The impact of continuous and intermittent supportive counseling on self-efficacy and continuation of breastfeeding in lactating women affected by COVID-19: a quasi-experimental trial.

BACKGROUND: Promoting exclusive breastfeeding can have a great effect in reducing the complications and mortality rate of mother and child. OBJECTIVE: The study aimed to compare the effects of continuous and intermittent supportive counselling on the self-efficacy and continuity of breastfeeding among Lactating mothers with COVID-19. METHODS: The study was a semi-experimental research method and was conducted on 73 mothers with COVID-19 who were hospitalized in Ayatollah Mousavi Hospital in Zanjan, Iran from May 2021 to April 2022. In the continuous counselling group, counselling was provided daily for 14 days, while in the intermittent counselling group, counselling was provided once a week for four weeks. Breastfeeding continuity was assessed based on the World Health Organization's classification, and breastfeeding self-efficacy was measured using Dennis' standard breastfeeding self-efficacy questionnaire (BSE) up to four months after delivery. The data were analyzed using chi-square tests, independent t-tests, paired t-tests, analysis of variance with repeated measures, and survival analysis (Kaplan-Meier) with a 95% confidence level. RESULTS: The survival analysis revealed that the cessation of exclusive breastfeeding occurred in 17 cases within the continuous counselling group and in 22 cases within the intermittent counselling group. The rates of continuation for exclusive breastfeeding were 52.8% and 40.5% in the continuous and intermittent counselling group respectively. However, no statistically significant differences were observed in the continuation of breastfeeding and the trend of changes in the mean scores of breastfeeding self-efficacies between the continuous and intermittent counselling groups. Furthermore, comparing the change in breastfeeding self-efficacy scores between the one-month and four-month follow-ups within the continuous counselling group, a statistically significant increase was observed. CONCLUSION: The results indicated no difference in the effectiveness of continuous and intermittent counseling methods in improving breastfeeding continuity in women with COVID-19. Further research is needed to explore the long-term effects of different counseling approaches on breastfeeding outcomes during crises. TRIAL REGISTRATION: The study was registered on the Iranian Registry of Clinical Trials website on 29/06/2021 with the registration code IRCT20150731023423N19. It can be accessed via this link: https://irct.behdasht.gov.ir/user/trial/55391/view .

The impact of combined administration of surfactant and intratracheal budesonide compared to surfactant alone on bronchopulmonary dysplasia (BPD) and mortality rate in preterm infants with respiratory distress syndrome: a single-blind randomized clinical trial.

BACKGROUND: Respiratory distress syndrome (RDS) is one of the most important and common disorders among premature infants. OBJECTIVE: This study aimed to compare the effect of the combination of surfactant and budesonide with surfactant alone on Bronchopulmonary dysplasia (BPD) and mortality rate among premature infants with RDS. METHOD: An outcome assessor-blind randomized clinical trial was conducted on 134 premature infants with RDS who were born in Ayatollah Mousavi Hospital, Zanjan, Iran in 2021. The covariate adaptive randomization method was utilized to allocate participants into two groups (surfactant alone and a combination of surfactant and budesonide). The primary outcomes were BPD and Mortality rate from admission to hospital discharge. The data in this study were analyzed using SPSS software version 18. RESULTS: Overall the comparison of mortality rate and BPD between the two groups did not show a significant difference(p > 0.05). The subgroup results showed that administering surfactant with budesonide to infants under 30 weeks of age significantly reduced the number of deaths compared to using surfactant alone (5 vs. 17). Similar positive effects were observed for the occurrence of Pulmonary Hemorrhage, the need for a second dose of surfactant, oxygen index, mean blood pressure and mean arterial pressure (MAP) in infants under 34 weeks of age compared to more than 34 weeks (p < 0.05). CONCLUSION: These findings suggest that the combination therapy of surfactant and budesonide may be beneficial, particularly in preterm infants with less than 34 weeks gestational age and 1500 birth weight. However, further studies with larger sample sizes and longer follow-up periods are needed to confirm these results and assess long-term outcomes. TRIAL REGISTRATION: The study was registered at the Iranian Registry of Clinical Trials website under the code IRCT20201222049802N1. https://en.irct.ir/user/trial/48117/view . REGISTRATION DATE: 28/02/2021. PUBLIC REPOSITORY: DATA SET: This research data set link is displayed on the Zanjan-Iran Medical Sciences website: https://repository.zums.ac.ir/cgi/users/login? target=https%3 A%2 F/repository.zums.ac.ir/id/eprint .

