Development and psychometric properties of the Reproductive Health Assessment in Systemic Lupus Erythematosus: Mixed-Methods study.

OBJECTIVES: Systemic lupus erythematosus (SLE) with a high morbidity rate (7% in general and 325/100.000 in reproductive period) was known as "the mother of autoimmune diseases." But healthcare providers hadn't reliable scales to measure the effectiveness of interventions to improve reproductive health. Women with systemic lupus erythematosus (SLE) express concern about a significant gap in their reproductive and sexual health during medical care due to the lack of a specific scale to measure this concept. This study developed psychometrically specific scale to evaluate this concept in Iranian women. METHODS: The study utilized a sequential-exploratory mixed-methods design, wherein the concept of reproductive health was clarified during the qualitative phase using conventional content analysis (inductive-deductive) to create a pool of RHASLE (Reproductive Health Assessment in SLE) items. During the psychometric process, the face, content, and construct validities of the RHASLE were checked with 650 individuals (320 using exploratory factor analysis [EFA] and 330 using confirmatory factor analysis [CFA]) through interviews and completion of the questionnaire. Convergent and divergent validities were then checked, and the reliability was assessed through stability and internal consistency. Finally, the measurement error, responsiveness, and interpretability of the scale were evaluated and confirmed. RESULTS: The study's findings revealed that the RHASLE consisted of 5 factors (33 items): physical-psychological disorder (13 items), relaxing feeling (6 items), spirituality (3 items), high-risk pregnancies (5 items), and sexual satisfaction (6 items). These factors explained a total of 99.97% of the variance in the concept of reproductive health. Confirmatory factor analysis confirmed the good model fit, and its validity and reliability were deemed acceptable. CONCLUSION: The RHASLE consisted of 27 items with high internal consistency, stability, responsiveness, and interpretability. That was able to get approval of Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Based on the results, RHASLE is a valid and reliable multidimensional scale that encompasses various aspects of reproductive health (physical, sexual, psychological, social, and spiritual).

Intimate partner violence after childbirth: an explanatory sequential mixed-methods study protocol.

BACKGROUND: Intimate partner violence (IPV) is the most common form of violence against women. Postpartum IPV refers to any type of IPV that occurs up to one year after childbirth and has many adverse impacts on mothers and their children. Considering the lack of sufficient information on the prevalence and factors related to IPV after childbirth in Iran, this study aimed to evaluate the frequency and severity of IPV, its different forms, and psychosocial factors related to IPV, as well as to explore how IPV is perceived among mothers one year after childbirth. METHODS: An explanatory sequential mixed-methods design was used to conduct this study in two phases. The first phase is a cross-sectional study that will be performed on postpartum mothers who have a one-year-old child referred to health care centers in the southern region of Tehran, Iran, with the aim of determining the prevalence of IPV and its related factors. The second phase is a qualitative conventional content analysis study with the purpose of exploring women's experiences and perceptions of IPV and its preventive or protective factors. Purposive sampling will be used. Based on the results of the quantitative phase, mothers who are at the two ends of the IPV spectrum (based on their total Conflict Tactics Scale (CTS-2) scores) will be selected, and in-depth and semistructured interviews will be conducted with them. Finally, the researchers will provide an interpretation of the quantitative results using qualitative data. DISCUSSION: This is the first study that uses a mixed methods approach to explain different dimensions of IPV, its related factors, and mothers' perceptions of it. By providing a better understanding of this phenomenon, it is hoped that the results of this research will be used by policymakers and officials of educational and cultural systems to plan and provide effective interventions, enact laws, and present educational and cultural programs to prevent IPV after childbirth. ETHICAL CODE: IR.TUMS.FNM.REC1400.200.

