Causal association between family health, perceived relationship quality components, and attitudes toward childbearing in Iranian women: A WHO model analysis.

BACKGROUND: Given the unprecedented global decline in fertility as a major demographic development in recent years, the present study was conducted to determine Causal association Between Family Health, Perceived Relationship Quality Components, and Attitudes toward Childbearing in Iranian Women: A WHO Model Analysis METHODS: In 2023, this descriptive study recruited 400 married women presenting to selected comprehensive health centers affiliated to Alborz University of Medical Sciences, Karaj, Iran. The data were collected through multistage stratified cluster sampling and using a socioeconomic status questionnaire (Ghodratnama), the Perceived Relationship Quality Components (PRQC) scale, the family-of-origin scale (FOS), the attitudes toward fertility and childbearing scale (AFCS) and a demographic checklist were analyzed in SPSS 25 and LISREL 8.8. RESULTS: According to the path analysis, family health exerted the most significant and positive causal effect on attitudes to childbearing directly through one path (B = 0.334) and relationship quality (B = 0.698) and duration of married life (B = 0.387) both directly and indirectly. The number of children (B = -0.057), however, exerted the most significant and negative causal effect on attitudes to childbearing through both paths. CONCLUSIONS: The present findings suggested the significant effects of family health and relationship quality on attitudes toward childbearing. It is therefore recommended that these variables be screened in comprehensive health centers, the associated limitations and problems be identified and appropriate training and counseling solutions be provided by health specialists.

Components related to ethical decision making in medical science students: A structural equation model.

BACKGROUND: Evaluating moral principles in the Society of Medical Sciences and health care workers (HCWs) is imperative due to their direct contact with the community and the significant impact of their attitudes and decisions on people's lives. This study aimed to determine the components related to ethical decisions in medical sciences students. METHODS: One thousand two hundred thirty-five eligible students in the Alborz University of Medical Sciences participated in this descriptive study. We gathered their socio-demographic information, assessed their moral reasoning, and used the ethical decisions questionnaire, Lutsen moral sensitivity questionnaire, and general health questionnaire (GHQ) for data gathering. The data were analyzed with SPSS software version 25 and LISREL version 8.8. RESULTS: According to the path analysis test findings, ethical reasoning significantly correlated with ethical decision-making (B = 0.40). The number of clinical courses passed, moral sensation (moral sensitivity), and the total number of passed academic semesters had the greatest positive and negative association with ethical decision-making, respectively. (B = 0.54), (B = 0.524) and (B = -0.11). CONCLUSION: Based on the findings of the moral reasoning test, the moral sensation was associated with ethical decision-making, which indicates the necessity of attending to ethical aspects, promoting moral reasoning, sensitivity, and students' accuracy.

Spatial, geographic, and demographic factors associated with adolescent and youth suicide: a systematic review study.

Background: Suicide is a public health issue and a main cause of mortality among adolescents and the youth worldwide, particularly in developing countries. Objectives: The present research is a systematic review aiming to investigate the spatial, geographical, and demographic factors related to suicide among adolescents and the youth. Methods: In this systematic review, two researchers examined PsycINFO, Web of Science, Scopus, and PubMed databases on December 7th, 2022 with no time limits from the beginning of publication until 2022 to identify the primary studies on spatial and geographic analysis on adolescent and youth suicides. Once duplicate studies were identified and removed, the titles and abstracts of studies were examined and irrelevant studies were also removed. Finally, 22 studies were reviewed based on the inclusion criteria. Results: Our findings show that suicide rates are generally higher among men, residents of rural and less densely populated regions, coastal and mountainous regions, natives, 15-29 age group, less privileged populations with social fragmentation, unemployed, divorced or lonely people, those who live in single parent families, people with mental health issues, and those with low levels of education. Conclusions: Stronger evidence supports the effects of geographic and demographic variables on youth and adolescent suicide rates as compared with spatial variables. These findings suggest that policy makers take spatial and demographic factors into consideration when health systems allocate resources for suicide prevention, and that national policymakers integrate demographic and geographic variables into health service programs. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023430994.