3Mixtatin versus MTA in pulp therapy of primary teeth: a systematic review and meta-analysis of current randomized controlled trials.

AIM: 3Mixtatin (a combination of Metronidazole, Minocycline, and Ciprofloxacin along with statins) is a novel biomaterial in pulp therapy, while Mineral Trioxide Aggregate (MTA) is considered the gold standard in endodontics. This study aimed to compare the clinical and radiographic success rates of MTA and 3Mixtatin in pulp therapy of primary teeth. METHODS AND MATERIALS: MEDLINE (PubMed), CENTRAL, Web of Science, Scopus, ProQuest databases, and Google Scholar were searched to identify randomized controlled trials (RCTs) on pulp therapy with 3Mixtatin and MTA in primary teeth, published up to February 2023. It should be noted that the protocol was previously registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021243626). RCTs were assessed independently by two researchers in terms of eligibility and quality. Data extracted and tabulated. The Cochrane Risk of Bias (RoB-2) tool was used to assess the risk of bias. The effect sizes were evaluated utilizing risk ratios (RRs). The heterogeneity investigation was conducted utilizing I² measurement at α = 0.10. RESULTS: Out of 86 retrieval records, four articles met the inclusion criteria. Based on clinical and radiographic outcomes, the application of 3Mixtatin in the pulp therapy of primary teeth was as successful as MTA in 12 months (Clinical RR = 1.087 | Radiographic RR = 2.132). The RoB-2 tool showed a low risk of bias in all included RCTs. CONCLUSION: The limited evidence showed the clinical and radiographic efficacy of 3Mixtatin as a potential alternative to MTA. Further empirical research with larger sample sizes and strict methodology will be essential to substantiate this assertion.

The prevalence of violence and its association with mental health among the Iranian population in one year after the outbreak of COVID-19 disease.

BACKGROUND: COVID-19 spread between and across nearly every country, with considerable negative health consequences. The current study aimed to determine the prevalence of violence and its association with mental health among Iranians older than 15 years in 2020. METHODS: Data was collected through National Mental Health Survey on 24,584 Iranians older than 15 years in 2020. were analyzed to determine the prevalence of violence and its association with mental health. Multi-stage sampling method was used, and data on demographic characteristics and domestic-social violence and mental health (GHQ-28) were collected. Data analysis was administered using descriptive statistics and a chi-square test at a 95% level. RESULTS: The mean age of participants was 44.18 ± 16.4 years. The overall prevalence of domestic and social violence was 11.4% and 5.5%, respectively. Verbal violence was the most common type; with 61.8% and 66.8% for domestic and social violence, respectively. A suspected case of mental disorder, female gender, being younger than 25 years, living apart together, unemployment, low education, and history of COVID-19 infection presented a significant association with domestic and social violence (p > 0.05). CONCLUSION: In comparison to the previous study in 2015, the prevalence of violence has increased. Therefore, domestic and social violence are the social concerns of Iranian society, indicating the necessity of appropriate interventions, particularly for those suspected of mental disorders and young women with low education levels.

The effect of cognitive behavioral counseling on anxiety and worry level of women with intermediate risk during first trimester screening for down syndrome: a randomized controlled trial: a randomized controlled trial.

