Association of social capital with mental health and quality of life among low- and high-risk pregnant women.

INTRODUCTION: Social capital means having resources and support in relationships and social ties. It can affect the individual's quality of life and mental health. The present study investigated the association between social capital with psychological status and quality of life among low-risk and high-risk pregnant women. METHODS: The present cross-sectional study was conducted with the participation of 394 pregnant women receiving prenatal care in urban comprehensive health centers in Qazvin, Iran. Two-stage sampling was used to select comprehensive health centers by random cluster sampling and then pregnant women randomly. Social capital, quality of life (QoL), psychological status, and demographic and obstetric characteristics were assessed. Uni-variable and multivariable linear regression models were used to analyze the data. RESULTS: Among the participants, 267 had low-risk pregnancies (67.77%) and the remainder were high-risk. The mean age of participants was 27.94 years (SD=5.86), the mean gestational age was 23.63 weeks (SD=7.71). The mean overall quality of life score among low-risk pregnant women was 32.00 (SD=5.27) and among high-risk pregnant women was 29.70 (SD=3.65). High-risk pregnant women experienced significantly higher anxiety and depression and fear of COVID-19. Social capital had a significant and weak relationship with anxiety among low-risk pregnant women (r = 0.22, p < 0.001). Also, a weak and significant relationship between social capital and anxiety (r = 0.24, p = 0.007), depression (r = 0.24, p = 0.007) and fear of COVID-19 (r = 0.27, p = 0.002) was found among high-risk pregnant women. CONCLUSION: Women with high-risk pregnancies experienced lower quality of life, higher anxiety and depression, and greater fear of COVID-19. There was also a weak relationship between social capital and the aforementioned variables among high-risk pregnant women. Designing and implementing interventions to increase quality of life and reduce anxiety and stress among high-risk pregnant women appears to be warranted.

Iranian women's attitude toward childbearing and its' association with generalized trust, social support, marital satisfaction and governmental childbearing incentives.

Background: Having a child is important event for families worldwide. Attitudes toward childbearing are influenced by many factors. The aim of the present study was to investigate Iranian women's attitude toward childbearing and its association with generalized trust, social support, marital satisfaction, mental health, and socio-economic characteristics in Qazvin province. Methods: A cross-sectional survey study was conducted between April and July 2022. Using convenience sampling, 347 women with no children or one child in Qazvin province (Iran) participated in the study. Data were collected via the Iranian online platform Porsline. The survey included a demographic and fertility characteristics questionnaire, Attitudes Toward the Government's Childbearing Incentives Scale (ATGCIS), Attitudes Toward Fertility and Childbearing Scale (ATFCS), ENRICH Marital Satisfaction Scale (ENRICH MSS), Patient Health Questionnaire (PHQ-4), Multidimensional Scale of Perceived Social Support (MSPSS), and Generalized Trust Scale (GTS). Findings: The average age of participants was 35.66 years (SD = 6.89). The score of attitudes toward fertility and childbearing was 84.66 out of 134 (SD = 19.17). The average number of expected children by the couple was 2.36 (SD = 1.35). Multivariable linear regression found a positive and significant relationship between participants' attitudes toward fertility and childbearing (ATFC) and (i) governmental childbearing incentives (ß = 0.365, p < 0.001, with 1.37 increase in ATFC with each unit increase in this scale) (ii) generalized trust (i.e., individual's expectation of others' trustworthiness), (ß = 0.155, p < 0.003, with 0.60 increase in ATFC with each unit increase in generalized trust) and (iii) marital satisfaction (ß = 0.146, p < 0.005, with 0.26 increase in ATFC with each unit increase marital satisfaction). The multivariable linear regression model also showed that attitudes toward fertility and childbearing was the only predictor of couples' expected number of children in the future (ß = 0.214, p < 0.001, with 0.38 increase in couples' expected number of children with each unit increase in ATFC). Conclusion: Government incentives were the strongest independent predictor of participants' attitudes toward childbearing which can indirectly influence couples' expected number of children in the future. Consequently, governments may be able to influence couples' childbearing decisions by providing appropriate incentives. Generalized trust and marital satisfaction were other significant predictors of attitudes toward childbearing. Therefore, implementing programs to improve generalized trust, and increasing marital satisfaction might be other influential measures in couples' childbearing decisions.