Intimate partner violence is the most common form of violence against women, with a higher prevalence in Asian and Eastern Mediterranean countries, including Iran. The period after childbirth is a stressful and anxiety-provoking event due to the increased physical, psychological, social, and economic needs of parents, leading to intimate partner violence. Studies show that women who experience violence after childbirth face many physical, sexual, and emotional problems. Additionally, it will have a negative impact on their baby. Many factors can lead to intimate partner violence, among which psychological factors are among the most important. Therefore, we decided to perform a study in two phases with the aim of determining the prevalence and factors related to intimate partner violence. In the first phase, we will study Iranian women who have a one-year child living in southern Tehran city and ask them to complete questionnaires related to intimate partner violence. In the second phase, we will conduct an interview with women who have experienced violence after childbirth to obtain more information about the factors involved.

Reproductive health of women with endometriosis: an improving educational intervention based on the planned behavior theory.

Background: Endometriosis is a chronic deliberating disease with devastating effects on reproductive health. The present study aimed to investigate the impact of education based on the theory of planned behavior (TPB) on the reproductive health of women with endometriosis. This research was a randomized controlled trial performed on 71 women with endometriosis (35 intervention and 36 control groups) referred to the infertility clinic of Imam Khomeini Hospital in Tehran, Iran. The educational intervention based on the structures of the TPB was performed in the intervention group in 4 sessions, weekly for 90-120 min. The demographic questionnaire, model constructs questionnaire, and endometriosis reproductive health questionnaire (ERHQ) in both groups were completed in 3 stages (before intervention, 4, and 8 weeks after the intervention). Data were analyzed using SPSS software version 24. Results: After the educational intervention, TPB values and overall reproductive health of women with endometriosis improved significantly in the intervention group (p < 0.05), while changes were not significant in the control group. Conclusion: The study results showed that education based on the TPB had positive effects on the reproductive health of patients. Trial registration: IRCT20120414009463N64. Registered 21 Jun 2021 - Retrospectively registered, http://www.irct.ir/trial/53341. Supplementary Information: The online version contains supplementary material available at 10.1186/s43043-023-00129-7.

Domains of competence in midwifery students: a basis for developing a competence assessment tool for iranian undergraduate midwifery students.

BACKGROUND: Current study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students. METHODS: Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth. RESULTS: Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20-56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories. CONCLUSION: The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.

Perceptions and experiences of women with premature ovarian insufficiency about sexual health and reproductive health.

BACKGROUND: Premature ovarian insufficiency (POI) is a condition with impaired ovarian function that occurred in women before the age of 40. Considering that women with POI are in reproductive age and their fertility and sexual life are afflicted by this disorder directly, the present study aimed to investigate perception and experience of women with POI of sexual and reproductive health (SRH). METHODS: This is a qualitative that was implemented based on the conventional content analysis approach. The data were collected using semi-structured in-depth interviews with 16 women having POI, based on purposeful sampling and continued until data saturation. The participants were women with POI that referred to the three infertility center in Tehran, Iran. The audio recorded data were transcribed verbatim and then analyzed using conventional content analysis based on the method proposed by Zhang and Wildmouth. RESULTS: After content analysis of the interviews with a focus on the perception and experience of women with POI of SRH, four main categories emerged i.e. endangerment of women's health, psychological agitation, disruption of social life and disturbance in sexual life. CONCLUSION: POI affects different aspects of women SRH (women physical, psychological, social and sexual heath). Therefore, knowledge of patients' concerns by health professionals is helpful to improve service delivery and increasing the effectiveness of treatment interventions by a comprehensive health care attitude.

Women empowerment in reproductive health: a systematic review of measurement properties.

