Investigating the effect of mindfulness counselling on sexual functioning of women with premenstrual syndrome.

Mindfulness exercises can improve a wide range of the psychological and interpersonal consequences of premenstrual syndrome. Nevertheless, there is sparse information about the effect of mindfulness counselling on sexual dysfunction in women with this condition. This study aimed to determine the effect of mindfulness counselling on the sexual functioning of women with premenstrual syndrome. In this controlled randomized study, 112 women diagnosed with premenstrual syndrome referred to selected urban healthcare centers in Isfahan, Iran, were randomly allocated to two groups (intervention and control), each with 56 participants. The intervention group underwent mindfulness counselling in eight 60-minute sessions online via Google Meet. The control group did not receive any kind of intervention. The principal measure was score on the Rosen Female Sexual Functioning Index (FSFI) before, immediately, and one month after the intervention. The data were analyzed by SPSS 23, through descriptive and analytical statistical tests (chi-square, Mann-Whitney, independent t-test, ANOVA, and repeated measure) with a significance level of 0.05. There was no statistically significant difference in the mean FSFI score (or the subscores) between the intervention and control groups (p greater than 0.05) at baseline. In the intervention group, there were significant increases (relative to both baseline and in comparison with the control group) in the mean subscores for sexual desire (P < 0.0001), orgasm (P = 0.01), satisfaction (P = 0.0001), sexual pain (P = 0.003), and general sexual functioning (P < 0.0001) immediately after and one month after the intervention, but the score for sexual arousal was significantly greater only at the one-month evaluation (P < 0.0001) and there were no differences in the scores for vaginal lubrication. On the other hand. Mindfulness counselling was effective in improving the sexual functioning of women suffering from premenstrual syndrome, and should be used for this purpose in healthcare centers.

Design and psychometric properties of a questionnaire for assessing sexual and reproductive health needs of married adolescent women: an exploratory sequential mixed methods study.

To date, there is no valid and reliable instrument to specifically evaluate married adolescent women's sexual and reproductive health (SRH) needs. Hence, the aim of this study was to develop and evaluate the psychometric properties of a questionnaire for assessing married adolescent women (MAW)'s SRH needs. The current exploratory sequential mixed method study was performed in two phases. In the first phase, a preliminary questionnaire was developed based on in-depth interviews with 34 MAW and four key informants as well as a comprehensive literature review. In the second phase, validity of the questionnaire was assessed using face, content, and construct validity and reliability of the questionnaire was assessed using internal consistency and test-retest reliability. Based on qualitative content analysis and literature review, 137 items were extracted. After several modifications of the generated items, a 108-item questionnaire was prepared for the psychometric process. After checking face and content validity, 85 items remained in the study. In the exploratory factor analysis, 11 items were removed and the remaining 74 items were categorised into nine factors. Cronbach's alpha coefficient and the intraclass correlation coefficient were found to be 0.878 and 0.99 for the whole scale, respectively.Impact StatementWhat is already known on this subject? Sexual and reproductive health (SRH) needs of married adolescent women (MAW) are different from those of married adult women or unmarried, sexually active adolescents. However, there are to date no valid and reliable instruments to specifically evaluate the SRH needs of this group of women.What do the results of this study add? The final version of questionnaire consists of 74 items in nine domains including need to improve MAW's sexual quality of life, promote MAW's SRH self-care, improve MAW's SRH self-efficacy, increase MAW's SRH knowledge, increase husband's involvement in MAW's SRH, improve the performance of health care providers, strengthen the family support to married adolescent women, improve family involvement in SRH education of MAW, and provide specific premarital counselling to MAW.What are the implications of these findings for clinical practice and/or future research? The 74-item questionnaire has acceptable validity and reliability. Therefore, it can be used by researchers and policymakers as an appropriate instrument for assessing MAW's SRH needs.

Reducing Labor Anxiety with Auriculotherapy: A Randomized Clinical Trial Study.