Sexual-related determinants of life satisfaction among married women: A cross-sectional study.

BACKGROUND AND AIM: Life satisfaction refers to the perceived satisfaction of individuals concerning various aspects of their lives. The present study investigated the predictive role of sexual-related determinants in life satisfaction among married women. METHODS: A cross-sectional study was conducted from August to November 2021. A total of 350 married women with at least six months of cohabitation with husbands were included in the study. The study utilized a multi-stage random sampling method from 10 comprehensive health centers in Qazvin, Iran. Scores on the Emotional Intimacy Questionnaire (EIQ), Dyadic Sexual Communication Scale (DSCS), Female Sexual Distress Questionnaire (FSDQ), Female Sexual Quality of Life Scale (FSQLS), Female Sexual Function Index (FSFI), and Life Satisfaction Scale (LSS) were assessed. Data were analyzed using univariable and multivariable linear regression models with a significance level of p < 0.05. RESULTS: The mean age of participants was 33.77 years (SD = 9.77) and they had been married for an average of 10.21 years (SD = 9.93). The mean scores on the LSS were 20.16 (out of 35; SD = 6.79). Based on the multivariable linear regression model adjusted for socio-demographic characteristics, the two strongest predictors of life satisfaction among Iranian married women were marital intimacy (ß = 0.49, p < 0.001) and sexual functioning (ß = 0.17, p = 0.009). Together, these variables explained 45% of variance in life satisfaction. CONCLUSION: Given that marital intimacy and sexual functioning were the most significant sexual-related determinants of life satisfaction among married women, designing and implementing interventions which increase women's marital intimacy and sexual functioning might improve married women's life satisfaction.

Mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life among women of reproductive age: An Iranian cross-sectional study.

OBJECTIVES: This study aimed to determine the mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life (QoL) among Iranian women of reproductive age. METHODS: A cross-sectional study comprising 324 married women was conducted. Online convenience sampling was used to collect data. SPSS PROCESS macro was used for the mediation analysis. The direct and indirect effects of the fear of COVID-19 on sexual QoL and marital satisfaction were estimated comprising a 95% CI using 5000 bootstrap samples. Pairwise comparisons between the mediators were calculated by Hayes' macros. RESULTS: A positive/negative or suspected history of COVID-19 infection had marginally significant relationship with marital satisfaction (p=0.049). The total effect of fear of COVID-19 on sexual QoL was significant (b=-1.31, SE=0.20, p<0.001). Fear of COVID-19 had no significant direct effect on sexual QoL (b=-0.22, SE=0.19, p=0.24) but it had an indirect effect on sexual QoL via mediation of psychological distress (b=-0.34, SE=0.09, 95% CI: -0.53 to -0.19) and domestic violence (b=-0.75, SE=0.18, 95% CI: -1.12 to -0.40). The total effect of fear of COVID-19 on marital satisfaction was significant (b=-1.91, SE=0.32, p<0.001). Fear of COVID-19 had no significant direct effect (b=0.20, SE=0.25, p=0.42) on marital satisfaction but it had an indirect effect on marital satisfaction via mediation of psychological distress (b=-0.59, SE=0.13, 95% CI: -0.86 to -0.36) and domestic violence (b=-1.51, SE=0.29, 95% CI: -2.08 to -0.92). CONCLUSION: The fear of COVID-19 during the pandemic indirectly decreased women's marital satisfaction and sexual QoL via increased psychological distress and domestic violence. Consequently, in critical situations such as the COVID-19 pandemic, improving couples' psychological health and reducing domestic violence are likely to improve women's sexual QoL and marital satisfaction.

