Factors affecting students' attitudes towards reproductive health in the north of Iran: Designing an educational program.

BACKGROUND: It is essential to empower young people to promote reproductive health (RH) and develop effective educational programs to prevent risky behaviors. This study aimed to investigate the factors affecting students' attitudes towards RH based on the ecological model and then design an educational program. METHODS: This cross-sectional study was conducted on 461 female students aged 18-29 in the north of Iran. This study was done in two stages. In the first stage, factors affecting the attitude towards RH including demographic questionnaire, interpersonal communication skills, family communication pattern, depression, stress and anxiety, body self-image, and self-confidence were determined. In the second stage, an educational program was designed based on the most effective factors. Independent t-test, ANOVA, and multiple linear regression were employed using SPSS version 20 software. Also, STATA version 15 software was utilized for statistical modeling to predict the best predictive model of attitude towards RH. RESULTS: 47.7% of students had a good attitude toward RH. The majority of students had problems with interpersonal communication skills (60.7%). Also, 28.5% experienced depression, 35.8% anxiety, and 12.8% stress at different levels. More than a quarter of the students (26.5%) had poor body self-image and 18.7% had Undesirable self-esteem. Interpersonal skills (P = 0.002), family communication pattern (P = 0.004), stress (p = 0.019), anxiety (P = 0.001), and body self-image (P = 0.034) have a significant relationship with the attitude towards RH. The multiple regression showed that the most important effective factor on RH is the dialogue orientation of family communication pattern (P = 0.041), stress (P = 0.002), and anxiety (P = 0.001). CONCLUSION: Stress and anxiety management training and the use of dialogue orientation in the family communication pattern for young female students are recommended based on the scientific model.

Subjective well-being predicts Covid-19 risk in the elderly: a case-control study.

BACKGROUND: Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB. METHODS: This case-control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants. RESULTS: The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947-0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB. DISCUSSION: This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.

Student Attitudes About Reproductive Health in Public Universities: A Cross-Sectional Study.

BACKGROUND: Determine attitude of young people to reproductive health issues can somewhat predict their behavior in this area. This helps us in planning future on reproductive health. The aim of this study was to determine the attitude of reproductive health and related factors among Iranian students in public universities in Iran. METHOD: A cross-sectional study was carried out. The tool was developed based on a literature review to find out about reproductive health attitudes and sociodemographic factors associated. The face and content validity of the questionnaire was performed using expert judgment. Cronbach's coefficient and test-retest were used to determine the reliability. Data were analyzed using the Statistical Package for Social Sciences software by independent t test, ANOVA, and multiple linear regression. RESULTS: Out of 461 respondents, the majority of students were nonmedical sciences (81.1%). The main sources of information for reproductive health awareness were the media (40%); 54.9% disagreed with having premarital sex in both sexes, while only 36% agreed to postpone sexual activity until marriage in order to prevent sexually transmitted diseases. Moreover, 64% believed that contraception would cause infertility in the future. The majority found the need for reproductive health services and education essential for single youth. Multiple regression showed a poor reproductive health attitude in nonmedical students, families who did not talk about boy-girl relationships, as well as in satellite users and hookah consumers. CONCLUSION: The students' level of attitude on reproductive health was not satisfactory. Intervention programs related to reproductive health taking into account the cultural aspects of Iranian society can protect young people from risky behaviors and unwanted pregnancies by creating a positive attitude.

Role of family communication patterns as predictors of behavioral health among students of public universities in north of Iran.

BACKGROUND: Communication is one of the oldest and greatest human achievements and the basis of social life. The aim of this study was to evaluate the role of family communication patterns as predictors of behavioral health among students of public universities in the north of Iran. MATERIALS AND METHODS: In this cross-sectional study, a total of 461 students from all the public universities of Babol, Iran, were selected in 2019. A stratified sampling random method was used to select the samples. The demographic characteristics, Depression Anxiety Stress Scale, Acceptance and Action Questionnaire, Rosenberg self-esteem questionnaire, and Communication Skills Interpersonal Test were used to collect data. Simple and multi-variate linear regressions as well as Pearson's correlation coefficient were utilized for data analysis. RESULTS: The mean and standard deviation scores of conversation orientation and conformity orientation were 35.61 ± 0.55 and 19.31 ± 0.41, respectively. Family conversation orientation was a significant predictor of behavioral health scales of students (except for acceptance and action), predicting negatively and significantly depression, anxiety, stress, and positively self-esteem and inter-personal communication skills of students. Family conformity orientation was also a significant predictor of behavioral health scales (except for inter-personal communication skills) of students, which predicted positively and significantly depression, anxiety, stress, and negatively acceptance, action, and students' self-esteem. CONCLUSION: To prevent behavioral health problems, it is necessary to observe conformity orientation and rely on conversation orientation.