INTRODUCTION: There is a considerable dearth of official metrics for women empowerment, which is pivotal to observe universal progress towards Sustainable Development Goals 5, targeting "achieve gender equality and empower all women and girls." This study aimed to introduce, critically appraise, and summarize the measurement properties of women empowerment scales in sexual and reproductive health. METHODS: A comprehensive systematic literature search through several international electronic databases, including PubMed, Scopus, Embase, ProQuest, and Science Direct was performed on September 2020, without a time limit. All studies aimed to develop and validate a measurement of women empowerment in sexual and reproductive health were included. The quality assessment was performed through a rating scale addressing the six criteria, including: a priori explicit theoretical framework, evaluating content validity, internal consistency, and factor analysis to assess structural validity. RESULTS: Of 5234 identified studies, fifteen were included. The majority of the studies were conducted in the United States. All studies but one used a standardized measure. Total items of each scale ranged from 8 to 23. The most common domains investigated were decision-making, freedom of coercion, and communication with the partner. Four studies did not use any conceptual framework. The individual agency followed by immediate relational agency were the main focus of included studies. Of the included studies, seven applied either literature review, expert panels, or empirical methods to develop the item pool. Cronbach's alpha coefficient reported in nine studies ranged from α = 0.56 to 0.87. Most of the studies but three lack reporting test-retest reliability ranging r = 0.69-0.87. Nine studies proved content validity. Six criteria were applied to scoring the scales, by which nine of fifteen articles were rated as medium quality, two rated as poor quality, and four rated as high quality. CONCLUSION: Most scales assessed various types of validity and Internal consistency for the reliability. Applying a theoretical framework, more rigorous validation of scales, and assessing the various dimensions of women empowerment in diverse contexts and different levels, namely structural agency, are needed to develop effective and representing scales.

Impact of endometriosis on reproductive health: an integrative review.

Endometriosis is a debilitating chronic disease that affects 10% of the general female population, with a frequency of 38% in infertile women. This review aims to provide an overview of the impact of endometriosis on different aspects of reproductive health. A literature search was performed in four international databases, including PubMed, Science Direct, Scopus, and Google scholar, from January 1995 to December 2019 to identify the potentially relevant articles. We included all relevant articles published in English and identified 46 studies on health issues in women with endometriosis. The research suggests that women with endometriosis are at risk for physical, psychosocial, social, and sexual disturbances and obstetrical complications. More research is needed to clarify better understanding of endometriosis complications specifically obstetrical consequences.

Concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents: a qualitative study.

BACKGROUND: Parents play an important role in promoting the sexual health of their adolescents. However, many parents experience several challenges. The purpose of this study was to explore the concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents. METHODS: This qualitative study was designed based on the conventional content analysis approach. Semi-structured and in-depth interviews were conducted with 16 parents of male adolescents aged 12-18 years. All interviews were audio recorded and transcribed verbatim. The data were collected through purposeful sampling and continued until data saturation. Finally, the Graneheim and Landman strategies were used to analyze data. RESULTS: According to the participants' comments, four main categories were extracted as follows: fear of emotional and sexual harms, quality of parent-child relationships, effect of media and cyberspace, and necessity of sexuality health education. CONCLUSIONS: The findings highlighted the need for sexuality health education through cooperation with schools for offering appropriate education to the students, parents, and school staffs. The results showed that parents required training to enhance their knowledge and skills to improve their communication with their adolescents about sexuality issues. Therefore, it is necessary to design, implement, and evaluate culture-appropriate educational programs to address the parents' concerns regarding adolescents' sexual health.

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine.

Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women's practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.

Reproductive health issues in female patients with beta-thalassaemia major: a narrative literature review.

ß-thalassaemia major (BTM) has a high prevalence worldwide and is associated with considerable morbidity and mortality. The aim of this review is to provide an illustrative overview of the reproductive health and pregnancy related issues in females with ß-thalassaemia. A literature search was performed in four international databases (1980-2018) to identify the potentially relevant articles. Common reproductive health disorders are hypo-gonadotrophic hypogonadism, infertility, delayed or absent sexual development, diabetes, hypothyroidism, hypoparathyroidism, osteopenia, preeclampsia, gestational hypertension, polyhydramnios, oligohydramnios, thrombosis, renal failure, peripheral vascular resistance, placenta previa, pleural effusion and pulmonary hypertension. Many of those aspects are related to iron overload and to ineffective erythropoiesis. Foetal complications include neural tube defects, abnormalities in different organs, spontaneous abortion, foetal loss, preterm birth, foetal growth restriction and low birth weight. Antenatal screening and accurate genetic prenatal examinations are effective measures to early diagnosis of thalassaemia and a detailed plan for management of pregnancies in BTM is important for favourable maternal and foetal outcome.