Predictors of breastfeeding self-efficacy during the covid-19 pandemic.

Background: Breastfeeding self-efficacy (BSE) is a strong predictor of the duration of breastfeeding. The aim of this study is to determine the predictors of BSE in breastfeeding mothers during the Covid-19 pandemic. Methods: A cross-sectional study was conducted with 300 breastfeeding mothers who breastfed during the Covid-19 pandemic. Convenience sampling was used to recruit participants. A battery of online questionnaires measured sociodemographic and obstetric characteristics, breastfeeding self-efficacy, spouse postpartum social support, perceived social support, anxiety and depression, and fear of Covid-19. Data were analyzed using Pearson correlation coefficients, one-way ANOVA, and multivariable linear regression via stepwise method. The significance level in this study was α = 0.05. Results: The mean BSE score among participants was 58.19 ± 10.48 (out of 70). Spouse postpartum social support (ß = 0.732, p = 0.04), intention to breastfeed (ß = 0.17, p = 0.001), use of formula while breastfeeding (ß = -0.09, p < 0.001), and depression (ß = - 0.11, p < 0.001) were significant predictors of BSE. However, fear of Covid-19 was not significantly correlated with BSE (p = 0.514). Conclusion: The results of the present study showed that fear of Covid-19 was not a significant predictor of BSE, while spouse postpartum social support and having the intention of breastfeeding were positively associated with BSE. Depression and simultaneous use of formula in feeding the infant was negatively associated with BSE during Covid-19. Overall, breastfeeding can be encouraged through counseling to improve receiving spousal support, increasing breastfeeding intent, and reducing depression.

Communal coping and its association with marital relations and psychological outcomes among healthcare professionals during the COVID-19 pandemic.

Background: Communal coping is a type of interdependency in which couples dealing with a health threat share assessment of a threat and respond together to the stress. The present study investigated communal coping in the COVID-19 pandemic and its association with psychological and relational outcomes among healthcare professionals. Methods: In the present cross-sectional survey study, 242 healthcare professionals from hospitals and health centers were recruited via convenience sampling between August and October 2020. Communal coping with working conditions during the COVID-19 pandemic, dyadic adjustment, psychological distress, and fear of COVID-19 along with demographic and professional characteristics were assessed via an online survey. Results: Multivariable linear regression showed that dyadic adjustment (ß = 0.73), psychological distress (ß = 0.16), fear of COVID-19 (ß = 0.11), and support gap (ß = -0.04) were significant independent variables associated with communal coping among healthcare professionals. Conclusion: Healthcare professionals coped communally within the family in dealing with working conditions during the COVID-19 pandemic. Dyadic adjustment was the strongest predictor of communal coping among healthcare professionals.

The relationship between cognitive schemas activated in sexual context and early maladaptive schemas among married women of childbearing age.