BACKGROUND: Anxiety related to prenatal screening programs negatively affects maternal and child health. OBJECTIVE: The study aimed to determine the effect of Cognitive Behavioral Counseling on the anxiety and worry levels of women with intermediate risk during first-trimester screening for Down Syndrome. METHODS: The study was a randomized controlled trial conducted on 52 pregnant women with intermediate risk (1: 51 - 1:1500) during first-trimester screening for Down Syndrome and without additional structural anomalies that referred to three cities of Zanjan province in 2021. The eligible women were randomly assigned to intervention and control groups, with a block size of four. The intervention group received CBC in four sessions of 120 min two times a week by phone. Data were collected using Vandenberg Anxiety Questionnaire, and Cambridge Worry Questionnaire in three phases baseline, after the intervention, and 6 weeks follow-ups. Data were analyzed using independent t-test, chi-square, and repeated measures ANOVA at a 95% confidence level. (P < 0.05). RESULTS: In the counselling group, the mean (SD) of a total score of anxiety before the intervention was 67.11 (20.68) which decreased to 32.50 (13.58) in six weeks after the intervention. Furthermore, the mean (SD) of a total score of worry before the intervention was 56.19 (16.76) which decreased to 32.96 (8.89) six weeks after the intervention. Based on the repeated measures ANOVA test, the mean total score of anxiety and worry were statistically significant 6 weeks after the intervention compared with the control group(p < 0.001). CONCLUSION: Based on the study results, CBC can reduce the anxiety and worry levels of women with intermediate risk during first trimester screening for Down Syndrome. TRIAL REGISTRATION: The study was registered at the Iranian Registry of Clinical Trials website under the code IRCT20160608028352N8, ( https://en.irct.ir/trial/49998 ). The first trial registration date was (29/08/2020).

Socio-economic inequalities in health-related quality of life among Iranian young people in the middle stage of adolescence: application of Health Equity Assessment Toolkit.

BACKGROUND: One of the main concerns of public health is the increasing inequality of health status, which has an adverse effect on people's life. PURPOSE: The current study aims to analyze the role of socioeconomic inequalities in health-related quality of life (QoL) among Iranian young people in the middle stage of adolescence. METHODS: A cross-sectional descriptive study was conducted on 576 young people in the middle stage of adolescence. The samples were selected using the Multi-stage sampling method. Data were collected by a demographic checklist, and KIDSCREEN-52 questionnaire and analyzed by SPSS ver.16. The Health Equity Assessment Toolkit (HEAT) Version 4.0 (beta) was used to assess adolescents' QoL inequalities in terms of socio-economic subgroups. RESULTS: The results show that 27.2 adolescents had low quality of life. The score of physical and autonomy components of QoL was significantly more in male versus school environment in female adolescents. Also, the asset index, father's, and mother's education, and family income in female adolescents, and the assets and family income in male adolescents were significantly related to the quality of life (p < 0.05). The risk of lower QOL in the poorest quintile was 1.12 times more than in the richest quintile. The consideration index of Asset in terms of sex was 4.5 and the modified Gini index was more than 0.5 in females and males. CONCLUSION: Our findings highlight the significant effects of socioeconomic inequality on the HRQL of Iranian adolescents. Requires a targeted policy approach to reach the poorest quintile for improving the quality of life of adolescents.

Determinants of COVID-19 vaccine acceptance in healthcare workers in Iran: National Survey.