Polycystic ovary syndrome and its impact on Iranian women's quality of life: a population-based study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a major public health concern worldwide affecting up to one in five women at reproductive age. It is associated with biochemical and hormonal disturbances as well as adverse cosmetic, reproductive, metabolic, and psychological consequences, resulting in worsened quality of life. The aim of the present study is evaluating the quality of life and determining its degrading factors among Iranian women suffering from this syndrome. METHODS: This cross-sectional study was conducted on 200 PCOS women in Hamadan, Iran. In order to measure quality of life we used the Persian version of Health-related Quality of Life Questionnaire for PCOS (PCOSQ). Descriptive statistics was used to explore the data. In addition linear regression analysis was performed to assess factors affecting health-related quality of life in this population. RESULTS: The mean score for quality of life domains (from the greatest to the least serious concern) were: infertility (3.43 ± 1.63), emotions (3.55 ± 1.17), menstrual problems (3.77 ± 1.36), body hair (3.80 ± 2.05) and weight (4.32 ± 1.80), respectively. The higher score represents better function. However, multivariate analysis revealed that hirsutism had the strongest impact on the patients' quality of life (p < 0.001) followed by infertility (p = 0.038) and menstrual irregularity (p = 0.003). CONCLUSION: The findings showed that impairment of quality of life was associated with PCOS related conditions such as hirsutism, infertility and menstrual problems.

Factors influencing the use of contraceptives through the lens of teenage women: a qualitative study in Iran.

BACKGROUND: One out of seven teenage girls in developing countries marries before the age of 15. While the fertility rate of teenage girls is high, the rate of contraceptive use remains low; therefore, this group of teenagers needs reproductive healthcare. This study was undertaken to explore factors influencing the use of contraceptives from the perspective of teenage women living in the city of Ardabil in Iran. METHODS: This qualitative study was conducted with 14 married women aged 13-19 years who attended in urban-rural healthcare centers in Ardabil. Eligible women were recruited using purposive sampling and were invited to take part in individual in-depth semi-structured interviews. The duration of the interviews varied from 45 to 90 min with an average of 55 min. Sampling continued until data saturation was reached and no new data was collected. Each interview was tape-recorded after obtaining the participant's permission, transcribed verbatim and analyzed for identifying categories and themes using conventional content analysis. RESULTS: Three themes and eight subthemes were developed. The themes were as follows: "insufficient familiarity with contraceptive methods", "pressure to become pregnant" and "misconceptions". CONCLUSION: Despite the high prevalence of early marriage in Iranian society, teenage women are not empowered or prepared for marriage and birth control. Sexual and reproductive healthcare services to teenage women should be improved to meet their needs.

Human infectious diseases and risk of preeclampsia: an updated review of the literature.

BACKGROUND: Preeclampsia (PE) is one of the major causes of maternal and perinatal morbidity and mortality, especially in low- and middle-income countries. In recent years, a growing body of literatures suggests that infections by bacteria, viruses, and parasites and their related inflammations play an important role in the pathogenesis of PE. METHODS: We searched PubMed, Google scholar, and Cochrane databases using the following search words: "infection and preeclampsia," "bacterial infection and preeclampsia," "viral infection and preeclampsia" and "parasitic infection and preeclampsia." RESULTS: The literature review revealed that many bacteria including Helicobacter pylori, Chlamydia pneumonia, and those are involved in periodontal disease or urinary tract infections (UTIs) and some viral agents such as Cytomegalovirus, herpes simplex virus type-2, human immunodeficiency virus, and some parasites especially Plasmodium spp. and Toxoplasma gondii can be effective in development of PE. Inflammation responses against infections has major role in the inducement of PE. The shift of immunological cytokine profile of Th2 toward Th1 and high levels of pro-inflammatory cytokines (TNF-ɑ, IL-12, IFN-γ, etc.), increase of oxidative stress, increase of anti-angiogenic proteins, increase of vascular endothelial growth factor receptor 1 (sVEGFR1), and complement C5a are the main potential mechanisms related to infections and enhanced development of PE. CONCLUSION: Thus, early diagnosis and treatment of bacterial, viral, and parasitic infections could be an effective strategy to reduce the incidence of PE.

