The effect of seven-step educational strategy on knowledge of diabetic foot ulcer prevention, critical thinking and self-efficacy of nursing students: A randomized controlled trial.

BACKGROUND: Diabetic foot ulcer is a significant complication of diabetes that carries a high mortality risk and is associated with substantial financial costs. Choosing a suitable educational model for nursing students as future nurses is necessary to improve knowledge and manage issues related to caring for diabetic patients. OBJECTIVES: To determine the effect of education based on the 7E learning cycle model on the knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy in nursing students. DESIGN: A single-blind, randomized controlled trial with a parallel group. SETTINGS: This study was conducted in a nursing school and hospitals covered by it in Iran. PARTICIPANTS: 98 students studying in the fourth semester of the Bachelor of Nursing course. METHODS: Students were divided into two distinct groups at random: an experimental group (class A, with 51 participants), and a control group (class B, with 47 participants). The participants of the experimental group were provided with an education based on the 7E learning cycle model, while the control group received conventional teaching method. Data collection methods included pre- and post-tests using research instruments (demographic questionnaire, Kaya Diabetic Foot Prevention Knowledge Questionnaire, Ricketts' Critical Thinking Disposition Questionnaire, and General Self-Efficacy Scale). The data were analyzed using descriptive statistics, non-parametric Mann-Whitney and Wilcoxon tests, parametric independent sample t-tests, ANCOVA, and paired sample t-tests. RESULTS: The difference in mean scores of diabetic foot ulcer prevention knowledge (Z = -6.232, p < 0.001), critical thinking (t (50) = -4.382, p < 0.001), and self-efficacy (Z = -4.427, p < 0.001) in the experimental group were statistically significant between the time interval before the intervention and one month after its completion. CONCLUSIONS: Compared to conventional method of teaching, education based on the 7E learning cycle model is a more effective method to improve nursing students' knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy.

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 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.

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 effect of educational program based on the clinical practice protocol on treatment adherence, self-efficacy and quality of life of patients undergoing coronary artery bypass graft surgery.

BACKGROUND AND AIM: Educating the patients undergoing coronary artery bypass graft (CABG) before and after surgery is one of the most important factors for success in this surgery, as it improves their treatment adherence, self-efficacy, and quality of life. The aim of this study was to determine the impact of the educational program based on clinical practice protocol upon treatment adherence, self-efficacy, and quality of life of patients undergoing CABG surgery in Tehran, Iran, during the period 2021-2022. MATERIALS AND METHODS: This experimental study was conducted on 100 patients who were undergoing CABG and were hospitalized in a public hospital (Shahid Modarres Educational Hospital) in Tehran, Iran, in 2021-2022. Patients were randomly assigned to intervention (n = 50) and control (n = 50) groups. Four questionnaires (demographic-clinical questionnaire, Modanloo's adherence to treatment questionnaire, Sullivan's self-efficacy questionnaire, and McNew's quality of life questionnaire) were completed by both intervention and control groups before and 1 month after the educational intervention. The intervention group received an education program based on the clinical practice protocol. Data were analyzed using descriptive and inferential methods in Statistical Package for the Social Sciences (SPSS) 22 software. RESULTS: The results of the study showed that the intervention and control groups were similar in terms of demographic and clinical characteristics. The average scores of treatment adherence, self-efficacy, and quality of life 1 month after the intervention were significantly higher in the intervention group compared to the control group. Also, the average scores of treatment adherence, self-efficacy, and quality of life were significantly higher 1 month after the intervention than before in the intervention group (P < 0.001). CONCLUSIONS: The results of this study showed that education program based on the clinical practice protocol can be effective and useful for increasing the level of treatment adherence, self-efficacy, and quality of life of patients undergoing CABG.

The effect of donepezil hydrochloride on post-COVID memory impairment: A randomized controlled trial.

BACKGROUND: Post-Coronavirus Disease (COVID-19) condition, known as "post-COVID syndrome," is associated with a range of complications persisting even after recovery. Among these complications, cognitive dysfunction, including memory impairment, has been relatively common observed, impacting executive function and quality of life. To date, no approved treatment exists for this specific complication. Therefore, the present clinical trial aimed to investigate the impact of Donepezil Hydrochloride on post-COVID memory impairment. METHODS: A randomized, controlled trial (Approval ID: IRCT20210816052203N1) was conducted, enrolling 25 patients with post-COVID memory impairment. Participants with a history of hospitalization were randomly assigned to either the drug group (n = 10) or the control group (n = 15). Memory indices were assessed at baseline, one month, and three months later using the Wechsler Memory Scale-Revised test. SPSS software and appropriate statistical tests were employed for data analysis. RESULTS: The statistical analysis revealed no significant difference in WMS-R subtest and index scores between the drug and control groups at the 4-week and 12-week follow-up periods. However, within the drug group, there was a notable increase in the visual reproduction I and verbal paired associates II subtests during the specified time intervals. CONCLUSION: While donepezil 5 mg did not exhibit a significant overall increase in memory scales compared to the control group over time, our findings suggest that this medication may exert a positive effect on specific memory subtests. Further research and exploration are warranted to better understand the potential benefits of donepezil in managing post-COVID-related memory impairment. TRIAL REGISTRATION: The study was approved by the Research Ethics Committee of Aja University of Medical Sciences (Approval ID: IR.AJAUMS.REC.1400.125) and registered in the Iranian Registry of Clinical Trials (IRCT) (Approval ID: IRCT20210816052203N1).

