Sexual function index adaptation for breast cancer patients (FSFI-BC)- translation and psychometric properties of Persian version.

BACKGROUND: Effective interventions to improve sexual dysfunction in breast cancer survivors need screening of these dysfunctions with a suitable instrument. The aim of present study was translation and identifying psychometric properties of Female Sexual Function Index - Adapted for Breast Cancer (FSFI-BC) which has been specifically developed for breast cancer survivors. METHOD: This methodological study was performed between February 2017 and October 2018. 200 breast cancer survivors in stage 1 or 2 who were selected through convenience sampling method, completed the questionnaire. Reliability was assessed by Cronbach's alfa and test re-test analysis and construct validity was performed through confirmatory (CFA) and exploratory factor analysis( EFA). RESULTS: Six factors were extracted in exploratory factor analysis (EFA). These factors explained 74.6% of the total variance in in NSA group and 0.821 in SA group. Reliability evaluation indicated high internal consistency and good test re-test reliability. Cronbach's alpha coefficient in all areas of the tool was above 0.7 (the lowest and the highest measures were 0.885 and 0.945, respectively), which is a good indicator for reliability of an instrument. Confirmatory factor analysis showed an acceptable fitness for seven factors of FSFI-BC questionnaire (Normed Fit Index or NFI = 0.9 for both groups, Comparative of Fit Index or CFI = 0.93 and 0.92, χ 2/df = 1.68 and 1.71 for SA(Sexually Active) and NSA(No Sexually Active) individuals, respectively) . CONCLUSION: Study findings suggest that Persian version of FSFI-BC is a suitable instrument for sexual dysfunction screening in breast cancer survivors.

The impact of the education program based on dimensions of quality of work life among emergency medical services providers.

BACKGROUND: Quality of work life is a vital factor for health care providers. This study aimed to determine the impact of the education program based on dimensions of quality of work life among emergency medical services employees. METHODS: The quasi-experimental study was conducted on 100 emergency medical services employees in Tehran, Iran, who were chosen using a convenience sampling method (50 in the intervention group and 50 in the control group). The information was gathered using a Demographic Questionnaire and a Walton Quality of Work Life Questionnaire with eight dimensions. The research was carried out in three stages: design, implementation, and evaluation of the education program. During the design phase, the educational needs of the participants were determined in terms of the dimensions of the quality of work life and work and total living space. The education program on work-life quality was implemented in four virtual group sessions, emphasizing the educational needs identified through uploading educational content to the WhatsApp application. The evaluation was conducted in two stages: before the education program and three months after the program. With a significance level of 0.05, the data was analyzed using SPSS version 24 software. RESULTS: The results revealed that an education program on the quality of work life and its dimensions, emphasizing strategies to improve work and total living space, can improve the score of this dimension in the intra-group comparison of both the intervention and control groups (p = 0.046), as well as in the inter-group comparison, at the three-month post-intervention stage, there is a significant difference and a significant increase (p = 0.030), but it does not have a significant effect on the quality of work life and its other dimensions. CONCLUSION: It is recommended that emergency medical services managers plan to improve the quality of working life of their employees, particularly in terms of work and total living space.

Comparison of gamification and role-playing education on nursing students' cardiopulmonary resuscitation self-efficacy.

BACKGROUND: Cardiopulmonary resuscitation (CPR) is one of the most fundamental skills a nursing student should be trained in. Gamification in education involves using game elements to increase motivation, engagement, and personalization of the learning process. The gamification method creates competition among students using various methods, comparing to the role-playing method which is a teaching method that allows individuals to actively engage in simulated scenarios. Therefore, this research aimed to compare the effect of CPR education using gamification and role-playing on the self-efficacy of nursing students. METHODS: This research was a quasi-experimental intervention type with three groups. A total of 154 nursing students participated in this study and were divided into intervention with role-playing (n = 53), gamification (n = 60) and conventional (lecture) (n = 41) groups. In the conventional method, CPR skills were taught to students using practical exercises. In the role-playing method, after training with moulages, a scenario was presented, and students were assigned roles. In the gamification method, after training with moulages, a scenario was presented, and after that, Kahoot software was used to create a sense of competition and excitement in the game. Self-efficacy scores were measured before and after interventions. Self-efficacy in CPR, knowledge, and skills of nursing students in CPR were assessed in each of the three groups using The Basic Resuscitation Skills Self- Efficacy Scale. RESULTS: In the present study, 154 nursing students, including 92 females and 62 males, participated. There was a statistically significant difference in the mean self-efficacy scores before and after training in both the gamification and role-playing groups (P < 0.05). There was a statistically significant difference in the mean self-efficacy scores among the three groups (gamification, role-playing, and lecture) (P < 0.05). CONCLUSION: Based on results it can be concluded that the teaching method used in CPR training affects the self-efficacy of CPR. Active methods, have a greater impact on CPR self-efficacy.