The relationships of spiritual health, pregnancy worries and stress and perceived social support with childbirth fear and experience: A path analysis.

BACKGROUND: Given maternal health is a major health indicator, the present research aimed at determining the causal relationships of spiritual health, worries, stress and perceived social support with the fear and experience of childbirth in pregnant women. METHODS: The present longitudinal prospective research recruited 352 pregnant women presenting to selected health centers in Qazvin, Iran in 2021. The data were collected using the Childbirth Experience Questionnaire-2 (CEQ-2), the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Persian version of the Pregnancy Worries and Stress Questionnaire (PWSQ), the Spiritual Health Questionnaire, the Socioeconomic Status (SES) questionnaire and a sociodemographic checklist, and were analyzed in SPSS-25 and Lisrel-8.8. RESULTS: The mean age of the participants was 28.1±6.8 years. According to the results of the path analysis, among the variables related to fear of childbirth, childbirth experience (B = -0.37, CI:-0.44;-0.22) in the direct path and perceived social support (B = -0.51, CI:-0.58;-0.43) in both direct and indirect paths demonstrated the most significant negative relationship. Among the variables related to childbirth experience, pregnancy worries and stress had a negative causal relationship (B = -0.06, CI:-0.079;-0.043) in the direct path, spiritual health showed the highest significant positive relationship (B = 0.01, CI: 0.008; 0.012) in the indirect path, and perceived social support (B = 0.112, CI: 0.092; 0.131) and the number of children (B = 0.32,CI: 0.30; 0.34) demonstrated the highest significant positive relationship in both direct and indirect paths. In other words, childbirth experience becomes more desirable as spiritual health, social support, and the number of children increases, and it becomes less desirable as pregnancy worries and stress rise. CONCLUSION: According to the present findings, various psychological, social, and spiritual factors are associated with childbirth fear and experience. It is thus necessary to utilize appropriate methods and promote training and support to reduce the adverse outcomes of childbirth.

Predictor factors affecting emotional and behavioral problems in school-aged (6-12 years) children during the COVID-19 pandemic: a cross-sectional study.

OBJECTIVES: The prolonged outbreak of COVID-19 has caused psychological problems in the community, especially in children. Given that limited studies have been conducted on this vulnerable group in Iran, we conducted this study to determine the predictor factors affecting emotional and behavioral problems in school-aged (6-12 years) children during the COVID-19 pandemic. METHODS: We conducted a cross-sectional study on 322 mothers of elementary school-aged children (6-12 years) from April 21 to June 21, 2021, in Karaj, Alborz, Iran. Sociodemographic checklist, socioeconomic status scale (SES), Depression, Anxiety, and Stress Scale (DASS-21), Corona Disease Anxiety Scale (CDAS), and the Rutter Children's Behavior Questionnaire (RCBQ) were used to evaluate the children's behavioral symptoms, the mental health of their mothers, and sociodemographic factors. RESULTS: In total, 17.7% of children (male = 27.0%, female = 11.7%) had behavioral problems. Results showed income (p-value = 0.007, 95%CI (-3.85- -0.607)), and physical activity of the child (p-value = 0.026, 95%CI (-1.03- -0.067)), were indirectly associated with children's behavioral symptoms. Having underlying disease (p-value = 0.00, 95%CI (1.712-5.949)), breastfeeding (p-value = 0.027, 95%CI (0.335-5.61)), corona-related anxiety (p-value = 0.00, 95%CI (0.158-0.318)), and DASS score (p-value = 0.00, 95%CI (0.149-0.334)) in the mothers, as well as male gender (p-value = 0.003, 95%CI (0.724-3.471)) were directly associated with children's behavioral symptoms. The most factors involved in the behavioral symptom score of children were corona-related anxiety (ß = .298), DASS (ß = 0.273), underlying disease of mothers (ß = 0.163), income (ß = -0.154), child's gender (ß = 0.142) and physical activity (ß = -0.101), and breastfeeding (ß = 0.099) respectively. CONCLUSION: Study findings showed that some factors affect the emotional and behavioral problems of school-aged (6-12 years) children during the COVID-19 pandemic. These data may help future researchers and policymakers with early intervention.