BACKGROUND: Healthy sex can be affected by cognitive schemas activated in the sexual context (CSASCs) and early maladaptive schemas (EMSs). Cognitive schemas are the nuclear structure of the cognitive system which facilitate the interaction between individuals and their environments. CSASCs are emotional and behavioral responses in the sexual context. EMSs are extremely stable, enduring and are developed throughout the life of the individual, beginning in childhood. The present study investigated the relationship between CSASCs and EMSs among married women of childbearing age. METHODS: In a cross-sectional study, 260 married women of childbearing age participated. Using two-stage sampling, ten comprehensive urban health centers were first randomly selected and then 26 individuals from each center were invited to participate. Data collection included demographic variables, the Young Schema Questionnaire-Short Form (YSQ-SF) with 15 EMSs (emotional deprivation, abandonment, mistrust/abuse, social alienation, defectiveness, incompetence, dependency, vulnerability to harm, enmeshment, subjugation of needs, self-sacrifice, emotional inhibition, unrelenting standards, entitlement, and insufficient self-control), and the Cognitive Schema Activation in Sexual Context Questionnaires (CSASCQ) with five subscales (undesirability/rejection, incompetence, self-depreciation, difference/loneliness, and helplessness). Data analysis was performed using a uni-variable and multi-variable linear regression model with a stepwise method at a significance level of 0.05. RESULTS: The mean age of the participants was 32.48 years and the average duration of their marriage was 10.34 years. The average score of early maladaptive schemas on the YSQ-SF was 151.5 (out of 450). Higher scores indicate more severe maladaptive schemas, although the total score has no defined cutoff point. Scores greater than 15 on each subscale constitute the internalization of that particular maladaptive schema. The highest average subscale scores were the schemas of self-sacrifice and unrelenting standards (M = 16.12, 15.90, respectively), indicating that these two schemas play important roles in the cognition of the participants. The mean score on the CSASCQ was 34.60 (SD ± 12.59; range: 25-125), with the highest mean reported on the loneliness subscale. Hypoactive sexual desire was the most common unpleasant sexual problem (6.9%) and disillusion was the most dominant feeling experienced by participants (33.3%). The results of the multivariable model showed that the following were significant predictors of the CSASC: three subscales of EMS (emotional deprivation [ß = 0.28], social isolation [ß = 0.31], and emotional inhibition [ß = 0.14]) and two demographic variables (job [ß = 0.11] and consanguineous marriage [ß = 0.20]). In total, the multi-variable model explained 92% of variance of CSASCs. CONCLUSIONS: The present study found a significant and meaningful association between EMSs and CSASCs adjusting for the effect of socio-demographic characteristics. The findings indicate that the study of schemas and schema therapy should be considered in both premarital and marital counseling.

Predictive factors associated with death depression in women with breast cancer.

A cross-sectional study with a convenience sample of 241 patients with breast cancer was conducted to investigate death depression and its explanatory factors in Iranian women who were diagnosed and undergoing treatment for breast cancer. Patients with significantly higher death depression were those who were housewives (ß = 0.6, p = 0.016), unskilled workers (ß = 15.8, p = 0.002), and retired (ß = 13.1, p = 0.002) as compared with those who were professionally employed with higher socio-economic status (ß = 17.4, p = 0.002); and those receiving combination therapy as compared to surgery only (ß = 6.3, p = 0.02). For patients with higher spiritual health scores, death depression was significantly lower (ß = -0.2, p < 0.001).

Sexual Satisfaction and Cognitive Schemas Activated in a Sexual Context among Iranian Married Women of Reproductive Age.

The present study examined the relationship between sexual satisfaction (SS) and cognitive schemas activated in sexual context. In a cross-sectional study, the participants comprised 313 Iranian married women (mean age of 36.7 years and mean marriage duration of 12.4 years). Data were collected utilizing an online survey comprising the Index of Sexual Satisfaction, the Cognitive Schema Activated in Sexual Context Questionnaire, and a number of sociodemographic questions. A linear regression model utilizing the stepwise method was performed. The mean score of cognitive schemas relating to sexual problems was 35.56 (out of 140; SD = 14.68) with the highest mean in the Difference/Loneliness subscale (higher scores indicating greater negative schema activation). The mean score of sexual satisfaction on the ISS was 96.80 (out of 125; SD = 16.77). The highest scores of cognitive schemas relating to sexual problems were observed among individuals with low sexual satisfaction. Based on a multivariable linear regression model, age (ß = 0.33), spouse social support (ß = 0.23), and spouse job (ß = 0.21) had the highest regression coefficients in relation to sexual satisfaction among Iranian married women. Cognitive schemas activated in a sexual context were strongly and significantly associated with sexual satisfaction among Iranian married women of reproductive age. The findings suggest that schema therapy techniques be used alongside initiatives to promote spouse social support to help prevent problematic sexual cognitive schemas.

The Effect of Sex Counseling Based on (Permission, Limited Information, Specific Suggestions, Intensive Therapy) Model on Sexual Satisfaction in Women with Cyclic Mastalgia: A Randomized Controlled Clinical Trial.