The effects of a hospital-to-home care transition program on perceived stress and readiness for hospital discharge in mothers of children with congenital heart disease undergoing corrective surgery.

BACKGROUND: The aim of this study was to investigate the effects of a hospital-to-home care transition (H2H-CT) program on perceived stress and readiness for hospital discharge (RHD) in mothers of children with congenital heart disease (CHD) undergoing corrective surgery. METHODS: This study used a quasi-experimental design and involved 78 mother-child dyads, 40 dyads in the intervention group and 38 dyads in the control group, who were affected by CHD undergoing corrective surgery. The participants received the H2H-CT program, which consisted of six face-to-face training sessions during hospitalization and six telephone counselling sessions. For perceived stress, data were collected at four intervals, including baseline, immediately, one month and three months after completion of the intervention. For RHD, data were collected at two times: baseline and immediately after the intervention. RESULTS: The results demonstrated a statistically significant reduction in the mean perceived stress score in mothers of children with CHD in intervention group before, immediately, four weeks and eight weeks after H2H-CT (P < 0.001). The results also indicated a significant increase in the mean RHD score in the intervention group following H2H-CT (P < 0.001). CONCLUSION: The H2H-CT program was found to be an effective intervention in reducing perceived stress and increasing RHD in mothers of children with CHD who undergoing corrective surgery. IMPLICATIONS TO PRACTICE: The results can be used by the nursing planners, nursing instructors, and pediatric nurses to use the results to enhance the mental health of mothers and enable them to provide quality care at home.

A Protection Motivation Theory-Based Empowerment Intervention for Promoting Health Behaviors in Women With Human Papillomavirus: An Experimental Study.

ABSTRACT: This experimental study on 70 women with human papillomavirus, referred to the specialized obstetrics and gynecology clinics of public hospitals in Iran in 2021, revealed that implementing the protection motivation theory-based empowerment intervention could promote their health behaviors.

Explaining sexual self-care status and its predictor factors in women referring to healthcare centers of Sari, Iran, 2021.

INTRODUCTION: With the increase in the prevalence of non-communicable diseases and chronic health problems along with population growth, one of the definitions that is expanding is the ability to adapt and self-manage against diseases and self-care. Although there are several studies to examine self-care in medical conditions, there are not enough concepts and data related to sexual self-care. Therefore, the present study was conducted with the aim of explaining the status of sexual self-care and its predictor factors in women of reproductive age referring to healthcare centers. MATERIAL AND METHODS: This research was a cross-sectional study that was conducted on 400 women of reproductive age that referring to healthcare centers affiliated to Mazandaran University of Medical Sciences, Sari in 2021. Data were collected using personal-obstetric characteristics and sexual self-care questionnaires in women of reproductive age. Pearson correlation coefficients, independent t-test, one-way analysis of variance and multiple linear regression model were used to analyze the data. RESULTS: The average total score of sexual self-care in reproductive age women participating in the research was 70.66% ± 12.52%. In addition, the prevention of women's cancers and the prevention of unintended pregnancies obtained the lowest and highest scores, respectively. Factors such as age, education, education related to medical sciences, history of HIV testing, history of HPV vaccination, source of sexual information, method of contraception and infection-related action in a person can affect the level of sexual self-care in women. Based on the final regression model, education related to medical sciences (B = 5.46, P = 0.035), family income (B = 5.58, P = 0.025), prevention method (B = 10.127, P = 0.000) and action related to infection in the person (B = 12.27, P = 0.047) were the final predictors of sexual self-care score in reproductive age women. CONCLUSION: Based on the findings of the study, development of self-care promotion programs for reproductive aged women are necessary in all areas of reproductive health, with a priority for women's cancer prevention, and focusing on promoting education and related economic assistance. The results of this study can be available to experts and policy makers to design programs to promote sexual self-care in women.