Sexual and Reproductive Health Challenges in Temporary Marriage: A Systematic Review.

BACKGROUND: Temporary marriage is a legal form of marriage in Shia Islam allowing a man and a woman to become married in a fixed period of time. This review was conducted to identify the potential effects of temporary marriage on the sexual and reproductive health of women. STUDY DESIGN: A systematic review . METHODS: Electronic databases, including Web of Knowledge, Embase, PubMed, Scopus, ScienceDirect, PsycINFO, ProQuest, IranMedex, Scientific Information Database (SID), and Magiran, were searched up to October 2020 to identify the studies carried out on sexual and reproductive health challenges in temporary marriage. All the selected articles were assessed for eligibility according to their titles and abstracts. RESULTS: During the search on articles published within 1995 to October 2020, 1,802 relevant records were identified, and after evaluation 30 full-text papers were included in the present systematic review. Out of the 34,085 study participants in the selected studies, 3,547 subjects had temporary marriage who were studied under six different categories, namely (1) sexually transmitted infections (STIs)/human immunodeficiency viruses, (2) early child marriage, (3) unplanned pregnancy and induced abortion, (4) violence, (5) psychosocial disorders, and (6) other issues. Individuals with temporary marriage are vulnerable and need to have easy access to health education and sexual and reproductive health services in a safe and unprejudiced environment. Ignoring the aforementioned facts will cause serious public health problems, especially for women from a lower socioeconomic background. CONCLUSION: In the current situation with under-reporting of temporary marriage-related events due to social stigma and absence of quality services in sexual and reproductive health, women with temporary marriage are under the additional risk of STIs, unwanted pregnancy, abortion, and violence.

Determinants of delay in diagnosis and end stage at presentation among breast cancer patients in Iran: a multi-center study.

One of the reasons for high mortality of breast cancer (BC) is long delay in seeking medical care and end stage at presentation. This study was designed to measure the association between a wide range of socio-demographic and clinical factors with diagnostic delay in BC and stage at presentation among Iranian patients. From June 2017 to December 2019, 725 patients with newly diagnosed BC in Shiraz and Kermanshah were selected and information on BC diagnosis delay was obtained from the patient's medical record. Data on socio-economic status was obtained via a structured interview. Our findings suggest that 45.8% of the patients were diagnosed at a late stage (stage 3 or higher). A total of 244 (34%) patients had more than 3 months delay in diagnosis. We found a significant association between stage at diagnosis and place of residence (adjusted odds ratio (aOR rural vs. urban = 1.69, 95% CI 1.49-1.97), marital status (aOR 1.61, 95% CI 1.42-1.88), family history of BC (aOR 1.46, 95% CI 1.01-2.13), and history of benign breast disease (BBD) (aOR 1.94, 95% CI 1.39-2.72) or unaware of breast self-examination (BSE) (aOR 1.42, 95% CI 1.42-1.85), delay time (aOR 3.25, 95% CI 1.04-5.21), and left breast tumor (aOR right vs. left 2.64, 95% CI 1.88-3.71) and smoking (aOR no vs. yes 1.59, 95% CI 1.36-1.97). Also, delay in diagnosis was associated with age, family income, health insurance, place of residence, marital status, menopausal status, history of BBD, awareness of breast self-examination, type of first symptoms, tumor histology type, BMI and comorbidity (p < 0.05 for all). Factors including history of BBD, awareness of BSE, and suffering from chronic diseases were factors associated with both delay in diagnosis and end stage of disease. These mainly modifiable factors are associated with the progression of the disease.