OBJECTIVES: To investigate the effect of auriculotherapy on reducing labor anxiety. METHODS: In this randomized clinical trial, 166 nulliparous pregnant women admitted to the Labor Ward of Izadi Hospital in Qom, Iran were included and assigned to two groups by randomized block design. In the intervention group (83 cases), auriculotherapy in "Shenmen, Thalamic, Zero, Brain, and Brain stem" was performed in dilatations of 4, 6 and 8 cm, between the contractions for 30 s in both ears at interval 1 h. While the control group received routine care. The Spielberger Inventory were completed pre- and post-interventions. RESULTS: The auriculotherapy was effective to reduce anxiety state in the intervention group compared to the control group (P=0.001). The score of state anxiety in the intervention group reduced for 7.0, 8.0 and 11.0 U in 4, 6, and 8 cm dilatations after the intervention. The score of trait anxiety in the intervention group reduced for 3.8, 4.0 and 8.3 U in 4, 6, and 8 cm dilatations after the intervention. There was no significant difference of delivery mode and newborns' weight and Apgar score between groups (P>0.05). No adverse postpartum outcome such as hemorrhage has been observed in both groups. CONCLUSION: Since most women are anxious during labor, it seems that auriculotherapy can be an easy and safe method to reduce labor anxiety. (Trial registration No. irct20121230011944n4).

Comparing the effect of individual counseling with counseling on social application on self-care and quality of life of women with gestational diabetes.

INTRODUCTION: The present study aimed to compare the effect of two different forms of face-to-face and counseling on a social application, i.e., WhatsApp, on self-care and quality of life of women with gestational diabetes. METHODS: The present research was an educational trial with control group, which was conducted on diabetic women between 24 and 26 weeks of pregnancy. A total of 126 subjects were included in the study using the convenient sampling method. They were assigned into three groups. All of the participants answered the questionnaires gestational diabetes self-care, and quality of life at the beginning and end of the study. The GATHER approach to counseling (G = Greeting, A = Ask, T = Tell, H = Help, R = Return) was performed in four 45-min sessions for face-to-face and WhatsApp groups in the pregnancy weeks of 27, 28, 29, and 30. The subjects in the control group received only the routine cares for gestational diabetes. T test, Chi squared test, and ANOVA repeated measurement test were used to analyze the data. RESULTS: Findings showed a significant difference among the three groups in self-care and quality of life (p = 0.001). There was also a significant difference among the three groups in fasting blood sugar after the intervention (p = 0.005). CONCLUSION: Self-care counseling, both in the form of face-to-face and on social networks, improved the score of self-care and quality of life as well as glucose tolerance test (GTT) in women with gestational diabetes.

The Effect of Solution-Oriented Counseling on Coping Strategies in Mental Health Issues in Women with Gestational Diabetes.

This study aimed to investigate the effectiveness of solution-oriented intervention in patients with gestational diabetes, stress and anxiety on using coping strategies. This study was a randomized clinical trial with a control group. The population consisted of 56 diabetic women under treatment with insulin, who obtained higher score in one of the psychological disorders using DASS-21 (Depression, anxiety, stress scale). The participants were randomly assigned in two interventional (n = 28) and control (n = 28) groups after signing the written informed consent forms. The solution-oriented interventional program was conducted in six 60-min sessions for 6 weeks. Immediately after the final session and 6-8 weeks after the first session of the intervention, both groups completed coping inventory for stressful situations. The analytical statistic of t-test, chi-square, and variance analysis with repeated measurements using SPSS were used to analyze the data. solution-oriented counseling increased the problem-solving coping strategy in the intervention group (P = 0.001); the scores obtained by the subjects in the interventional group after adjusting the score before the intervention increased 2.68 units immediately after the intervention, which was not statistically significant (p-value = 0.44). However, it increased 11.5 scores six weeks after the intervention, which was statistically significant (P = 0.00). But, emotional and avoidance coping strategies were not significantly different between the two groups. This technique can be easily trained to all clients, and since it is focused on finding various solutions for psychological problems by clients, it can be used to reduce stress and anxiety in other chronic diseases as well.IRCT code: The code of this clinical trial study is IRCT20200202046339N1.

Enhancing Breastfeeding - Home-Based Education on Self-Efficacy: A Preventive Strategy.