Clinical and Socio-Demographic Variables Associated With Long COVID-19: A Cross-Sectional Study.

Considering the importance of long COVID-19 (LC), this study aimed to investigate the relationship between clinical/sociodemographic factors and LC symptoms (LCS). This online cross-sectional study was conducted on 308 people infected with COVID-19 in Alborz, Iran, from April 1 to June 1, 2022. Multivariable logistic regression models were applied to measure the association between the LCS with other variables. Overall, 76.6% of participants had at least one LCS. Results from the multivariate logistic regression analysis showed that females (crude odds ratio [OR] [95% confidence interval (CI)]: 2.725 [1.42, 5.22]), educated persons (3.747 [1.58, 8.84]), people with a higher number of COVID-19 reinfection (2.280 [1.30, 3.97]), having an underlying disease (1.996 [1.01, 3.93]), and COVID-19 severity (3.321 [1.037, 10.635]) had higher odds of LC than others (all p < .05). Study findings provide additional clinical/sociodemographic data on risk for LC. These data may inform future research and clinical practice for potential risk identification and early intervention.

The relationship between social determinants of health and fear of contracting infectious diseases in pregnant women presenting to health centers in Kashan, Iran: a path analysis study.

INTRODUCTION: Pregnancy is one of the most critical times in a woman's life that is accompanied by a lot of worry, fear, and stress for the mother, and fear of contracting diseases and losing the children are among the most important of them. The present study investigated the relationship between the social determinants of health and fear of contracting infectious diseases in pregnant women using path analysis. METHODS: This cross-sectional study was conducted on 330 pregnant Iranian women in Kashan from September 21th, 2021, to May 25th, 2022, using a multi-stage method. Data were collected through demographic and obstetric details, fear of COVID-19, perceived social support, socioeconomic status, and pregnancy-related anxiety questionnaires. The collected data were then analyzed using SPSS-21 and Lisrel-8 software. RESULTS: According to the path analysis results, among the variables that have a causal relationship with fear of contracting infectious diseases through only one path, pregnancy anxiety (B = 0.21) had the highest positive relationship and social support had the highest negative relationship (B=-0.18) in the direct path. Among the variables that have a causal relationship with fear of contracting infectious diseases in both paths, socioeconomic status (B=-0.42) had the highest negative causal relationship with fear of contracting infectious diseases. CONCLUSION: According to the path analysis results, the fear of contracting infectious diseases in pregnant women in Kashan is moderate and prevalent, which indicates the necessity of screening pregnant women for such problems during epidemics. Moreover, to prevent this fear and its adverse consequences, the following strategies are recommended: helping promote mothers' and women's awareness, offering social support through healthcare providers, and taking measures to mitigate pregnancy-related anxiety in high-risk individuals and groups.

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.

The effect of social determinants of health on quality of life among Afghan refugees in Iran during the COVID-19 pandemic: a path analysis.

BACKGROUND: The COVID-19 pandemic has created significant challenges in 2020 in the world and Iran. To help vulnerable groups such as refugees during the response and recovery phases of the COVID-19 pandemic, identifying the quality of life (QOL) and its associated factors is helpful. Considering that research in this field is limited, this study evaluated the effect of social determinants of health on the quality of life among Afghan refugees in Iran during the COVID-19 pandemic. METHODS: We conducted a cross-sectional study on 300 Afghan refugees and migrants in Alborz province, Iran, from February to May 2022 using Convenience sampling. Data were completed using the socioeconomic status scale (SES), World Health Organization's quality of life -BREF (WHOQOL), Depression, Anxiety and Stress Scale-21 Items (DASS-21), and COVID-19 Post-Traumatic Stress Disorder Checklist (COVID-PTSD). In addition, path analysis was applied to evaluate the relationships among the research variables with quality of life. RESULTS: 64.3% of the study participants were male, with a mean of 29.29 ± 9.64 years. The path analysis showed that SES had the most positive relationship (B = .266), and the number of COVID-19 cases had the most negative relationship (B = -.169) with the quality of life from both paths. The self-rated health had the most positive relationship (B = .25), and the DASS score had the most negative relationship (B = -.2) with the quality of life through only one path. Access to medical services was the only variable that indirectly had a positive causal relationship with QOL (B = .044). CONCLUSION: We provided an empirical model that illustrates the relationships between quality of life and social determinants of health among Afghan refugees and migrants during the Covid19 pandemic. The negative emotional states of Depression, Anxiety, and Stress (DAS) as a mediator play an essential role in the quality of life and other variables.