BACKGROUND: More than half of the population of women suffer from cyclic mastalgia which can interfere with women's sexual function and affect their sexual satisfaction. The current study was conducted to determine the effect of sexual counseling on sexual satisfaction in women with cyclic mastalgia. MATERIALS AND METHODS: This randomized controlled trial study was performed on 81 women with cyclic mastalgia. The subjects were randomly divided into two groups of intervention (n = 40) and control (n = 41). Intervention was performed as Permission, Limited information, Specific suggestions, Intensive therapy (PLISSIT) sex counseling in four sessions for a maximum of 90 min in the intervention group. The demographic checklist and Index of Sexual Satisfaction (ISS) were used for data collection. Follow-up was performed 1 and 3 months after the intervention. The obtained data were analyzed using repeated-measures test. RESULTS: The intervention and control groups were in good balance in terms of demographic characteristics and sexual satisfaction scores prior to the intervention and no statistically significant differences were observed. There was a statistically significant increase in the mean (SD) score of female sexual satisfaction in the intervention group: 93 (12.52), 101.15 (7.70),101.37 (5.31), (F (1,39) = 27.4, p < 0.001). We also observed a decrease in the mean (SD) score of sexual satisfaction in the control group: 93.39 (13.12), 90.68 (8.41), 90.85 (6.57), (F (1,40) = 11.9, p < 0.001) 1 and 3 months following the intervention. CONCLUSIONS: This study revealed that individual counseling by PLISSIT sex counseling could lead to improvement in sexual satisfaction index in women with cyclic breast pain.

Psychometric properties of Postpartum Partner Support Scale-Persian version.

AIM: The aim of the present study was to translate the Postpartum Partner Support Scale (PPSS) into Persian and evaluate its psychometric properties among postpartum women. DESIGN: A total of 248 women aged 18-39 years participated in this psychometric study. The PPSS was translated into Persian using a forward-backward method. Confirmatory factor analysis (CFA) and Rasch model analysis were used to assess the psychometric properties of the PPSS. In addition, the Edinburgh Postpartum Depression Scale (EPDS) was completed simultaneously to assess the construct validity. Internal consistency of the questionnaire was assessed by calculating the Cronbach's alpha coefficient and corrected item-total correlation. RESULTS: The unidimensionality of the PPSS was supported in both CFA and Rasch analysis. The PPSS had a significant negative association with EPDS (r = -0.39 p < .001). The scale had excellent internal consistency (Cronbach's alpha = 0.94) and the correlation between items and total score was satisfactory. CONCLUSION: The Persian version of PPSS with 20 items is a valid and reliable scale to assess postpartum support.

The Effect of Healthy Lifestyle Promotion Intervention on Quality of Life in Cyclic Mastalgia via Individual Counseling: A Randomized Controlled Clinical Trial.

BACKGROUND: Despite high number of visited cases, there are no certain therapeutic guidelines for mastalgia. Generally pain is associated with poor quality of life in all dimensions. The present study aimed to investigate the effect of healthy lifestyle promotion intervention on the quality of life in cyclic mastalgia. METHODS: This study was a randomized controlled trial (RCT) conducted on women suffering from cyclic mastalgia at the age of 20 and older before menopausal age referred to the health centers of Karaj,Iran from September 2017 to August 2018. The participants were randomly assigned to intervention (N=40) and control groups (N=40). Intervention was carried out in two 46-minute sessions and two 90-minute sessions for the intervention group. The quality of life was assessed before and after the intervention in both groups using the World Health Organization Quality of Life-BREF (WHOQOL-BREF). The data were analyzed through SPSS statistical software(version 21) using independent sample t-test, Chi-square,and Paired t-test. Besides, P<0.05 was considered as statistically significant. RESULTS: Before the intervention, both groups were matched in terms of marital status, educational level, occupation, history of breastfeeding, and mean scores of quality of life (P>0.05). After the intervention, the mean score of life quality in physical, social, environmental, and general health dimensions in the intervention group increased significantly compared to the control group (P>0.001). This difference was not statistically significant in the mental health dimension (P=0.086). CONCLUSION: The present study indicated that healthy lifestyle promotion intervention could improve the quality of life of women with cyclic mastalgia.Trial Registration Number: IRCT2017100236513N1.