Sexual health literacy and its related factors among couples: A population-based study in Iran.

Sexual health literacy is one of the factors that affect sexual health. Several factors can influence sexual health literacy. As a result, the current study was carried out to determine sexual health literacy and its associated factors among Iranian couples. In 2022, 410 couples of reproductive age were referred to comprehensive health service centers and private clinics in Kerman city for the descriptive-analytical study. The study questionnaires included sexual health literacy for adults, sexual knowledge and attitude scale, marital intimacy scale, sexual intimacy scale, depression anxiety stress scale, sexual self-efficacy, the multidimensional scale of perceived social support, and socioeconomic status. Finally, multiple linear stepwise regression models were used to determine the factors related to sexual health literacy using the SPSS software version 22. According to the findings of this study, the mean(SD) of sexual health literacy in couples was 68.76(12.96), which was a desirable level. Furthermore, the findings revealed that sexual self-efficacy (B = 0.649، P<0.001), sexual knowledge and attitude (B = 0.217، P<0.001), the ability to identify reliable and non-reliable sources (B = -3.116، P<0.001), feelings of shame and embarrassment for obtaining sexual information (B = 1.860، P = 0.011), social support (B = 0.127، P<0.001) and the obscenity of sexual issues in family (B = 1.764، P = 0.015) were the final predictors of sexual health literacy in couples. It is suggested that researchers and health managers consider these factors when designing interventions to promote sexual health literacy.

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.

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.

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.

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.

Assessment of Nurses' Caring Behaviors from the Perspective of Covid-19 Patients.

Caring behaviors are an important focus of nurses' physical and technical aspects of caring. By identifying and comprehending the nurses' caring behaviors from the perspective of the patients, as well as taking into account the elements influencing caring behaviors during the Covid-19 pandemic, we may plan to offer nursing care and caring behaviors based on the needs of the patients. In this cross-sectional study, purposive sampling was used to collect data from both the Demographic Questionnaire and the Nurses' Caring Behavior Questionnaire. The results showed that the respectful relationship field had an average score of 33.57, the professional knowledge and skill field at 15.35, and the overall mean score for the questionnaire was 43.92, with the mean score from the questionnaire being higher than the real mean score. It may be concluded that this component of nurses' behavior is seen favorably by patients in the Covid-19 ward. Additionally, the patients in the Covid-19 ward thought the mean score from the questionnaire on professional knowledge and skills was good because it was higher than the real mean score. The questionnaire's overall score was likewise greater than its mean overall score. Overall, it can be concluded that patients in the Covid-19 ward have a positive opinion of the nurses' level of caring behaviors. These results indicate that it is possible to achieve ideal caring and full patient satisfaction by planning and considering future outlook in order to educate and empower nurses in terms of correct caring behaviors, and to provide quality caretaking.

Effect of maternal polycystic ovary syndrome (PCOS) on screening of aneuploidy in the first and second trimesters.

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and hormonal disorder in women. This study aimed to assess the effect of maternal PCOS on screening of aneuploidy in the first and second-trimesters. METHODS: This case-control study was conducted in Arash Hospital and Nilou Laboratory in 2017-2018. The screening test was conducted on 90 PCOS and 90 healthy mothers. Finally, the first and second-trimester screening was compared between the two groups using Chi-square, Mann-Whitney's U and students T tests and regression model by SPSS 21. P < 0.05 was considered as statistically significant. RESULTS: Free Beta-Human Chorionic Gonadotropin (Free-ß-HCG) (P = 0.04), inhibin-A (P = 0.001) and Alpha Fetoprotein (AFP) (P = 0.02) levels were higher in the PCOS women comparing to the healthy women but there was no significant difference between the mean of HCG, Plasma Protein A (PAPP-A), and Unconjugated Estriol (UE3) between the two groups. Pre-eclampsia (P < 0.001) and trisomy 18 risks in quad screening were higher in the PCOS women (P = 0.002) than the control group; however, trisomy 13, trisomy 18 and trisomy 21 risks, Smith-Lemli-Opitz Syndrome (SLOS) and Neural Tube Defect (NTD) risks were not different between the two groups. The logistic regression model showed that the first- and second-trimester screening of aneuploidywas related to PCOS. CONCLUSIONS: There was a significant difference in the mean of free-ß-HCG, inhibin-A, AFP level, and the risks of pre-eclampsia, SLOS and trisomy 18 between the two groups but no significant association was found in the mean of HCG, PAPP-A, UE3, NTD and other aneuploidies between the two groups. PCOS may affect the first- and second-trimester screening tests and pregnancy health. It may also require correction in the calculation of risks related to the first- and second-trimester screening for aneuploidy.

Interventions promoting mental health dimensions in infertile women: a systematic review.