Predictor Factors of Female Sexual Distress in a Population-Based Sample of Iranian Women: a Path Analysis.

PURPOSE: To investigate the direct and indirect effects of demographic characteristics, relationship satisfaction, and psychological factors on female sexual distress (FSD) using path analysis. MATERIALS AND METHODS: This study was conducted in two stages. Initially we obtained the FSD predictor factor's conceptual model through a literature review and expert panel. In the Second stage, a population-based cross-sectional study on 207 non-pregnant and married women (without any age restriction) in Zanjan, Iran was conducted. FSDs-R, FSFI-6, DASS-21, and GEMREL Standard questionnaires and the demographic researcher-made questionnaire were used in this study. The data undergone path analysis based on the initial conceptual model. RESULTS: Sexual function (SF) had the strongest relationship with FSD from the direct path (ß = -.49) and overall effect (ß = -.58). The highest indirect effect belonged to depression-anxiety-stress level (ß = .284) mediated by SF (ß = -.42) and relationships satisfaction with spouse (ß = -.20). Age difference (ß = -.13) and relationships satisfaction with spouse (ß = -.19) had only a direct effect on FSD. Marriage Duration had only indirect effect on FSD through mediating role on SF (ß = -.26) and depression-anxiety-stress level (ß = -.15). CONCLUSION:  Among the predictor factors investigated in this study, sexual dysfunction is the most important predictor of FSD. In addition; men older than their spouses, longer marriage duration, relationship dissatisfaction with the spouse and higher rate of depression-anxiety-stress have positive correlation with SD. Therefore, we should offer a combination of the mentioned factors in providing care for women with SD.

Predictor role of marital conflict on maternal competency with mediating role of perceived stress and concerns during pregnancy: A structural equation model.

AIM: Pregnancy prepares the mother for the transition to motherhood. Maternal concerns during pregnancy cause reduced time spent with the spouse and lack of social support; additional stresses such as marital conflicts could impact maternal competency. This study aimed to assess the predictive effect of marital conflicts with the mediating role of perceived stress and pregnancy concern on maternal competency. METHODS: This was a longitudinal study. It was done on 250 mothers referred to selected health centers in Alborz province. The sampling method was convenient. Marital conflicts, perceived stress, and pregnancy concerns questionnaires were completed in the third trimester of pregnancy, and the maternal competency questionnaire was completed 6 weeks after delivery. Data were analyzed by SPSS software and smart partial least squares. RESULTS: The results of structural equations showed that marital conflicts have a negative and significant effect on maternal competency (ß = -0.14), marital conflicts have a positive and significant effect on perceived stress (ß = 0.42), and marital conflicts have a positive and significant effect on pregnancy concern (ß = 0.31). Also, perceived stress negatively and significantly affected maternal competency (ß = -0.36). DISCUSSION: Results of the study showed the necessities for screening and identifying mothers with conflicts and assessing the perceived stress of mothers will improve the mental health of pregnant mothers and consequently increase maternal competency.

Seafarers' mental health status and life satisfaction: Structural equation model.