BACKGROUND AND AIM: It seems that acceptance of COVID-19 vaccination is the most effective way to tackle the COVID-19 pandemic now. Health care workers (HCWs) are one of the most important groups who are at risk for COVID-19 infection. This study aimed to assess the COVID-19 vaccine acceptance among HCWs in Iran and its determinants. METHODS: A cross-sectional survey was carried out among 3600 HCWs in Iran. Data were collected through a self-administered questionnaire by a trained team from February to March 2021. Multi-stage cluster sampling method was used for selecting respondents of the study. Multivariate logistic regression analysis was used to determine the key factors of COVID-19 vaccine acceptance among participants. P-value < 0.05 was considered statistically significant. RESULTS: Out of the 3536 respondents, 2191 (62.1%) intended to uptake the COVID-19 vaccine. Only about 10 percent of respondents said they did not trust any vaccine (domestic or foreign). Willing to accept a COVID-19 vaccine was relatively high among males, doctors, and those who had a history of hospitalization due to COVID-19 infection. The multivariate regression analysis showed respondents who were 40-50 years (aOR: 1.56; 95% CI: 1.47-1.66), had a history of COVID-19 infection (aOR: 0.85; 95% CI: 0.83-0.88), and hospitalized due to COVID-19 infection (aOR: 2.18; 95% CI: 1.97-2.39), were significantly associated with vaccine acceptance (p < 0.05). CONCLUSION: Our study showed moderate acceptance of COVID-19 vaccination in the HCWs in the Islamic Republic of Iran. The most important factor in the acceptance of the COVID-19 vaccine by the health staff is having a history of hospitalization. Further training and justification of health personnel is needed to increase the acceptance of COVID 19 vaccine.

Effects of supportive counseling using a positive psychology approach on coping patterns among pregnant women with nausea and vomiting.

BACKGROUND: Pregnancy nausea and vomiting (NVP) are associated with a wide range of physical and mental changes in the mothers and could affect their adaptation to pregnancy. There is a gap of knowledge regarding the effectiveness of a positive psychology approach counselling on improving coping patterns in women with NVP. OBJECTIVE: This study aimed to determine the effect of supportive counselling with a positive psychology approach on improving coping patterns in women with NVP. METHOD: The current study was a randomized controlled trial on 60 pregnant women who experienced nausea and vomiting in Zanjan a province in the northwest of Iran, 2020-2021. Using four-block random sampling, eligible women were randomly assigned to the intervention and control groups. According to the Seligman protocol, the intervention group received supportive counselling in six sessions of 45 min3 times a week. The revised prenatal coping inventory (Nu PCI) was used to collect data and analyzed using Chi-square, repeated measures ANOVA, and MANOVA at a 95% confidence level. RESULTS: In the counseling group, the mean (SD) of a total score of coping with pregnancy before the intervention was 6.11 (1.31) which increased to 8.40 (1.03) in 4 weeks after the intervention. Based on the MANOVA test with adjusting the number of pregnancies, the mean total score of coping with pregnancy was statistically significant 4 weeks after the intervention compared with the control group (Adjusted mean difference (AMD) = -1.84, CI95% -2.36, -1.32, p = 0.001). CONCLUSION: The use of positive psychology in supportive counselling improved the coping of mothers suffering from nausea and vomiting during pregnancy. It is recommended that this approach be incorporated into prenatal care to promote the health of pregnant women. TRIAL REGISTRATION: The study was registered at the Iranian Registry of Clinical Trials website under the code IRCT20150731023423N17 . Registration date: 2020-10-31, Expected recruitment start date: 2020-11-01. IRCT Id: IRCT20150731023423N17.

Influential factors of general anxiety disorder among Iranian pregnant women during the second peak of COVID-19 pandemic.

The aim of the study was to determine the rate and related factors of prenatal general anxiety disorder in the second peak of the COVID-19 pandemic in Iran. A cross-sectional descriptive study was conducted on 2336 pregnant women who referred to health centers of Zanjan province in Iran from June to September 2020. The samples were selected using a multi-stage sampling method. Data were collected by telephone using a General Anxiety Disorder questionnaire (GAD) and analyzed with descriptive statistics and the logistic regression model at a 95% confidence level. Results show that, during the pandemic of COVID-19 more than 78% of Iranian pregnant women had severe anxiety. The odds of having general anxiety disorder in urban residency was 1.80 times more than the rural residence and getting information about preventive and self-care guidelines of COVID-19 were 1.24 times more than the other information (P < 0.05). Our findings show a higher level of anxiety disorder in pregnant women during the COVID-19 pandemic, and also the place of residence and type of information received about COVID-19 are the main predictors of anxiety level. Therefore, the continuous monitoring of pregnant women for evaluating anxiety disorder during the outbreaks is recommended as a routine schedule.