Estimation of global rating changes in quality of life and marital satisfaction among reproductive age women in Iran and Afghanistan before and after COVID-19 pandemic.

BACKGROUND: Quality of life and marital satisfaction are important components of reproductive-age women's health. This study aimed to compare the quality of life and marital satisfaction in women of reproductive age in Iran and Afghanistan before and after the COVID-19 pandemic. METHODS: This was a cross-sectional study on a sample of Iranian and Afghan women of reproductive age. To collect the data, the 12-item short-form health survey (SF-12) and the Enrich marital satisfaction scale were used to assess the quality of life and marital satisfaction, respectively. In addition, the Global Rating of Change (GRC) was used in order to evaluate the quality of life and marital satisfaction compared to before the COVID-19 pandemic. Data were evaluated descriptively through statistics including sing t-test, and chi-square, Logistic regression was performed to assess the relationship between outcome variables and independent variables. RESULTS: In all 599 reproductive-age women (300 Iranian, and 299 Afghan) were studied. After adjusting for demographic variables, no significant difference was observed between the two groups for the physical component (P = 0.05) and mental component summary scores of quality of life (P = 0.166) as measured by the SF-12. The majority of Iranian women reported that their quality of life was worsened compared to before the pandemic (57.2%), while in the Afghan group, a higher percentage declared that it was unchanged (58.9%). The mental component of quality of life had no significant relationship with any of the independent variables including nationality. In contrast, the physical component quality of life had a significant relationship with nationality (P = 0.01). Iranian women had more marital satisfaction than Afghan women (P<0.001) and marital satisfaction had a significant relationship with nationality (P<0.001). Most women in both groups (70% of Iranian and 60% of Afghan women) declared that their marital satisfaction unchanged compared to before the COVID-19 pandemic. CONCLUSION: The results showed that the quality of life of Iranian and Afghan women of reproductive age was almost the same before and after the pandemic. However, Iranians scored lower on the mental component summary and Afghans reported lower scores on the physical component summary. Marital satisfaction of Afghan women was much lower than that of Iranian women. The findings suggest the need for serious attention by health care authorities. Providing a supportive environment might be considered a primary step towards a better quality of life for these populations.

Family-centered empowerment approach to optimize phosphate management among hemodialysis patients: an experimental study.

BACKGROUND: This study aimed to investigate the effect of a family-centered empowerment program on hyperphosphatemia management. METHOD: This experimental study was performed on 80 randomly selected eligible patients with hyperphosphatemia undergoing hemodialysis. Patients were assigned randomly to two groups of family-centered empowerment program (FCEPG) and control group (CG) by coin toss (40 people per group). Data collection tools were the researcher-made Phosphate Control Knowledge Scale, the researcher-made Adherence to Dietary Restriction of Phosphorus Intake Scale, the eight-item Morisky Medication Adherence Scale, and serum phosphorus measurements. Data were collected before the intervention, one month, and three months after the intervention. Patients in FCEPG participated in a family-centered empowerment program. The statistical significance level was considered to be 0.05. RESULTS: Inter-group comparisons showed no significant difference between FCEPG and CG in terms of the mean score of knowledge of phosphate control, adherence to dietary restriction of phosphorus intake, adherence to medication, and the mean serum phosphorus level before the empowerment program, but showed significant differences between them in these respects at one month after the program and three months after the program (p < 0.05). Intra-group comparisons showed a significant difference in FCEPG between the mean and standard deviation of all four variables before the empowerment program and the corresponding values one month and three months after the program (P < 0.05). CONCLUSION: The findings of this study can be used in various fields of healthcare in the hospital and community.

The relationship between social determinants of health and postpartum weight retention based on the World Health Organization model: path analysis.