Background: A variety of factors influence seafarers' health. Such factors might affect their satisfaction with life. Aims: To examine the relationships between seafarers' mental health status and satisfaction with life by using a structural equation method. Methods: In this survey, 470 seafarers were selected via convenience sampling method from two shipping companies. Validated questionnaires including Satisfaction with Life Scale (SWLS), generalized anxiety disorder-7 (GAD-7), Post-traumatic Stress Disorder-8 (PTSD-8), Patient Health Questionnaire-9 (PHQ-9), General Health Questionnaire-12 (GHQ-12), Perceived Health status and Depression-Anxiety-Stress scale-21 (DASS-21) were used to assess different aspects of well-being and life satisfaction. The stratified path analysis method was applied to analyze the data. Results: 439 seafarers (200 officers and 237 non-officers) with a mean age of 34.5 (SD: 8.05) participated in the current study. The GHQ score directly affected satisfaction with life in both officers (ß = 0.35) and non-officers (ß = 0.40). Also, perceived health status directly and indirectly affected satisfaction with life among officers (ß = 0.19) and non-officers (ß = 0.06). While officers working days per month indirectly impacted satisfaction with life through the general anxiety disorder, perceived health status, depression, anxiety, stress and current mental health. In non-officers, generalized anxiety disorder had the most potent indirect effects on satisfaction with life through perceived health status and current mental health. Conclusion: Perceived health status, directly and indirectly, affected seafarers' satisfaction with life. Measures should be taken in order to improve seafarers' perceived health status and its effects on satisfaction with life.

Predictors of Perceived Stress and Quality of Life among Women during the COVID-19 Outbreak: A Cross-sectional Study from Karaj, Iran.

Background: The emergence of the coronavirus disease of the 2019 (COVID-19) pandemic in Iran has markedly affected lives and taken a toll on Iranians' mental health, especially in women. The current study investigated factors that contributed to both perceived stress and quality of life (Qol) among women during the COVID-19 pandemic in Karaj, Iran. Methods: A cross-sectional online survey study was conducted between November 30, 2020, and January 30, 2021. A researcher-made questionnaire with 4 subscales, including information seeking, social support, primary appraisal, and secondary appraisal, was used. Perceived Stress Scale (PSS-10), and 36-Item Short Form Survey (SF-36) questionnaires were also applied. A total of 581 participants completed the study. The convenience sampling method was used in this study. Multiple mediation analyses were applied using pathway analysis. Results: The mean age ± SD of the participants was 38.57±7.68 years, and 40.8% had a higher education than a high school diploma. Based on the final fitted model, higher perceived stress had a direct impact on mental QoL (ß = 0.47). The Comparative Fit Index (CFI), Incremental fit index (IFI), and Goodness of Fit Index (GFI) were calculated as 1, and χ2/df was 4.87. Educational level and social support from both the direct and indirect pathway affected QoL. Social support affected both information-seeking behavior and secondary appraisal (ß = 0.50: 95% CI, 0.38-0.59). Furthermore, information-seeking behavior and secondary appraisal affected perceived stress. Perceived stress followed by educational level had the strongest and primary appraisal had the poorest indirect association with mental QoL. Conclusion: In conclusion, primary appraisal, secondary appraisal, social support, educational level, perceived stress, and information-seeking behavior were correlated with higher levels of mental QoL among women. Social support and improving the situation appraisal can provide appreciated support to manage stress induced by the COVID-19 pandemic. Further assessment is needed to determine the vulnerable groups such as illiterate people.

Relationships among COVID-19 phobia, health anxiety, and social relations in women living with HIV in Iran: A path analysis.

INTRODUCTION: The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide and imposed a significant physical and psychological burden on people, especially women living with HIV (WLHIV). However, WLHIV were not studied as well as others during the pandemic. Hence, this study aimed to determine the relationships between COVID-19 phobia, health anxiety, and social relations in WLHIV. MATERIALS AND METHODS: This cross-sectional study enrolled 300 WLHIV who had records at the Iranian Research Center for HIV/AIDS of Tehran University of Medical Sciences. Data were collected using sociodemographic questionnaire, the fear of COVID-19 scale, the social relations questionnaire, the socioeconomic status scale and the health anxiety inventory. Path-analysis was used to assess the direct and indirct associations between variables. RESULTS: Based on the path analysis, among variables that had significant causal relationships with social relations, socioeconomic status (ß = -0.14) showed the greatest negative relationship, and health anxiety (ß = 0.11) had the strongest positive relationship on the direct path. On the indirect path, fear of COVID-19 (ß = 0.049) displayed the greatest positive relationship. The level of education (ß = 0.29) was the only variable showing a significant positive relationship with social relations on both direct and indirect paths. CONCLUSION: Our result showed that increased fear and health anxiety related to a higher social relations score in WLHIV. Hence, due to their vulnerability, these people require more support and education to adhere to health protocols in future pandemics and similar situations.