The comparison of sexual function in women with or without experience of female genital circumcision: A case-control study in a Kurdish region of Iran.

Studies on the sexual consequences of female genital circumcision are controversial. In this article, we intend to compare the sexual function in women with or without experience of circumcision in the Kurdish region of Mahabad in Iran. In this case-control study 550 women completed the demographic and Female Sexual Function Index (FSFI) questionnaires. Female genital circumcision was associated with reduction of lubrication and sexual satisfaction as well as increasing dyspareunia compared to the uncircumcised women. However, there was no significant difference between two groups regarding to arousal, desire and orgasm of women.

The relationship between general health and coping style with perceived stress in primigravida healthy pregnant women: Using the PATH model.

The aim of this study was to analyze relationships among general health, coping style, and perceived stress in healthy primigravida pregnant women. A cross-sectional study was conducted at public health clinics in Hamadan city, Iran between July and December 2015. In total, 380 pregnant women were selected through stratified random sampling. Data were collected using the Revised Prenatal Coping Inventory and General Health Questionnaire. Perceived stress was assessed through an interview comprised of open-ended questions. The final PATH model fit well; general health (ß = 0.02) as well as anxiety and sleep disorders (ß = 0.03) were slightly directly associated with perceived stress, and only planning-preparation was related to perceived stress through general health (ß = 0.09). The findings enhance the knowledge gained from previous perinatal stress research. General health status was directly related to stress, and coping style was indirectly related to stress. Coping styles may mediate the relationship between general health status and perceived stress, suggesting that midwives should attempt to improve the general health of women to reduce stress and its consequences during pregnancy by teaching patients appropriate coping styles. Further studies on the effect of coping style interventions on stress are warranted.

The effect of educational intervention on the quality of life of women suffering from pregnancy-related nausea and vomiting: a systematic review.

OBJECTIVE: The present study aimed to determine the influence of educational interventions on improving the quality of life (QOL) of women suffering from pregnancy-related nausea and vomiting (NVP) as a systematic review. METHODS: The current systematic review followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guideline. The English electronic databases were used to identify relevant studies published 2000 until 14 August 2023. The search strategies employed were based on Mesh browser keywords and free-text words. The study risk of bias was evaluated using the Cochrane Collaboration's tool for assessing the risk of bias tools and publication bias was evaluated using a funnel plot and Begg and Egger tests. The heterogeneity of the studies was evaluated using I2 and tau-squared tests. Data were analyzed using the RevMan 5 software. Results of the random-effects meta-analysis were presented using the standard mean difference, along with a 95% confidence interval (CI). RESULTS: Out of the seven randomized clinical/control trial (RCT) studies with a total of 946 subjects included in the review, five studies reported a significant result, indicating that the interventions had a statistically significant effect on the QOL of women suffering NVP and in two studies did not have a significant result. A subgroup analysis was done based on the type of quality-of-life measurements. The pooled standardized mean difference (SMD) of four articles (Nausea and Vomiting Pregnancy Quality of Life, NVPQOL) with a total of 335 subjects was -2.91, and CI of -4.72 to -1.11, p value = .002, I2 = 97.2%. The pooled SMD of three articles (SF36) with a total of 611 subjects was -0.05, and CI of -0.23 to -0.12, p value = .550, I2 = 10%. CONCLUSIONS: The overall results of the analysis indicated that educational intervention had a small positive impact on the QOL of women experiencing NVP. However, to draw a better conclusion, it is recommended to conduct further studies with larger sample sizes and longer follow-up periods.

The Effect of Media Distractions on Women During Breastfeeding and Infant Care: A Descriptive Cross-Sectional Study.