The Effect of Sexual Counseling Based on EX­PLISSIT Model on Improving the Sexual Function of Married Women with Systemic Lupus Erythematosus: A Randomized Controlled Trial.

Systemic Lupus erythematosus (SLE) is a multisystem autoimmune disease. This disease triggers sexual dysfunction due to physiological, cognitive and mental effects. Since sexual function is often ignored in these patients, this study aimed to investigate the effect of sexual counseling based on EX­PLISSIT model on improving the sexual function of married women with SLE. This clinical trial was conducted on 101 married women suffering from SLE (18-49 years) residing in Tehran. Randomization was performed by random block allocation with six blocks in a rheumatology clinic. A demographic questionnaire, the Depression, Anxiety, Stress Scales-21 Items (DASS-21), and the female sexual function index were used to collect the data. The intervention group received counselling sessions every week while the control group (n = 55) received routine care for the disease. Eight and twelve weeks after completion of counselling sessions, outcomes compared between the intervention and control groups, using independent ttest, paired t-test, repeated measures and Chi-squared test. The scores of sexual function in both groups did not differ significantly before the intervention (p > 0.05). At the first follow-up session, the score of all sexual function domains except sexual pain increased significantly in the intervention group while a significant reduction was observed in all domains of sexual function in the control group (p < 0.05). In the second follow-up, sexual function significantly increased in the intervention group whereas it significantly decreased in the control group (p < 0.05). According to the findings of this study, counseling based on EX-PLISSIT model positively affected the sexual function of women with SLE. Therefore, this model can be used as a cost-effective and simple counseling method to improve the sexual functions.

The Effect of Yoga on Maternal Anxiety in Women with Excessive Gestational Weight Gain: A Randomized Controlled Trial.

BACKGROUND: Excessive gestational weight gain (EGWG) and anxiety are comorbid conditions that increase the risk of adverse maternal and neonatal outcomes. This study was conducted to investigate the effect of yoga on the anxiety of women with EGWG. MATERIALS AND METHODS: This randomized controlled trial was performed on EGWG pregnant women referring to comprehensive health centers in Qom city, Iran, between October 2021 and August 2022. Eighty-eight participants were assigned to the intervention (N = 44) and control (N = 44) groups. The experimental group participated in six sessions of 90-min yoga classes, and the control group only received routine care. Two questionnaires including a demographic information questionnaire and the State-Trait Anxiety Inventory (STAI) questionnaire were used for data collection. Data were analyzed using SPSS software version 22. RESULTS: The results of this study showed a statistically significant difference between the two groups in terms of trait anxiety (25.84 ± 3.45 vs. 57.38 ± 8.07; p < 0.05) and state anxiety (27.93 ± 3.72 vs. 60.13 ± 8.13; p < 0.05) after intervention. On the other hand, the trait and state anxiety rates were stable in the experimental group before and after intervention, while they increased to the severe form of anxiety in the control group (effect size = -21.84 ± 10.66 vs. -19.43 ± 8.44). CONCLUSION: The result of this study showed that yoga has a positive effect on the anxiety of pregnant women with EGWG and can be used as a preventive or complementary solution to control the anxiety of these mothers.Exzessive Gewichtszunahme in der Schwangerschaft (EGWG) und Angst sind Komorbiditäten, die das Risiko für einen ungünstigen Verlauf für Mutter und Kind erhöhen. Diese Studie wurde durchgeführt, um die Auswirkung von Yoga auf Angst bei Frauen mit exzessiver Gewichtszunahme in der Schwangerschaft zu untersuchen.Diese randomisierte, kontrollierte Studie wurde bei Schwangeren mit EGWG durchgeführt, die sich zwischen Oktober 2021 und August 2022 an Zentren für ganzheitliche Gesundheit in der Stadt Ghom im Iran vorstellten. 88 Teilnehmerinnen wurden einer Interventions- (N = 44) und einer Kontrollgruppe (N = 44) zugeteilt. Die experimentelle Gruppe nahm an einem Yogakurs von sechsmal 90 minuten Dauer teil, die Kontrollgruppe erhielt lediglich die Standardversorgung. Die Datenerhebung erfolgte mit zwei Fragebögen: einem Fragebogen zu demografischen Angaben und dem State-Trait-Angstinventar (STAI). Die Auswertung der Daten erfolgte mit SPSS-Software, Version 22.Die Ergebnisse dieser Studie zeigten einen statistisch signifikanten Unterschied zwischen beiden Gruppen im Hinblick auf Eigenschaftsangst (25.84 ± 3.45 vs. 57.38 ± 8.07; p < 0.05) und Zustandsangst (27.93 ± 3.72 vs. 60.13 ± 8.13; p < 0.05) nach der Intervention. Auf der anderen Seite waren die Raten von Eigenschafts- und Zustandsangst in der experimentellen Gruppe vor und nach der Intervention stabil, während sie in der Kontrollgruppe zur schweren Form von Angst anstiegen (Effektstärke = −21.84 ± 10.66 vs. −19.43 ± 8.44).Die Ergebnisse dieser Studie zeigen, dass Yoga sich bei Schwangeren mit EGWG positive auf Angst auswirkt und als präventive oder komplementäre Lösung zur Beherrschung von Angst bei diesen Müttern eingesetzt werden kann.

