in SPSS software. A p value < 0.050 was considered statistically significant. RESULTS: In total, 46 students participated in this study. The Mean (SD) age of the study participants was 18.80 (1.06) years. There was a significant difference in students' clinical competency between the control and intervention groups (Mann-Whitney U-test: p = 0.010). Mean (SD) of clinical competency in the control and SLM groups was 58.19 (6.41) and 62.83 (6.05), respectively. Results of the group equivalency test indicated that all demographic variables were equivalent between the groups. Moreover, there was no significant difference between women and men in terms of clinical competency. CONCLUSIONS: According to the results, the use of SLM could help the students enhance the quality of nursing clinical competency.

Determining Occupational Performance Issues in Women with Breast Cancer Referred to Treatment Centers of Hamadan, Iran

Objective: Women with breast cancer experience functional limitations at the time of diagnosis and after the initial treatment of cancer. Such limitations interfere with participation in self-care, work affairs, and leisure activities. The present study aimed to determine occupational performance priorities in women with breast cancer who had referred to treatment centers in Hamadan, Iran. Methods: In this cross-sectional, descriptive-analytical study, 102 women with breast cancer who had referred to treatment centers in Hamadan were selected through convenience sampling. The participants' information was gathered using their medical records and a demographic information questionnaire. Then, they were interviewed using the Canadian Occupational Performance Measure (COPM) to determine their occupational performance issues. The gathered data were coded and analyzed using the SPSS statistical software, version 16. Results: The results indicated that out of the 22 defined codes for the patients' selected activities, 45.8%, 30.8%, and 23.4% belonged to self-care, productivity, and leisure domains, respectively. Conclusion: Women with breast cancer experience various occupational performance issues due to disease complications and received treatments. In the present study, self-care comprised the occupational performance priority. Determining the clients' intervention priorities, which is among the bases of occupational therapy interventions, can help women with breast cancer reach the desired quality of life.

Predictors of Preeclampsia Based on a 10-Year Case-Control Study.

Objective: To investigate the predictors of preeclampsia based on a 10-years case-control study. Materials and methods: The present retrospective, case-control study was carried out in a referral Hospital in Hamadan, Iran, during 2005-2015. Using a hospital information system (HIS), all the available information on hospitalized preeclamptic patients during 10-years period was collected and all preeclamptic women were qualified for the study as the case group (729 subjects) and the same number of non-preeclamptic women were assigned to the control group. The required data were collected using the researcher-made questionnaire and analyzed using descriptive statistics, chi-square test, independent t-test and logistic regression. Results: The results show that high age (OR = 1.04), low education (diploma compared to illiterate OR = 0.51 and middle school education compared to illiterate OR = 0.55), blood group O (AB: OR = 0.32; B: OR = 0.36; A: OR = 0.26) and fertilization during autumn (spring: OR = 0.41; summer: OR = 0.26; autumn: OR = 1.13) could raise the risk of preeclampsia. Conclusion: High age, low education, blood group O and fertilization in cold seasons could be the risk factors of preeclampsia. Recognizing the risk factors of preeclampsia could help the determination of high risk cases and designing of effective interventions.

Effect of Menstrugole on primary dysmenorrhea: a randomized clinical trial.

OBJECTIVE: Primary dysmenorrhea occurs in more than 50% of women of reproductive age. This survey evaluated the effects of Menstrugole on the alleviation of primary dysmenorrhea. METHODS: This study was performed in western Iran between August 15 and December 15, 2017, in female students with primary dysmenorrhea. The students were randomly divided into 2 groups and received placebo or a Menstrugole capsule for 3 days in each of 2 menstrual cycles. The visual analog scale was used to assess pain severity. The χ2 test, one-way analysis of variance, and the paired t-test were used for statistical evaluation. RESULTS: We compared the severity of pain between the 2 groups. There was a significant change in the mean pain score during the first (P<0.001) and second months (P<0.001) after the use of Menstrugole, compared with that in the placebo group. CONCLUSION: Menstrugole decreased pain severity in female students, and can be considered by health care providers for treatment of primary dysmenorrhea.