Background: In modern world, the pervasive use of media technologies has seen a significant increase across various domains. The study aimed to assess the level of distraction among lactating women during feeding and infant care, along with exploring associated factors. Methods: This cross-sectional study included 120 lactating mothers who visited comprehensive health centers in Zanjan City in 2023. The inclusion criteria were lactating mothers older than 18 years, who were within 42 days postpartum. A multistage sampling method was used for participant selection. Data were gathered using a standard maternal distraction questionnaire and analyzed using descriptive statistics, independent t-tests, and analysis of variance (ANOVA) test with a confidence level of 95%. Results: The study found that smartphone use (69.7%) was the most common source of distraction for mothers during breastfeeding, while reading books (17.5%) was the least distracting. In addition, 85% of mothers watched television while caring for their babies (except during breastfeeding), and a significant percentage used landline phones (92.5%) and mobile phones (79.2%). It was noted that older mothers tended to be less distracted during feeding or baby care compared with young mothers. Furthermore, maternal attention during baby feeding increased with higher education levels and having more children (p < 0.05). Conclusion: The study concludes that young mothers with lower levels of education experience significantly high levels of distraction while caring for their babies or breastfeeding. Given the substantial availability of media products, interventions are needed to raise mothers' awareness about the importance of maintaining eye contact with their babies and implementing strategies for managing distractions.

Investigating the influence of family-oriented counselling on breastfeeding continuity in mothers experiencing distractions: A randomized controlled trial.

The prevalence of distraction among breastfeeding mothers is on the rise, primarily attributed to the escalating use of media technologies. This study aimed to assess the influence of family-oriented counselling on the continuity of breastfeeding in mothers experiencing distractions. This randomized controlled trial included 120 eligible lactating mothers who accessed postpartum services at comprehensive health centers in Zanjan, a city in northwest Iran from August 21, 2022 to May 10, 2023. Participants were assigned to two groups through block randomization with a block size of four. The intervention group received Family-Oriented Counselling in three sessions at weekly intervals, and the control group received standard postpartum care. The study measured outcomes using the Maternal Distraction Questionnaire and breastfeeding patterns before, monthly, and up to 4 months after counselling. Data analysis employed statistical methods, including the Chi-square test, independent t-test, repeated measures ANOVA, and the Kaplan-Meier method, with a significance level set at P < 0.05. The results showed that the continuation of exclusive breastfeeding was 33 (55 %) in the intervention group and 21 (35 %) in the control group. This difference was statistically significant (p = 0.001). The reduction in distraction scores over time was more pronounced in the intervention group compared to the control group. The between-group effect was found to be statistically significant with an eta effect size of 0.73 (p = 0.001). In conclusion, the study suggests that the implementation of a family-centered intervention was effective in promoting the continuation of breastfeeding and reducing maternal distractions both during breastfeeding and non-breastfeeding activities. This approach proves to be a valuable step in enhancing the health of both mother and child. The findings underscore the importance of considering such interventions in health policymaking.

COVID-19 Vaccine Intention Among Iranian Health Workers: Application of the HBM Model.

The study aimed to determine the application of the health belief model (HBM) in the acceptance of COVID-19 vaccination among health workers in 2021. The cross-sectional study was conducted on 3600 health workers from February to March 2021. Data was collected using a researcher-made questionnaire that included the intention to receive vaccines based on the health belief model constructs. Data were analyzed using descriptive statistics indicators, Chi-square, ANOVA test, and logistic regression model at a 95% confidence level. More than 62% of the participants intended to receive the vaccine. The odds of intention to receive the vaccine among people who worked in the health center and did not have a history of hospitalization due to COVID-19 disease were 1.50 and 2.10 units more than the others. Intention to receive the vaccine in individuals with high perceived sensitivity was 1.10 units. Furthermore, in terms of perceived benefits, self-efficacy, and cue-to-action constructs were 1.15, 1.34, and 1.65 units respectively. The rate of vaccine acceptance among Iranian health care workers was relatively good and the constructs of HBM in predicting the rate of intention to receive the vaccine had good applicability.