BACKGROUND: Scientific developments have brought hope to infertile couples; however, the results are not always favorable. This makes women suffer psychological pressure. Therefore, previous studies have investigated the effectiveness of many psychological interventions but no research identified the most common psychological interventions. In this regard, the present review aimed to investigate different psychological interventions that promote mental health in infertile to identify the most frequent (common) ones. METHODS: In the present study, the search was carried out using appropriate keywords Infertility, psychological interventions, mental health, stress, anxiety, depression and women in the Google Scholar، Magiran، SID، Pubmed، Scopus، Science Direct، ProQuest، Web of Science databases and One of the leading websites in health- WHO with Persian and English languages and two operators of "AND" and "OR" between 2000 and 2021. RESULTS: First, 7319 articles were searched, 6948 articles of which were removed due to irrelevant subjects, and 31 articles were removed due to duplication. 340 abstracts were examined and the results of 60 articles were extracted. Two approaches (examining the type and content of intervention) were used to extract findings. The first approach indicated high diversity in psychological interventions, leading to the categorization of the interventions into 4 categories of cognitive behavioral therapy (CBT), mind-body interventions (MBI), stress management skills, and others. CBT and MBI and stress management skills were found as the most frequent promoting interventions for mental health in infertile women. The second approach indicated the differences in protocols (number of sessions and time of interventions). CONCLUSION: Despite differences in protocol of interventions under study, the results of all articles revealed the effectiveness of interventions in improving infertile women's mental health; therefore, it is suggested to apply the most common psychological interventions based on scientific evidence (CBT, MBI, and stress management skills) along with infertility treatment methods. The results will help the specialists, policy-makers, and planners to select and implement the most appropriate psychological interventions for infertile women.

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.

Evaluation of the relationship between vitamin D levels with oocyte quality in breast cancer women: a cross-sectional study.

Recent evidence suggests that vitamin D deficiency could play an important role in the development of non-skeletal diseases, including cancer. Vitamin D also affects the function of the reproductive system. In the present study, the relationship between 25(OH)D levels with oocyte quality in Breast Cancer (BC) women and control group have been investigated. After initial evaluations, ovarian stimulation began with the GnRH antagonist protocol in the BC group (N = 16) and control group (N = 16). The serum and follicular fluid (FF) 25(OH)D levels were measured at the time of oocyte retrieval and their relationship to oocyte quality was examined. The mean levels of serum and FF 25(OH)D in BC women were significantly lower than in the control group (22.26 ± 7.98 vs. 29.61 ± 9.12, P = 0.02, 21.65 ± 7.59 vs. 28.00 ± 9.05, P = 0.04, respectively). There was a significant correlation between the levels of 25(OH)D in FF and serum in BC women (r = 0.873, P < 0.001). But there was no correlation between the serum or FF 25(OH)D levels with the parameters related to oocytes (P > 0.05). In the BC women, the number of dysmorph and highly dysmorph oocytes was higher than in the control group (P < 0.001). Women with BC referring to infertility centers for fertility preservation are more likely to be deficient in serum 25(OH)D level; this subsequently affects the FF 25(OH)D level. However, serum and FF 25(OH)D levels may not be suitable indicators for examining maturity and quality of oocytes in terms of morphology in BC women, and the poor morphological quality of oocytes in BC women may be due to other factors.

Determining the psychometric properties of safety attitudes questionnaire in NICUs.

INTRODUCTION: This study aimed to translate and assess the psychometric properties of the Persian version of the "Safety Attitude Questionnaire" in the NICUs. METHODS: In this psychometric study, the "Safety Attitude Questionnaire" was translated into Persian. Then this version was used for psychometric evaluation. For this purpose, the qualitative face, content validity and construct validity were performed by confirmatory factor analysis. Internal consistency and stability reliability were calculated. Data were analyzed using SPSS and AMOS software. RESULTS: Face validity was also performed with a slight change in four items. The factor structure of the tool was determined by confirmatory factor analysis. Fit indices were appropriate. Internal consistency reliability in the whole questionnaire was 0.65 and the stability reliability was calculated to be 0.64. DISCUSSION AND CONCLUSION: "Safety Attitude Questionnaire" has appropriate psychometric properties and can be used in NICUs.

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.

Factors Affecting the Providing of Sexual Health Services by Midwives: A Qualitative Research in Iran.

Background: Sexual health is one of the most important aspects of health. In Iran, most services associated with reproductive and sexual health are provided by midwives at health centers. As different factors are effective in providing care services associated with sexual health, the present study aims to investigate the factors affecting the provision of sexual health services by midwives. Materials and Methods: In this qualitative content analysis study, data were collected by conducting in-depth interviews with 16 midwives, 7 key informants, and 6 stakeholders. Besides, the sampling method was purposeful, and data analysis was conducted using conventional content analysis and MAXQDA software. Results: After analyzing the content of the qualitative data, two themes were extracted, which included facilitators of and barriers to providing sexual health services by midwives. Conclusions: By modifying educational curricula, providing in-service training, and adopting appropriate policies, barriers for providing accessible sexual health services by midwives can be reduced.