Perception of Female Identity in Women with Premature Ovarian Insufficiency: A Qualitative Study.

Background: Premature ovarian insufficiency (POI) occurs in women before the age of 40. Although the outcomes of POI in women include its adverse effects on general health, sexual-reproductive health, and finally reduced quality of life. One of the first adverse consequences is a threat to female identity of the patients. The purpose of the present study was to investigate the perception and experience of women with POI about female identity. Methods: In this qualitative study, interviews were conducted with 15 women having POI. Data included participants' recorded voices that were analyzed using conventional content analysis. Results: After content analysis of the interviews with a focus on the perception and experience of women with POI about female identity, four categories emerged; they included the failure in realization of motherhood dream, the importance of menstruation, construction of female identity, and attempts to normalize the situation. Conclusion: After analyzing the emerged categories obtained by interviewing with POI women, it seems that physicians need to pay special attention to the distortion of the female identity of these patients and educate the medical team about the importance of the effect of treatment on improving their emotional health.

Interventions to improve social support among postpartum mothers: A systematic review.

Background: Poor and insufficient social support to the mother in the post-partum period impairs the effective functioning of her new role as a mother, and it is an important risk factor for the maternal depression and stress after childbirth. Thus, interventions to improve social support to mothers in their postpartum period are required. The present review aimed to investigate the effectiveness of the existing interventions aimed at improving social support among postpartum women. Methods: In this systematic review, PubMed, Scopus, Science Direct, Cochrane Library, Web of Science, EMBASE, Google Scholar, IranDoc, IranMedex, MagIran and SID were searched until January 2022. Full-text articles on the social support outcome, published in English or Persian, which used the design of randomized controlled trials (RCTs) or comparison groups and involved postpartum or pregnant women as participants were included. The quality of the studies was assessed based on the seven criteria offered by Cochrane guidelines. Results: Our review included 10 studies involving 3328 women. According to our results, the following interventions were successful in increasing social support compared to the controlled conditions: counseling with men in the prenatal period, interventions based on interpersonal psychotherapy (IPT), advanced practice nurse (APN), internet support, and home visiting in the postpartum period. Conclusion: These interventions could be provided to mothers during their prenatal or postpartum care. However, which one of these interventions is the most effective in improving social support among postpartum mothers was not identified in the present study.