BACKGROUND: The aim of this study is to evaluate the effects of home-based education intervention on the exclusivity and promoting the rates of self-efficacy of breastfeeding. MATERIALS AND METHODS: A randomized controlled trial was conducted Arak University of Medical Sciences in Takeghani Hospital in Iran between June 2015 and October 2015. A total of 130 eligible and voluntary women hospitalized in Arak University of Medical Sciences Hospital postpartum wards were randomized to receive usual care (n = 65) or education with CD and pamphlets (n = 65). Data regarding exclusive breastfeeding were collected using Denis and Fox's breastfeeding self-efficacy questionnaire. The primary outcome was collected by one assistant researcher during first postpartum visit. The secondary outcome was collected 4 weeks after birth of babies by telephone interviews. Data analysis was performed using descriptive (frequency, mean), independent samples t-test, Student's t-test, t 2-test, and Chi-square test. All values of P < 0.05 were considered statistically significant. RESULTS: There was no significant differences between the intervention and control groups with regard to age (P = 0.086) and gestational age (P = 0.741). The breastfeeding self-efficacy scores were higher in the intervention group (63.66 ± 6.11) than in the control group (57.04 ± 6.18) after 1 month of childbirth (P = 0.001). The exclusive breastfeeding rate in intervention group was 89.2 (n = 58) at 1st month after education compared with 55.4% (n = 36) in control group (P = 0.001). CONCLUSIONS: In a setting, a high breastfeeding rate and self-efficacy scores were found in education group. Therefore, nurses and midwives are thus required to adopt various health education strategies, such as home education, encourage breastfeeding.

Thermo-therapy and cryotherapy to decrease the symptoms of restless leg syndrome during the pregnancy: A randomized clinical trial.

BACKGROUND AND PURPOSE: Restless legs syndrome (RLS) is a common sensory-motor disorder among the pregnant women. The aim of this study is to compare the impacts of two methods of immersion of legs in cold and warm water on the RLS symptoms among the pregnant women. METHODS: This randomized clinical trial was conducted on 80 pregnant women with RLS who referred to Taleghani educational-therapy center. After obtaining their informed consent, they were selected by accessible method and randomly allocated into group 1 (warm water) and group 2 (cold water). Group 1 were asked to put their legs in cold water for 10 min every night for 2 weeks. The group 2 put their legs in warm water under the same condition. The severity of RLS was measured before and after the study. Data analysis was conducted using descriptive as well as the analytical statistics such as Chi-square, independent T test, pair T test, Mann-Whitney U, Wilcoxon and covariance. RESULTS: After intervention, mean RLS of the cold water group was11.02 ± 4.93; while this mean was 13.50 ± 4.74 in the warm water group. The difference between the two groups was significant (p = 0.017). Results also revealed that the severity of RLS symptoms at the end of the treatment was different from the beginning of the research in both groups (p = 0.001). The intervention with both warm and cold water declined the RLS symptoms among pregnant women. CONCLUSION: The warm and cold water can be used for this purpose depending on the women's preference. However, this article recommends the cold water for more reducing of symptoms.

Perceived Barriers to Accessing Pregnancy-Related Health Information Among Married Adolescent Women: A Qualitative Study in Iran.

STUDY OBJECTIVE: To date, no study has reported barriers to accessing pregnancy-related health information among married women younger than the age of 19 years. Indeed, the voice of the girls being married is absent in the literature. We sought to explore the barriers to accessing pregnancy-related health information from the perspective of Iranian married adolescent women. DESIGN: Qualitative study. SETTING: The research was conducted in Mashhad city (health care centers) and Shahrood County (a maternity teaching hospital, and urban/rural health care centers) in Iran. PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Twenty-four married adolescent women aged 14-19 years were recruited through purposive sampling. Individual in-depth interviews were tape-recorded, transcribed verbatim, and analyzed using conventional content analysis. Prolonged engagement with participants, maximum-variation sampling, member checking, peer deferring, and external audit were used to enhance the rigor of the study. RESULTS: The results showed 3 categories: "structural barriers," "individual barriers," and "sociocultural barriers." The structural barriers category consisted of 2 subcategories, namely, poor quality of education and counseling in the health care centers, and transportation barriers. The 2 subcategories of the individual barriers category consisted of affective barriers and cognitive barriers. The sociocultural barriers category included the following 2 subcategories: husband's decision-making power and fear of being labeled infertile. CONCLUSION: The barriers identified in this study should be considered when designing educational interventions for married adolescent women. Moreover, further research is needed to enhance current knowledge on this topic.