BACKGROUND: Postpartum weight retention (PPWR) causes obesity, chronic diseases, and occurring adverse maternal-fetal and neonatal outcomes. Given the social factors' effect on health and disease and considering the lack of information on social determinants of health (SDH) effects on PPWR, this study was conducted to survey the relationship between SDH and PPWR based on the World Health Organization (WHO) model. METHODS: A cross-sectional study was performed on 400 women six months after delivery in 2020. Twelve health centers were randomly selected from the three universities of Medical Sciences in the city of Tehran, Iran. Participants were selected by convenience method and based on eligibility. Questionnaires used included: Lifestyle Profile Health Promoting II, Short Form Postpartum Quality of Life Questionnaire, Multidimensional Scale of Perceived Social Support, Postpartum Social Support, Depression Anxiety Stress Scales, and questionnaires designed by reviewing the literature about breastfeeding, sleep, contraceptive, child health, unhealthy behaviors, postpartum nutritional awareness/beliefs, body satisfaction, access to postpartum care, socioeconomic status, demographic, and obstetric questionnaire. Data analysis was performed in SPSS-23, and the relationship model was examined using the path analysis method in LISREL-8.8. RESULTS: Path analysis indicated the direct effect of six intermediate factors on PPWR including: gestational weight gain (ß = 0.42), access to postpartum care (ß = 0.11), postpartum nutritional awareness/beliefs (ß=-0.17), anxiety (ß = 0.09), sleep duration (ß=-0.09), pre-pregnancy body mass index (ß = 0.09). Among the structural factors, woman's education and socioeconomic status had an indirect negative effect on PPWR. The model fit indices showed good fit (RMSE = 0/05, GFI = 0.92, CFI = 0.92, χ2/df = 2.17). CONCLUSION: The results indicate the effect of structural and intermediate determinants of health on PPWR. It is recommended to use the proposed model as an appropriate framework in the research, design, and implementation of programs to prevent and control PPWR.

Prevalence of depression in infertile men: a systematic review and meta-analysis.

BACKGROUND: Generally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men. METHODS: This research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle-Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively. RESULTS: Twenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively. CONCLUSION: Based on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.

Effectiveness of listening to music and playing with Lego on children's postoperative pain.

PURPOSE: The present study aimed to compare the effectiveness of music and playing with Lego in postoperative management pain in children. DESIGN AND METHODS: In this three-group quasi-experimental study, the participants in this interventional study were 96 children aged 6 to 12 years admitted to the pediatric surgery ward of Mofid Hospital and Medical Center in Tehran. The participants were selected using convenience sampling. They were then randomly placed into three intervention groups. Pain intensity was measured for the participants in all three groups before the intervention. The intervention was performed in two 15-min sessions with an interval of 5 min in three intervention groups. Then pain intensity was measured using the Oucher Pain Scale before the intervention and in four intervals: Immediately after the intervention, half an hour, one hour, and 3 h after the intervention, respectively. Pain intensity was also measured at the same time intervals for the participants in the control group. The collected data were analyzed with SPSS-25 software using descriptive statistics, the Bonferroni test, and Tukey's test. RESULTS: The data showed that the three groups were identical in terms of demographic characteristics (p > 0.05).A comparison of the music listening group and the control group showed statistically significant difference in terms of postoperative pain (P < 0.05).However, the data showed significant differences between the control group and the Lego group in terms of pain intensity immediately after the intervention, half an hour, one hour, and 3 h after the intervention, respectively (p < 0.05).The data also revealed a significant difference between the children in the music group and the Lego group at all phases (p < 0.05), and the children in the Lego group reported less pain after the intervention compared to the children in the music listening group. Nevertheless, there was a statistically significant difference between the three groups in terms of reported pain intensity half an hour, one hour, and three hours after the intervention (p < 0.05). CONCLUSION: The results showed that playing with Legos had a greater effect on reducing postoperative pain in children than listening to music. Thus, nurses are recommended to make arrangements for children to play with Legos after surgery. PRACTICE IMPLICATION: Playing with Legos can be used to control postoperative pain in school-age children in medical centers and wards of pediatric hospitals.

Psychometric evaluation of the Persian version of the Hospital Survey on Patient Safety Culture Questionnaire (HSOPSC) in neonatal intensive care units: a methodological study.