Prevention of osteoporosis in menopausal women: A systematic review of nonpharmacological clinical trials.

Osteoporosis is a systemic skeletal disease that is associated with negative physical and psychosocial consequences, so understanding the effective strategies that can be used in the prevention of osteoporosis is especially important. The aim of this study was to integrative review the published interventional of nonpharmacological studies regarding the prevention and treatment of osteoporosis among menopausal women. In this systematic review, databases such as PubMed, PsycInfo, Web of Science (ISI), Scopus, ScienceDirect, EmBase, Cochrane library, Google scholar, and Iranian databases, such as Scientific Information Database and Magiran, were searched. The latest search was performed between "November 2020 and December 2020" separately by two researchers and then double-checked by them. The quality of the included studies was assessed using the Jadad score calculation tool. Twenty eight randomized controlled trials and quasi-experimental studies were included in this current study. The quality assessment indicated that 19 studies had acceptable (good) methodological quality and also 9 studies had weak methodological quality. The main results of this study were classified in three main categories such as exercise or physical activity training (n = 15), educational sessions (n = 11), and other interventions (n = 2). The results of most included studies showed that nonpharmacological strategies such as physical activity and educational interventions are considered as the appropriate actions to prevention of osteoporosis among menopausal women so implementing these strategies can be a good alternative for women with contraindication of hormone therapy or therapeutic treatment.

Exploring the impact of endometriosis on women's lives: A qualitative study in Iran.

AIM: Considering the wide impact of endometriosis on various aspects of health, this study aimed to explore the impact of endometriosis on Iranian women's lives. DESIGN: The present study used a qualitative approach and conventional content analysis. METHODS: Twenty patients suffering from endometriosis referring to Imam Khomeini Hospital in Tehran took part in this study. The sampling was done purposefully until data saturation. After deep semi-structured interviews, the content analysis of the interviews was done according to the steps proposed by Zhang and Wildemuth. RESULTS: The mean age of the participants was 34.53 (SD: 5.81) years (range: 23-43) with duration of illness of 6.30 ± 5.86 years. Their educational level varied from high school to university, and most of them were employed. Analysis of the data from participants' experiences led to the formation of 5 categories under the titles "Physical suffering, instability of marital life, mental disorder, disruption in social life and self-care" and 11 subcategories. CONCLUSION: The findings of the present study showed that endometriosis can adversely affect women's lives including physical, sexual, psychological and social problems. Although in some cases patients adopt different strategies for self-care, the need for more support is felt.

Endometriosis reproductive health questionnaire (ERHQ): A self-administered questionnaire to measure the reproductive health in women with endometriosis.

INTRODUCTION: Endometriosis is a disabling disease impacting on different aspects of reproductive health. The present study aims to develop and evaluate the psychometric properties of a questionnaire to measure the reproductive health in women with endometriosis. MATERIAL AND METHODS: This study used an exploratory mixed-methods design and included three phases. In the first phase, a sample of 20 women with endometriosis participated in semi-structured interviews. In the second phase, item pools were generated. In the third phase, face validity, content validity, and construct validity were assessed. To estimate the reliability of the tool internal consistency and test-retest methods were used. RESULTS: sixty items were included in the psychometric evaluation stage of the scale. After the assessment of the content validity ratio (CVR), content validity index (CVI), and exploratory factor analysis, 15 items were omitted, leaving 35 items in the final scale. The exploratory factor analysis revealed four factors: physical problems, psychological problems, counteracting strategies, and instability of marital life. The reliability, according to Cronbach's alpha was 0.809, and the external reliability, as evaluated by the test-retest method and the intraclass correlation, was 0.825. CONCLUSION: ERHQ is a new, valid, and reliable patient-generated instrument to measure the reproductive health in women with endometriosis. It can be used by researchers and health providers to provide a better understanding of the impact of endometriosis on different aspects of reproductive health over time and to meet the needs of patients living with this condition.