Spouse's social support in the postpartum period, predictors and its relationship with postpartum depression in a sample of Iranian primiparous women.

OBJECTIVE: To investigate the predictive factors of receiving spousal support in the postpartum period and its relationship with postpartum depression (PPD). METHODS: This cross-sectional study was conducted between January and May 2019 in 250 primiparous women to determine the predictors of spousal social support in the postpartum period. Three scales were used to collect data: The Demographic and Obstetric Checklist, the Postpartum Partner Support Scale, and the Edinburgh Postpartum Depression Scale. RESULTS: Multivariate regression showed that the employment status of the spouse and life satisfaction variables were predictive of whether social support was received from a spouse in the postpartum period. In total, the variables examined in this model explained 19% of the variance for a mother receiving spousal social support in the postpartum period. PPD and spousal social support had a moderately inverse and significant correlation (ß = -0.39). CONCLUSION: Life satisfaction and employment of the spouse are important predictive variables for receiving social support of the spouse in the postpartum period. There is also a significant inverse relationship between PPD and spousal social support.

The effect of ear acupressure (auriculotherapy) on sexual function of lactating women: protocol of a randomized sham controlled trial.

BACKGROUND: Lactation has a negative effect on female sexual function. Hormonal changes during lactation cause changes which might lead to dyspareunia, lack of libido, and anorgasmia. There are various pharmacological and non-pharmacological approaches to treat sexual dysfunction. While pharmacological treatment has multiple unwanted side effects, non-pharmacological therapies such as complementary medicine are a potential safer alternative. The aim of this study is to evaluate the effect of ear acupressure on sexual function of lactating women. METHODS/DESIGN: This is a randomized clinical trial with a parallel sham control group. In this study, 76 lactating women between 6 months and 1 year after childbirth were referred to health care centers in Qazvin City and would be invited to participate. Participants will be divided into intervention (n = 38) and control (n = 38) groups using simple block randomization. Both intervention and sham control groups will be visited over 10 sessions within a 4-day interval. At each visit, the adhesives containing Vaccaria seed will be adhered for the intervention group, while non-latex-based adhesives with no Vaccaria seeds will be placed on the same ear acupoints for the sham control group. Selected ear acupoints include genitalia (two ear points), pelvic point, master shoulder, and posterior pituitary gland. The women will be asked to hold the seeds on their ears for 3 days and press each ear point three times a day for 20 s. After 3 days, they will be asked to remove the seeds from their ears and rest for 1 day. Sexual function as primary outcome in both groups will be assessed using the Female Sexual Function Index before and immediately after 1 and 2 months after the intervention. Also, Sexual Quality of Life as secondary outcome will be assessed using Sexual Quality of Life-Female (SQOL-F) before and 2 months after intervention. Data will be analyzed using repeated measure ANOVA at the significant level of 0.05. DISCUSSION: This study is expected to support the impact of ear channel ear acupressure on sexual function in lactating women. TRIAL REGISTRATION: Iranian Clinical Trial Registration Center IRCT20190626044028N1 . Registered on 16 August 2019.

The effect of psychoeducational intervention, based on a self-regulation model on menstrual distress in adolescents: a protocol of a randomized controlled trial.