Exploring Effective Contextual Factors for Regular Cervical Cancer Screening in Iranian Women: A Qualitative Study

Background: Adherence to regular screening programs for cervical cancer in Iranian women is not common. The aim of this study was to explore contextual factors influencing behavior and compliance with guidelines. Methods: This qualitative content analysis study was conducted in 2016-2017 in Hamadan city, Iran. Semi-structured in-depth interviews were conducted with 31 participants who were selected purposefully on referring to health centers. Twenty-three were women with various experiences of cervical cancer screening and 8 were health care providers (4 midwives, 1 gynecologist, 1 general practitioner and 1 family health expert). Guba and Lincoln criteria were used for tustworthiness. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted from the data: an opportunity maker system, opportunities to become acquainted, concerns for healthy living, and perception of cancer. Conclusion: The results showed sensitivity of health care providers and their appropriate performance in relation to regular screening behavior of women is very important. Women's perception of cancer and its curability is another factor with a major effect on screening behavior. Opportunities for people to become acquainted with the Pap smear in a variety of ways and concern for healthy living and the need to have a healthy life to ensure quality of life were also found to be important.

The Effect of Cognitive Behavioral Therapy on Marital Quality among Women.

BACKGROUND: Marital quality reflects the individual's overall evaluation of marital relationship. The aim of study was examine the effect of cognitive behavioral counseling on marital quality among women. MATERIALS AND METHODS: The experimental study was a randomized clinical trial with two groups, on 198 qualified women who referred to selected health care centers in Hamadan, Iran in 2016. The intervention participants attended four 90-minute sessions of cognitive behavioral counseling. Demographic information questionnaire and marital quality scale [Revised Dyadic Adjustment Scale (RDAS)] were completed by the two groups before and after the intervention. To perform the comparisons, t test, Chi-square test and Fisher's test, Logistic Regression and covariance analysis were used. Covariance analysis or change analysis were employed. Statistical analysis was done using SPSS Software, version 21.0. The significance level was set at 5% (P<0.05). RESULTS: According to the results of the present study, the mean age in the control group and the intervention group was 23.58 ± 7.54 and 35.04 ± 7.91 years old, respectively. Covariance analysis was utilized to examine the marital quality scores. In this analysis, after modification of the variables of age, marital quality score of agreement and satisfaction before the intervention, and income status, the total marital quality score experienced a significant change in all dimensions (P<0.05) and the mean scores increased remarkably. Moreover, according to the cut-off point of the dimensions, the scores of all dimensions increased remarkably and the proportion of individuals with high marital quality before and after the intervention changed significantly (P<0.05). CONCLUSION: Due to the role of sexual relations in stabilizing marriage, cognitive behavioral consultation was effective in improving marital quality especially after agreement and can be used in health care centers in order to improve the relationship between couples and reduce divorce rates (Registration number: IRCT201610209014N125).

The Effect of Cognitive-Behavioral Consultation on Sexual Function among Women: a Randomized Clinical Trial.

Introduction: Sexual dysfunction is one of the most common causes of family breakdowns. In recent years, various approaches have been proposed to resolve this issue. The present study was carried out in order to examine the effect of cognitive-behavioral consultation on sexual function among women who had referred to health centers in Hamadan. Method: A randomized clinical trial was conducted in two groups. It focused on 198 qualified women who had referred to selected health centers of Hamadan in 2016. The participants were selected by simple random sampling (99 people in each group).The intervention group received four 2-hour sessions of cognitive-behavioral group consultation. The required data were collected using a questionnaire of demographic characteristics and Female Sexual Function Index (FSFI). For ethical considerations, by the end of the study, sexual counseling for the control group was provided. To analyze the collected data, SPSS 13 was employed; t-test was used for independent samples. ANCOVA was also utilized. The significance level was set at 0.05. Results: The results showed that the two groups were not significantly different in terms of mean pretest scores in all domains, except for sexual satisfaction and total sexual function. However, after cognitive-behavioral consultation sessions, the intervention group experienced a significant increase in all behavioral domains and total sexual function as compared to the control group. Conclusion: Cognitive-behavioral consultation among women can play a positive and effective role in improving sexual relationships. Therefore, the effectiveness of this type of consultation can be confirmed with more certainty.