The relationship model among parent-child relationship, coping responses and behavioral problems in children with attention deficit hyperactivity disorder.

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) constitutes a prevalent behavioral problem. The present study examined the parent-child relationship model and investigated strategies to cope with behavioral problems in children with ADHD. METHODS: This descriptive study selected 300 children with ADHD using convenience sampling. The data collected using the child behavior checklist, the parent-child relationship scale (PCRS), the Billings and Moos Coping Checklist, the socioeconomic status questionnaire, the general health questionnaire-28 (GHQ-28) and a demographic checklist were analyzed in SPSS-25 and LISREL 8.8. RESULTS: According to the results of the path analysis on the relationship model among parent-child relationship domains, coping responses and children's behavioral problems, parent-child dependency domain (B = 0.22) in the direct path, disease duration (B = 0.085) in the indirect path, and conflicts in the domain of parent-child relationship (B = 0.366) in both direct and indirect paths had the most positive causal effect on behavioral problems. Furthermore, intimacy in the said domain (B = -0.42) had the most negative causal effect in both direct and indirect paths. The extent to which parents used coping responses via the direct path had a positive causal effect on behavioral problems (B = 0.12). Based on the path analysis test findings in the relationship model among positive parent-child relationship, coping responses and children's behavioral problems, the positive parent-child relationship score had the most negative causal effect via the direct path (B = -0.56). Conversely, the child's age had the highest positive causal effect via the indirect path (B = 0.1) on behavioral problems in children. CONCLUSION: Based on findings, there is a causal and significant relationship between the parent-child relationship and the extent to which coping responses are used. It is recommended that training programs be developed to strengthen communication skills, coping responses and problem-solving techniques in parents.

Socioeconomic inequality in different phenotypes of childhood obesity and its determinants in Iran: a Blinder-Oaxaca decomposition method.

BACKGROUND: Childhood obesity has become a significant public health issue worldwide. Socioeconomic status is among its key determinants. This study examined the socioeconomic inequality in different phenotypes of childhood obesity at the national level in Iran. METHODS: This national, multistage school cross-sectional study was undertaken in 2015 on 14,400 students aged 7-18 years from urban and rural areas of 30 provinces of Iran. Using principal component analysis, socioeconomic status (SES) was categorized into tertiles. SES inequality in different phenotypes of obesity (i.e., generalized obesity", "abdominal obesity", and combined obesity) was estimated using the concentration index. The determinants of this inequality were assessed by the Blinder-Oaxaca decomposition method. RESULTS: Overall, 14,274 students completed the study (response rate: 99%). The mean age was 12.28 years, 50.6% were boys, and 71.42% lived in urban areas. The prevalence of generalized obesity and abdominal obesity was 20.8% and 11.3%, respectively. The concentration index for different phenotypes of obesity was positive, indicating that inequality is more common amongst the low SES groups. High SES, being male, living in a rural, and having a positive family history of obesity were associated with general obesity. Moderate physical activity and living in a rural area were associated with abdominal obesity. In addition, living in a rural area, having a high SES, being male, and having a positive family history of obesity were associated with combined obesity. CONCLUSION: According to the present study findings, all childhood obesity phenotypes were more prevalent in Iranian children with high SES. Therefore, due to obesity and other diseases, it is essential to implement environmental changes in addition to designing macro-educational programs and prevention strategies.

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.

Social networks and internet emotional relationships on mental health and quality of life in students: structural equation modelling.