INTRODUCTION: Menstrual distress caused by primary dysmenorrhea is associated with physical and psychological symptoms-before, after, and during menstruation. Leventhal's self-regulation educational model is based on the cognitive and emotional experiences of threat responses to symptoms and relates to coping responses. This study aims to investigate the effect of the implementation of a psychoeducational intervention, based on the self-regulation model of menstrual distress in adolescents. METHODS/DESIGN: In this randomized controlled trial, 120 adolescent girls with moderate to severe menstrual pain (based on visual analog scale (VAS) ≥ 4) from twelve randomly selected high schools in Qazvin City will be enrolled in the study and will be randomly assigned to either a 3-session psychoeducational intervention (n = 60) or control (n = 60) groups. The sessions will be between 60 and 90 min apiece, and they will run for three consecutive weeks (one session per week). The data collection tools will include questionnaire eliciting menstrual information and demographics, the VAS, the Moos Menstrual Distress Questionnaire, and the illness perception questionnaire. One month prior to the intervention, both groups will participate in an initial assessment to assess the severity of their pain and level of menstrual distress. Finally, all questionnaires will be completed for three consecutive months after the intervention is completed. DISCUSSION: It is anticipated that findings of this study will provide evidence for the effectiveness of the Leventhal self-regulation model. Implications for improved practice, understanding, and treatment for menstrual distress may also arise. ETHICAL CONSIDERATIONS: The research protocol will be reviewed by the ethics committee, which is affiliated with the Qazvin University of Medical Sciences (Decree code: IR.QUMS.REC.1398.043). TRIAL REGISTRATION: IRCT20190625044002N1 . Registration date: 2019-09-03.

Death anxiety in patients with cancer: A systematic review and meta-analysis.

PURPOSE: The present study was designed to estimate the rate of death anxiety and the factors influencing its occurrence in cancer patients using a systematic review and meta-analysis approach. METHOD: Five academic databases, including Scopus, PubMed, Science Direct, Embase, and ProQuest, were searched systematically from inception until the end of January 2020. Observational studies that reported mean score of death anxiety in cancer patients, regardless of language restriction, were eligible to be included. The Newcastle-Ottawa Scale was used to assess the methodological quality of included studies. A meta-analysis was performed using a random effect model with the DerSimonian and Laird weighted method. Publication bias was assessed using the funnel plot and Begg's and Egger's tests. RESULTS: The estimated pooled mean for death anxiety among cancer patients was 6.84 (CI95% = [5.98, 7.69]). Publication bias and small study effects were not detected. Subgroup analysis and a meta-regression showed that the estimated pooled mean was higher in Asian studies (M = 7.57) compared to European (M = 6.47) and North American studies (M = 5.57); in breast cancer patients (M = 9.68) compared to studies examining different types of cancers; in female only participants (M = 7.37) compared to studies with both genders (M = 6.60); and in married participants compared to non-married participants. CONCLUSIONS: The findings suggest that death anxiety in patients with cancer is moderate and is influenced by socio-demographic factors such as region, type of cancer, sex, and marital status.

Examining the effect of a brief psychoeducation intervention based on self-regulation model on sexual satisfaction for women with breast cancer: A randomized controlled trial.

PURPOSE: The main goal of this study was to investigate whether the Self-Regulation Model could improve sexual satisfaction for women diagnosed with breast cancer. METHODS: Adult women diagnosed with breast cancer were recruited from a hospital in Qazvin, Iran. Participants were randomly assigned to either an intervention group (n = 40) or a control group (n = 40). All participants were administered a demographic questionnaire and an Index of Sexual Satisfaction (ISS) pre-intervention, immediately post-intervention, and 1, 2, and 3 months following the intervention. The control group completed the assessments along the same time line as the intervention group. Women in the experimental group were provided three sessions of a psychological individual intervention which included psychoeducation regarding their diagnosis and personalized intervention strategies to improve their overall sexual satisfaction with sexual intercourse. Each intervention took between 60 and 90 min to administer. RESULTS: The experimental and control group participants were well balanced in terms of demographic characteristics and sexual satisfaction scores before the intervention. The intervention group showed a positive increasing trend in the sexual satisfaction scores over time while the control group participants had a negative trend (p < 0.05). There were also statistical differences in the sexual satisfaction scores at each follow-up month (p < 0.05) adjusted for the baseline score and relevant demographical variables, showing longer term effects with a significant increase in sexual satisfaction over time. CONCLUSION: Providing a psychoeducational based intervention provided an increase of sexual satisfaction during intercourse for women diagnosed with breast cancer. The psychoeducation based intervention provided an opportunity for participants to dispel common myths regarding their disease and obtain new strategies and skills to improve their sexual satisfaction from intercourse with their partners.