Lipid peroxidation, thiol groups, and total antioxidant capacity in mothers in natural vaginal delivery with and without Entonox: A cohort study.

BACKGROUND AND OBJECTIVES: Considering that very few studies have been conducted on the effect of Entonox on oxidative stress markers, this study was conducted to compare these markers in natural vaginal delivery (NVD) with and without Entonox. MATERIALS AND METHODS: The present cohort study was conducted on 120 women in maternity wards divided into two groups, including an NVD group with and an NVD group without Entonox. After obtaining the mothers' written consent, 5 cc of venous blood was taken at the end of their second stage of labor for lipid peroxidation, thiol groups, and total antioxidant capacity tests. The data obtained were analyzed using descriptive (mean) and inferential (t-test) statistics. RESULTS: Lipid peroxide was 6.267 ± 5.39 in NVD without Entonox and 5.12 ± 3.89 in NVD with Entonox, suggesting the lack of a statistically significant difference (p = 0.191). Thiol marker was 0.34 ± 0.26 in NVD without and 0.26 ± 0.24 in NVD with Entonox, suggesting the lack of a statistically significant difference (p = 0.09).The FRAP results were 0.936 ± 0.696 in NVD without and 1.21 ± 0.89 in NVD with Entonox, suggesting the lack of a statistically significant difference (p = 0.06). DISCUSSION: Entonox can be safely used in NVD without increasing the risk of oxidative stress.

Knowledge, attitude, self-efficacy and estimation of frequency of condom use among Iranian students based on a crosswise model.

BACKGROUND: This study aimed to evaluate the knowledge, attitude and self-efficacy and condom use among Iranian students. METHODS: Knowledge, attitudes towards condoms and self-efficacy of condom use questionnaire were translated and back translated. Then content validity ratio (CVR) and content validity index (CVI) questions higher than 0.6 and 0.71 were accepted, respectively. A "crosswise model" was used to estimate condom use. After pretest on 10 students, reliability test was done by test-re-test and Cronbach's α. A multi stage sampling was done for 1500 students in Shahroud universities. They filled in a self administered questionnaire and gave it back to the researcher after 40-50 min. FINDINGS: Knowledge, in females was (3.03±1.1) and in males was (3.53±0.83) (p=0.001). Also a small percentage of the students, i.e. 83 girls (9.1%) and six boys (1.1%) had good self-efficacy of condom use (p=0.001). Estimates relating to the use of condoms with a crosswise test showed that 16% of girls (CI=16, 24) and 27% of boys (CI=17, 38) had used a condom during intercourse. CONCLUSION: It seems that these three important indicators of reproductive health should be incorporated in AIDS control programs and training programs should emphasize it more.

The effects of stress inoculation training on perceived stress in pregnant women.

A total of 64 pregnant women were assigned into two groups of cases and controls. Both groups filled out the Perceived Stress Scale at pre-test. Cognitive-behavioral coping skill training was delivered to the case group. After the end of the intervention, both groups completed the same scale again. The results showed that the mean perceived stress of the cases and controls was 27.77 ± 6.033 and 18.97 ± 3.268, respectively (p = 0.001). Therefore, midwives are recommended to plan educational interventions to decrease perceived stress in pregnant women.

Prevalence of preterm labor in Iran: A systematic review and meta-analysis.