BACKGROUND: Social networks and relationships create a sense of belonging and social identity; hence, can affect mental health and the quality of life, especially in young people. The present study was conducted to determine the predicting role of social networks and internet emotional relationships on students' mental health and quality of life. METHODS: The present cross-sectional study was conducted in 2021 on 350 students at Alborz University of Medical Sciences selected by convenience sampling. Data were collected using five questionnaires: socioeconomic status, social networks, internet emotional relationships, stress, anxiety, depression scale (DASS-21), quality of life, and a checklist of demographic details. Data were analyzed in SPSS-25, PLS-3, and Lisrel-8.8. RESULTS: According to the path analysis, the DASS-21 score had the most significant positive causal association with internet emotional relationships in the direct path (B = 0.22) and the most negative association with socioeconomic status (B = - 0.09). Quality of life had the highest negative causal association with the DASS-21 score in the direct path (B = - 0.26) and the highest positive association with socioeconomic status in the indirect path (B = 0.02). The mean duration of using social networks (B ≈ - 0.07) and internet emotional relationships (B ≈ - 0.09) had the highest negative association with quality of life. CONCLUSION: The use of the internet and virtual networks, internet emotional relationships, and unfavorable socioeconomic status were associated with higher DASS-21 scores and reduced quality of life in the students. Since students are the future of countries, it is necessary for policymakers to further address this group and their concerns.

Determining the effectiveness of cognitive behavioral therapy interventions based on the transdiagnostic approach in the treatment of common mental health problems: Presenting an experience from the Islamic Republic of Iran.

INTRODUCTION: There is growing support to develop transdiagnostic approaches that provide new insights into mental health problems and cut across the existing traditional diagnostic boundaries all over the world. The present study was conducted to test the transdiagnostic cognitive behavioral therapy (TCBT) approach in treating patients with common mental health problems and evaluate its effectiveness compared to the current treatment settings of the healthcare system. METHODS: A randomized controlled trial was conducted in Semnan Province, north of Iran. The study took pace in urban health centers. A sample of 520 Iranian adults, tested as positive on the Kessler Psychological Distress Scale, were enrolled. Participants who received a score above the cut-off point in any of the three mental health disorders (depression, anxiety, or obsessive compulsive disorder [OCD]) based on the locally validated study instrument were randomly allocated to the study. The intervention group received TCBT during eight sessions provided by trained general health service providers without previous mental health training; the standby control group received Mental Health Services as Usual (MHSU). The post-test interviews were conducted using the study instrument after the completion of both group treatments. RESULTS: A total of 459 individuals (87.8% female) ultimately entered the study. The withdrawal rate was 24% (53 participants in the TCBT and 56 in the MHSU). Reduction in depression, anxiety, and OCD symptoms was significant within each group and when comparing TCBT and MHSU (mean difference). CONCLUSION: This trial recommends that the transdiagnostic CBT approach can be effective in improving common mental health problems and functions among individuals by trained general healthcare providers in the primary healthcare system. The results can be more useful in decision making when defining the process of providing mental healthcare in the National Primary Healthcare System.

Factors affecting mental health and happiness in the elderly: A structural equation model by gender differences.

PURPOSE: There are few studies on the gender differences in mental health, happiness, and their related factors among the older population through the structural equation model (SEM) in Iran. We conducted this study to evaluate the factors affecting mental health and happiness in the elderly using an SEM by gender differences. METHODS: A cross-sectional study was conducted on 739 elderly people in 2019 in Karaj, Iran. Sociodemographic, Symptom Checklist-90-Revised (SCL90-R), and the Oxford Happiness Inventory were applied to evaluate the relationships between happiness, mental health, and sociodemographic factors by using statistical path analysis with Lisrel 8.8 and SPSS-17. RESULTS: Overall, 55.5% of the participants in the study were female. The SCL90 (p value = .000) and happiness (p value = .000) scores showed significant differences between men and women. Fit indices confirmed the high model fitness, desirability, and logical relationships between the variables according to the conceptual model in both men (X2 = 3.2, df = 1) and women (X2 = 5.4, df = 2) groups. According to the path analysis, among the variables that affected happiness just through the direct path, education had the most positive causal relationship in men (B = .13) and women (B = .16), but mental health problems in men (B = -.33) and women (B = -.26), as well as the distance from home to the healthcare center in men (B = -.13) and women (B = -.11), had the most negative causal relationship with happiness respectively. Age was the only variable that was negatively related to happiness through direct and indirect paths in the women (B = -.188). CONCLUSION: We provided an empirical model that illustrates the relationships between happiness, mental health, and related factors in the older population. Gender differences in path analysis showed that age negatively affects the happiness of older women but not men.