The effect of music-based interventions on short-term postpartum episiotomy pain: A systematic review and meta-analysis.

Episiotomy took over as the most common surgery in the field of midwifery that was performed in the second stage of labor to facilitate delivery, and reduce perineal damage. Music is one of the methods used to combat pain. We applied a meta-analysis to investigate whether music-based interventions can reduce short-term postpartum episiotomy pain. Four main English databases including Embase, PubMed, Web of Science, and Scopus were searched until July 2022. All randomized controlled trials (RCTs) with at least two groups (control and intervention) that aimed to measure the effect of music therapy on episiotomy pain were included in the present review. The Cochrane risk of bias checklist was used to assess study quality. Study heterogeneity was determined using the I2 statistic and publication bias using Begg's and Egger's tests. Results of random effect analysis are presented as Standard Mean Difference (SMD) with 95% confidence intervals (CI). Data were analyzed using the STATA software version 16. In total, seven articles with 677 subjects were included in the meta-analysis. Overall, the pool estimates of the meta-analysis demonstrated that music therapy has a positive impact on reducing short-term pain derived from episiotomy in both primiparous and multiparous compared to the control group (pooled SMD = -1.60; CI = -2.18, -1.02, p-value<0.001). The heterogeneity was high among including studies (I2 = 95.7%, p < 0.001). Our result showed that music-based interventions can be considered a choice for the management of short-term postpartum episiotomy pain among both primiparous and multiparous women. Future studies with large sample sizes and longer follow-up periods will be required to draw better conclusions about the long-term effects on postpartum pain.

Can integrating religiosity and spirituality into postpartum care improve the quality of life in women with preeclampsia.

Background: Women with a history of preeclampsia frequently have a lower level of physical well-being and emotional problems. Objective: This study aimed to determine the effect of integrating religiosity and spirituality into postpartum care can improve the quality of life in women with preeclampsia. Methods: This study was a randomized controlled clinical trial conducted on 40 women with preeclampsia. All eligible participants were allocated to two control and intervention groups using a random blocking method. Data were collected using Mother-Generated Index (MGI) in pre-intervention and 6 weeks later and analyzed using descriptive statistics, Chi-square test, and independent t-tests. The significance level was p < 0.05. Results: The mean, Standard deviation (SD) of the total score of MGI before intervention in the intervention group was 5.35 (1.09) which increased to 8.00 (0.50) 6 weeks after intervention. In the control group, the pre-test score of MGI was 5.81 (0.97) which increased to 6.69 (1.37) after 6 weeks of follow-up. The difference between the two groups was statistically significant after the intervention based on an independent t-test (p = 0.001).The mean (SD) of five subscales included Feelings toward herself, Feelings toward the child, Feelings toward her husband and others, Feelings toward sex, and Physical health status after intervention in the intervention group statistically significantly increased compared to the control group (p < 0.011). Conclusion: The integration of spiritual counseling with the educational content of postpartum care had a positive impact on improving the postpartum QoL of women with preeclampsia. For better conclusions, a study with a large sample size needed to be conducted in the future. Clinical Trial Registration: https://en.irct.ir/user/trial/50832/view, identifier IRCT20150731023423N16.

A Systematic Review of the Correlation Between Marital Relationship and Breastfeeding Self-Efficacy, and Duration of Breastfeeding.