BACKGROUND: A valid and reliable tool compatible with the culture is needed to evaluate the safety culture as one of the vital and promotional components in improving the quality of safety and health care. This study aimed to investigate the psychometric properties of the Persian version of the "Hospital Survey on Patient Safety Culture (HSOPSC)" in physicians and nurses working in Neonatal Intensive Care Units. METHODS: In this methodological research, the qualitative face, content validity, and construct validity were performed by Confirmatory Factor Analysis to the psychometric evaluation of the HSOPSC questionnaire. Based on convenience sampling and the inclusion criteria, 360 individuals completed the questionnaire. Internal consistency and stability were measured. Data analysis was performed using SPSS 21 and LISREL. RESULTS: In examining the construct validity, fit indices were not appropriate for the 12-dimension model of the Persian version. According to T-value, six heterogeneous items and a dimension were omitted. The 11-dimension model with 36 items showed an appropriate fit with the data. Cronbach's alpha was evaluated at 0.79, and the stability was 0.82 (p˂0.001). CONCLUSION: The Persian version of HSOPSC with 11 dimensions and 36 items has favorable validity and reliability and can be used in NICUs.

Is there any relationship between nurses' perceived organizational justice, moral sensitivity, moral courage, moral distress and burnout?

AIM: The present study is an attempt to investigate the relationship between Corley's model variables in mental health nurses. BACKGROUND: Based on Corley's model, burnout and moral distress in nurses are, in retrospect, the consequences of the interplay of organizational and individual factors such as perceived organizational justice, moral sensitivity, and moral courage. The relationship between two variables or three variables of Corley's moral distress model has been investigated, but the test of Corley's moral distress model with more variables has not been done. Therefore, this research was proposed with the aim of investigating the relationship between the variables of moral courage and moral sensitivity (as characteristics of nurses), perceived organizational justice (as an antecedent), moral distress, and job burnout (as consequences of moral distress). METHODS: The study was conducted as a descriptive correlational study involving 500 nurses working in the mental health wards of hospitals. Data collection was conducted using perceived organizational justice scale, moral sensitivity scale, moral courage scale, moral distress scale, and burnout inventory. RESULTS: The results showed a significant relationship between perceived organizational justice, moral sensitivity, moral courage, and moral distress (< 0.05). Moreover, perceived organizational justice and moral distress had an inverse relationship. Moral sensitivity and moral courage had a direct relationship with moral distress (< 0.05). Furthermore, the results showed inadequate model fitness. CONCLUSIONS: This study adds to the existing knowledge about the experiences of mental health nurses and their interactions with both organizational and individual factors. It highlights that the connections between perceived organizational justice, moral sensitivity, moral courage, moral distress, and burnout are intricate and multifaceted. As we deepen our understanding of these relationships, it opens the door for the development of interventions and strategies to enhance nurses' well-being and the quality of care they deliver in mental health settings. Moreover, future research and ongoing refinement and expansion of Corley's model will be crucial in addressing the complex challenges within the healthcare sector.

Factors Related to Health Literacy Among the Iranian Population: A Scoping Review.

Background: The identification of the determinants of health literacy is an essential prerequisite for developing health literacy promotion programs. While these factors have been reported in previous studies, there is a lack of a comprehensive review specifically focused on the Iranian population. Therefore, this review aimed to identify the factors related to health literacy in Iran. Methods: This scoping review used the Arksey and O'Malley methodological framework and the Joanna Briggs Institute framework. A search was performed in English-language databases-Web of Science, Scopus, and PubMed-using the MeSH keyword of "health literacy," and in Persian-language databases-Magirean and SID-using the related keywords. A narrative synthesis was conducted to describe all included studies' characteristics and explore factors associated with health literacy. Results: A total of 76 studies were included. Based on the results of the study, related factors included personal factors-including sex, age, education level, field of study, parents' education level, marital status, occupation, work experience, employment status, ethnicity, income, socioeconomic status, medical history, duration of disease, addiction, number of children, media literacy, information literacy, computer literacy, and self-efficacy-situational factors-including use of the internet, use of social networks, social support, source of information, and participation in health education classes-and societal and environmental factors-including place of residence and type of insurance. Conclusion: Modifiable factors identified in this study were self-efficacy, social support, information sources, media literacy, information literacy, computer literacy, internet or social networks, and participation in health education classes. Planners can consider these factors when developing interventions to promote health literacy.

The effect of Benson relaxation technique on the severity of symptoms and quality of life in children with irritable bowel syndrome (IBS): a quasi-experimental study.