Predictors of death anxiety among patients with heart disease.

Objective: This research examines whether or not socio-demographic factors and hope predict death anxiety among patients with heart disease.Materials and Methods: Our sample consisted of 500 respondents who were hospitalized in a medical institution in Iran. Data were collected using the Templer Death Anxiety Scale (TDAS) and the Herth Hope Index (HHI).Results: The results of current study indicated that higher economic status, having one's main source of income from friends, increased age, increased religious belief, and increased hope were associated with lower death anxiety.Conclusion: These results highlight that improving hope, and religiosity among cardiac patients may be an effective means by which to reduce their death anxiety.

Sexual distress and sexual function in a sample of Iranian women with gynecologic cancers.

PURPOSE: This study aims to examine the correlation between sexual function and sexual distress, and to determine the predictive factors of sexual function and sexual distress in women with gynecologic cancers. METHODS: In this cross-sectional study, 387 subjects were referred to Velayat Hospital in Qazvin, Iran, using convenience sampling method between June and August 2016. Data were collected using a demographic questionnaire, the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale-Revised (FSDS-R). RESULTS: Mean scores of sexual function and sexual distress were 19.4 ±â€¯6.7 and 29.2 ±â€¯12.9, respectively. There was no significant correlation between sexual function and sexual distress. Multivariate predictors of FSFI were cancer stage (p = 0.023), cancer type (p = 0.025), duration of disease (ß = -0.10, 95% CI [-0.17, - 0.02], p = 0.017) and social support (ß = 0.53, 95% CI [0.24, 0.83], p < 0.001). Predictors of FSDS-R were economic status (p = 0.040) and type of cancer (p = 0.016). There was a negative relation between the overall score on FSDS-R and FSFI sub domains of desire (ß = -1.4, p = 0.033) and arousal (ß = -2.1, p = 0.024). CONCLUSIONS: This study did not support a relation between sexual function and sexual distress. Other factors, however, including cancer type, economic status and social support may affect sexual function and sexual distress. Future studies needed to determine further factors which can affect the sexual distress and sexual function of gynecologic cancer patients.

Opposite-sex relationship questionnaire for female adolescents: development and psychometric evaluation.

Aim The goal of the present study is to adopt state-of-the-art techniques and standards to develop and evaluate a measure, called the opposite-sex relationship questionnaire for female adolescents (OSRQFA), to assess the reasons why adolescent girls would or would not develop, a relationship with an adolescent boy. Methods A mixed-method, sequential, exploratory design was adopted. In the qualitative phase, an in-depth interview approach was used to identify the properties and dimensions to be included in the OSRQFA. In the quantitative phase, the psychometric properties of the OSRQFA were evaluated according to face, content and construct validity. Reliability and stability were assessed with Cronbach's α and test-retest analysis, respectively. Results A preliminary questionnaire including 86 items which emerged from the qualitative phase of the study was designed. Based on the impact scores for face validity and the cutoff points for the content validity ratio (CVR) and content validity index (CVI), the preliminary questionnaire was reduced to 57 items. The Kaiser criteria (eigenvalues >1) and scree plot tests demonstrated that 21 items forming six factors, which were labeled 'innate predilection', 'abstinence', 'peer pressure', 'fear of the relationship consequences', 'family atmosphere' and 'risk taking', that accounted for an estimated 66.19% of variance provided an optimal fit with the data. These scales had acceptable levels of internal consistency (α = 0.822) and stability (r = 0.871, p < 0.001). Conclusion The OSRQFA with 21 items and 6 factors demonstrated suitable validity and reliability in a sample of Iranian female adolescents. The OSRQFA's has good psychometric properties, and can be used by other researchers in future studies.