Background: Breastfeeding as an important key to sustainable development strategies is the best nutrition for ensuring healthy growth and development in the first 1,000 days of life. Objective: The current systematic review and meta-analysis were conducted to evaluate the correlation between marital relationship satisfaction and breastfeeding self-efficacy and duration of breastfeeding. Method: A systematical search was carried out in main electronic databases (PubMed, Scopus, Embase, ProQuest, and Web of Science) and gray literature until June 2022. The study's risk of bias was assessed using the Newcastle-Ottawa risk-of-bias tool. Publication bias was evaluated using a funnel plot, and Begg's and Egger's tests. The degree of heterogeneity was assessed using the I2 test. To estimate common effect size r coefficient (r) and confidence intervals (95% CIs), random-effect models were fitted, and the results were presented using forest plots. Results: In total, 13 studies with 5,843 subjects were included in the meta-analysis. Overall, the pool estimates show a positive correlation between marital relationship satisfaction, and breastfeeding self-efficacy (r = 0.27, 95% CI (0.09-0.50), p = 0.024), but this relationship was not found in the term of breastfeeding duration (r = 0.11, 95% CI [-0.01 to 0.23], p = 0.079). The heterogeneity of studies was high (I2 = 95.2%) Conclusion: Our finding confirms a positive and moderate level of correlation between marital relationship satisfaction and breastfeeding self-efficacy. It is suggested to conduct more studies to reach appropriate conclusions regarding marital relationship satisfaction and breastfeeding duration.

Predictive factors of Sexual Quality of Life in women with polycystic ovary syndrome: a path analysis.

Polycystic ovarian syndrome (PCOS) is one of the common endocrine disorders. This study aimed to assess predictive factors of sexual quality of life among Iranian women with PCOS. A cross-sectional study was conducted on 100 women with PCOS in Hamadan, Iran, from July to October 2021. Data was collected using The Sexual Quality of Life-Female (SQOL-F) questionnaire, The Hurlbert Index of Sexual Compatibility, hirsutism, and a general health questionnaire (GHQ-28). Data were analyzed using descriptive statistics, Bivariate Pearson correlations, and a path model by the SPSS, Version 16, and LISREL software version 8.5. The average age of participants was 32.80 years. The mean (SD) of the total SQOL-F, sexual compatibility, and GHQ were 69.36 (18.78), 55.44 (7.07), and 58.06 (12.87), respectively. Our results showed that hirsutism score, GHQ, and sexual compatibility were the main predictors of the SQOL-F. Sexual compatibility has an indirect effect on the SQOL-F through the GHQ. The findings of the present study suggest that women with PCOS should be routinely screened for sexual quality of life by qualified health professionals. In addition, the necessary medical interventions and counseling should be done for improving sexual compatibility, mental health, and clinical manifestation of these women.

The effect of peer-to-peer education on health literacy, knowledge, and adherence to COVID-19 protocols in vulnerable adolescents.

BACKGROUND: The study was done to examine the effectiveness of peer-to-peer education on increasing health literacy, knowledge s, and observance of coronavirus disease (COVID-19) health prevention protocols in vulnerable adolescents. METHOD: The study was a one-group intervention (before and after the intervention) that was performed on 1200 vulnerable adolescents living in varamin. The educational intervention was presented to adolescents in a face-to-face session. In the next step, the adolescents were taught the information received by three members of their families. Data were evaluated using a self-designed questionnaire before, and three months after the intervention. The paired t-test was used to compare scores of health literacy, compliance, and knowledge before and after the intervention at a 0.05 confidence level. The Multiple linear regression model was used to determine the predictive factors of observance of COVID-19 preventive behaviors. RESULTS: The most of adolescents were in the age group of 14 to 18 years (60%) and most of them were girls (61.5%). The most important source of information about COVID-19 disease was radio and television (59.6%). The results showed that the effectiveness of the intervention in increasing the adolescents' health literacy, knowledge, and adherence to preventive behaviors were 40%, 30%, and 23%, respectively. The effectiveness of the intervention in increasing their families' health literacy and adherence to the protocols were 11% and 20%, respectively (p = 0.001). DISCUSSION: Involving volunteer adolescents as health ambassadors and transmitting messages and methods of promoting personal protection against COVID-19 epidemics to family members had a significant effect on increasing the knowledge and adherence to the health procedures.