AIM: This study aimed to determine the effect of the Benson relaxation technique on the severity of symptoms and quality of life in children with irritable bowel syndrome (IBS). DESIGN: This quasi-experimental study was carried out on children with irritable bowel syndrome in Iran. METHOD: Sixty children were randomly divided into control and experimental groups. The Benson relaxation technique was implemented for three weeks for experimental group, while the control group only received the typical medical therapy with no special intervention. The questionnaire of Irritable Bowel Syndrome-quality of life-34 (IBS-QOL-34), and Bowel Symptoms Severity and Frequency Scale (BSS-FS) were used for data gathering before and three weeks after the intervention. Data were analyzed using statistics, appropriate parametric and non-parametric tests. RESULTS: According to the results, the experimental group had lower mean scores of qualities of life before the intervention (p < 0.05). The mean score of symptom severity in children with IBS was 13.88 in the experimental group, which changed to 9.83 in the post-test, indicating a significant difference (p < 0.000). The pre-test and post-test mean scores for quality of life in this group were 118.94 and 102.77, respectively, indicating a significant difference (P < 0.001). CONCLUSION: The Benson relaxation technique can be a non-pharmacological solution to reduce the severity of symptoms and improve the quality of life of children with IBS. IMPLICATION TO PRACTICE: This technique is supposed to contribute as a further intervention in clinical contexts.

Predictors of the relationship between the duration of cancer and care time with the supportive care needs of patients and the quality of life of their caregivers: a path analysis.

BACKGROUND: Breast cancer (BC) patients face various physical and psychological challenges. The mutual impacts of patients and caregivers on each other show the need for further supportive care from the community and family. This study aimed to identify the predictors of the direct and indirect relationships of the duration of cancer (CANCERT) and care time (CARET) with the supportive care needs (SCN) of the patients and the quality of life (QOL) of their family caregivers. METHODS: This descriptive study included 150 patients and their caregivers in Iran. Data were collected using the Supportive Care Needs Survey-Short Form (SCNS-SF34), the Caregiver Quality of Life Index-Cancer (CQOLC) scale, and a socio-demographic checklist. The data were then analyzed in SPSS-24 and Lisrel-8.8 software using descriptive statistics and path analysis. RESULTS: The mean age of the patients and caregivers was 45.76 ± 10.44 and 43.46 ± 9.5, respectively. The majority of patients (96%) were in stages II and III of the disease. There was no statistically significant relationship between cancer stages with SCN of the patients and also caregivers' QOL (P > 0.05). Based on the test results, the CANCERT was positively correlated with the patients' care and support needs (SN) in total effect (ß = 0.24). The patients' sexuality needs had the highest negative correlation with their CANCERT in the direct path (ß = - 0.27) and had the highest negative correlation with psychological needs in the indirect path (ß = - 0.174). The CARET (hours per day) had positive correlation with health systems and information needs in both the direct (ß = 0.26) and indirect paths (ß = 0.15). The highest positive correlation with physical needs was in the direct path (ß = 0.34). The caregivers' QOL had a negative and direct relationship with the CANCERT (ß = - 0.19), and there was a positive and direct relationship between CARET and the caregivers' QOL (ß = 0.18). CONCLUSIONS: The correlations obtained from this study are not necessarily strong, yet they are important and should be noticed and tested in the future studies. The present findings reveal the need to provide comprehensive care, planning to provide supportive care, and counseling to both BC patients and their family caregivers, especially when the duration of the disease is prolonged.

The Maternal Postpartum Quality of Life Instrument (MPQOL-I): development and psychometric evaluation in an exploratory sequential mixed-method study.

BACKGROUND: " Postpartum quality of life" refers to women's satisfaction of their position in life, based on cultural status, expectations, values, attitudes, goals, and living standards. Hence the need to pay attention to more specific dimensions of quality of life in the postpartum period is being sensed. This study was conducted to develop the Maternal Postpartum Quality of Life Instrument (MPQOL-I) and assess its psychometric properties. METHODS: This methodological study was conducted in 2019-2020. This exploratory, sequential mixed-method study was conducted in two phases. The first phase is MPQOL-I development and the second phase is psychometric evaluation of the developed scale. In the quantitative (psychometric evaluation) phase, face, content, construct, convergent, and discriminant validity and reliability of the scale were tested. RESULTS: In this study, 5 factors were extracted from items through exploratory factor analysis: (1) received support, (2) sexual relations, (3) bonding with newborn, (4) breastfeeding and newborn care, and (5) the transition period. These factors accounted for 53.26% of the total variance. The results of the confirmatory factor analysis suggested the goodness-of-fit indices was acceptable. Furthermore, the internal consistency and composite reliability indices of factors were greater than 0.7. CONCLUSION: The sixteen-item Persian language MPQOL-I is a valid and reliable instrument for postpartum quality of life assessment. It includes items from different aspects of postpartum quality of life and can be used for the early diagnosis of impaired postpartum quality of life. Further studies are needed to assess the psychometric properties of MPQOL-I in different cultures and communities.