Frequency and causes of emergency hysterectomy along with vaginal delivery and caesarean section in Hamadan, Iran.

BACKGROUND: Emergency hysterectomy (peripartum) is a high-risk surgery that almost always is done in the treatment or prevention of severe and life-threatening bleeding that occurs after vaginal delivery or caesarean. OBJECTIVE: To compare the frequency and causes of emergency hysterectomy along with the vaginal delivery and caesarean section (CS). METHODS: The cross-sectional research was conducted on patients who underwent a peripartum hysterectomy from 2005 to 2015 at Fatemieh Hospital in Hamadan City, Iran. Data collection tools included a questionnaire about demographic features and factors associated with hysterectomy surgery. Data were analyzed using SPSS version 21 and by descriptive statistics, chi-square, paired t-test, and one-way analysis of variance (ANOVA). RESULTS: The mean age of women was 33.4±5.09 years. In recent years, 37 cases of hysterectomy were reported, with the peak occurring in 2015. The highest prevalence of hysterectomy was associated with 28 (77.8%) women with a third pregnancy and second parity, while 32 cases (86.5) were related to those with no history of vaginal delivery, 15 (45.5%) were related to repeated CS and second repeated CS; 28 cases (75.7%) to those with no history of placenta previa; 21 cases (56.8) to the majority with the anterior placenta;, 33 cases (97.1%) to those with no over-distance of uterine; and 36 cases (97.3%) to those without a history of uterine myoma. Among 37 cases who had hysterectomy, placenta accreta was observed in 27 cases (77.1%), with placenta increta in three (8.1%) and placental attachment, including percreta, were seen in seven cases (18.9 %). CONCLUSION: The rate of hysterectomy in multiparous women (in their third or fourth pregnancy) was higher. The greatest cause of hysterectomy was related to attached placenta including accreta, uterus atony, a history of CS, multipara, and repeated CS. Therefore, due to the increase in the number of CSs in recent years, planning should be taken into account in order to encourage pregnant women for vaginal delivery.

Impact of a Stress Management Intervention Program on Sexual Functioning and Stress Reduction in Women with Breast Cancer

Breast cancer as the most common cancer among women endangers various aspects of their sexual lives and is a major culprit regarding health impairment and low life quality. The aim of this study was to examine the effect of a stress management intervention program on sexual functioning and stress reduction in women with breast cancer. This study employed a quasi-experimental pre-test, post-test design which included follow-up checks and a control group. To this end, 104 women with breast cancer referring to Hamadan's Mahdiyeh MRI Center at the time of data collection were conventionally selected in 2015. Using permuted blocks, they were randomly divided into experimental and control groups (n= 52), only the former receiving stress management counseling for 18 hours. Data were collected through a demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and Harry's stress questionnaire, filled out by patients before and after the intervention. To analyze the data, descriptive statistics and two-way ANOVA were used. The results showed that cognitive - behavioral stress management group therapy improved total sexual functioning and its subscales. After the treatment, there was a significant difference in mean scores between the groups (p=0.01). Moreover, significant differences were observed in the mean scores for stress with improvement in the experimental group in post-test results. Cognitive - behavioral group therapy for stress management was thuis found to improve total sexual functioning and its subscales and reduce the level of stress in the experimental group after the intervention and follow-up period with an interval of two weeks. Therefore, this method can be used as a complementary therapy along with medical treatment in oncology centers.