Diagnostic accuracy of first and early second trimester multiple biomarkers for prediction of gestational diabetes mellitus: a multivariate longitudinal approach.

BACKGROUND: Gestational Diabetes Mellitus (GDM) is an underlying cause of maternal and newborn morbidity and mortality all around the world. Timely diagnosis of GDM plays an important role in reducing its adverse consequences and burden. This study aimed to determine diagnostic accuracy of multiple indicators in complete blood count (CBC) test for early prediction of GDM. METHODS: In this prospective cohort study, the data from 600 pregnant women was analyzed. In the study sample, the two-step approach was utilized for the diagnosis of GDM at 24-28 weeks of gestation. We also used the repeated measures of hemoglobin (Hb), hematocrit (Hct), fasting blood sugar (FBS) and red blood cell count (RBC) in the first and early second trimesters of pregnancy as the longitudinal multiple indicators for early diagnosis of GDM. The classification of pregnant women to GDM and non-GDM groups was performed using a statistical technique based on the random-effects modeling framework. RESULTS: Among the sample, 49 women (8.2%) were diagnosed with GDM. In the first and early second trimester of pregnancy, the mean HcT, Hb and FBS of women with GDM was significantly higher than non-GDMs (P < 0.001). The concurrent use of multiple longitudinal data from HcT, Hb, RBC and FBS in the first and early second trimester of pregnancy resulted in a sensitivity, specificity and area under the curve (AUC) of 87%, 70% and 83%, respectively, for early prediction of GDM. CONCLUSIONS: In general, our findings showed that the concurrent use of repeated measures data on Hct, Hb, FBS and RBC in the first and early second trimester of pregnancy might be utilized as an acceptable tool to predict GDM earlier in pregnancy.

Sexuality and psychological well-being in different polycystic ovary syndrome phenotypes compared with healthy controls: a cross-sectional study.

INTRODUCTION: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale. MATERIALS AND METHODS: The present cross-sectional study was carried out on 192 women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12. RESULTS: In the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P < 0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P < 0.05). CONCLUSION: The results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women's QoL and sexual function should be considered according to the relevant PCOS phenotypes.

Development and Psychometric Properties of Pregnant Women's Decision-making Questionnaire for Choosing a Prenatal Care Provider (CPCP-60): A Research From Southwest of Iran.

Background: The selection of a competent prenatal care provider for women is of a major concern. The purpose of this research was to design a questionnaire for pregnant women's decision-making regarding choosing a prenatal care provider and to assess its psychometric properties. Methods: This study used an exploratory mixed method. In the qualitative phase, a semi-structured individual interview was done with 33 participants in Shiraz, Iran. Based on the outcomes of the previous step and the literature study, the items of the questionnaire were designed in the quantitative phase. Then, the Cosmin criteria were developed to consider the psychometric properties of the questionnaire. In order to examine the validity of the CPCP-60 questionnaire, an exploratory factor analysis was performed. Reliability was assessed by the Cronbach alpha coefficient test and retest. Data were analyzed using the SPSS Version 21. Results: The CPCP-60 questionnaire included 60 items. After the exploratory factor analysis, 4 factors were extracted that expressed 60.52% of the total variance: professional and communication skills, personal traits of prenatal care providers, and characteristics of pregnancy and childbirth centers. The content validity index and the content validity ratio were 0.90 and 0.76, respectively. A Cronbach alpha of 0.941 and a test-retest of 0.951 demonstrated excellent reliability for the CPCP-60 questionnaire. The responsiveness and the interpretability were acceptable. The minimal detectable change (MDC) of the questionnaire (9.70) was less than the minimal important change (MIC) (12.91). Conclusion: Considering the reliability and validity of the CPCP-60 questionnaire, and its compatibility to the culture of the Iranian society, it can be used in clinical research to evaluate the decision-making of pregnant women on choosing a competent prenatal care provider in Iran.