BACKGROUND: Preterm labor, which defines as live-birth delivery before 37 weeks of gestation is a main determinant of neonatal morbidity and mortality around the world. OBJECTIVE: The aim of this study was to determine the prevalence of preterm labor in Iran by a meta-analysis study, to be as a final measure for policy makers in this field. MATERIALS AND METHODS: In this meta-analysis, the databases of Thomson database (Web of Knowledge), PubMed/Medline, Science Direct, Scopus, Google Scholar, Iranmedex, Scientific Information Database (SID), Magiran, and Medlib were searched for articles in English and Persian language published between 1995 and 2014. Among the studies with regard to the inclusion and exclusion criteria, 14 studies (out of 1370 publications) were selected. Data were analyzed by using Stata software version 11. The heterogeneity of reported prevalence among studies was evaluated by the Chi-square based Q test and I2 statistics. RESULTS: The results of Chi-square based on Q test and I2 statistics revealed severe heterogeneity (Q=2505.12, p-value < 0.001 and I2= 99.5%) and consequently, the random effect model was used for the meta-analysis. Based on the random effect model, the overall estimated prevalence of preterm in Iran was 9.2% (95% CI: 7.6 - 10.7). CONCLUSION: Present study summarized the results of previous studies and provided a comprehensive view about the preterm delivery in Iran. In order to achieve a more desirable level and its reduction in the coming years, identifying affecting factor and interventional and preventive actions seem necessary.

Violence against women by their intimate partners in Shahroud in northeastern region of Iran.

BACKGROUND: Violence against women is one of the worst consequences of cultural, political, and socio-economic inequalities between men and women. Intimate Partner Violence (IPV) has been identified as an important cause of morbidity from multiple mental, physical, sexual, and reproductive health outcomes. Nonetheless, the prevalence and related factors of this international problem have not been investigated extensively in some parts of the world. The aims of this research were to determine the prevalence of physical and mental violence perpetrated by men against their intimate partners and to assess the associated factors of partner violence among women in Shahroud in northeastern region of Iran in 2010. METHODS: This Cross-Sectional study was conducted in Shahroud, in northeast of Iran in 2010. Cluster sampling was done from primary health service institutions, universities, public schools and governmental organizations throughout the city and six hundred married women completed the study. A structured questionnaire with 34 items was designed in three parts to assess the physically (10 items) and mentally (15 items) violent acts by a current intimate male partner and identify collative behaviors (9 items) of victims. The Logistic regression analysis was applied to determine the net effect of background variables on the IPV occurrence within the past year. RESULTS: About 20% of the participants experienced at least one type of physical violence. Increased risk of physical violence was positively associated with the younger age of the couple (OR=3.08, P<0.05), lower education (OR=2.28, P<0.01) and having a semi-manual skilled occupation of husband (OR=3.62, P<0.05), husband's heavy cigarette smoking (OR=2.62, P<0.01), and his drug abuse (OR=2.1, P<0.05). About 85% of the women had experienced mental harassment within the past twelve months. Logistic Regression Analysis found that lower education (OR=3.06, P<0.01) and having semi-manual skilled occupation (OR=3.8, P<0.05) of husband, increasing years of marriage (OR=2.8, P<0.01), husband's heavy cigarette smoking (OR=2.3, P<0.01) and his abusing the use of drugs (OR=3.4, P<0.01) had significant associations with women's experience of mental violence. CONCLUSIONS: Some socioeconomic characteristics such as educational level, occupational status of men, heavy smoking and drug abusing are associated with the occurrence of violence against one's intimate partner. Since IPV is usually unreported, healthcare providers should be aware of the risk factors associated with domestic violence to be able to design preventive measures against its negative health outcomes in women.

Estimation of sexual behavior in the 18-to-24-years-old Iranian youth based on a crosswise model study.

BACKGROUND: In many countries, negative social attitude towards sensitive issues such as sexual behavior has resulted in false and invalid data concerning this issue.This is an analytical cross-sectional study, in which a total number of 1500 single students from universities of Shahroud City were sampled using a multi stage technique. The students were assured that their information disclosed for the researcher will be treated as private and confidential. The results were analyzed using crosswise model, Crosswise Regression, T-test and Chi-square tests. FINDINGS: It seems that the prevalence of sexual behavior among Iranian youth is 41% (CI = 36-53). CONCLUSION: Findings showed that estimation sexual relationship in Iranian single youth is high. Thus, devising training models according to the Islamic-Iranian culture is necessary in order to prevent risky sexual behavior.

Development and adaptation of Iranian youth reproductive health questionnaire.

Iran is a young country, and sexual behavior is shaped in this period. This research aimed to provide an assessment tool to evaluate Iranian youth reproductive health. This multistage research was conducted to design a valid questionnaire in the domains of knowledge, attitude, and behavior of the youth in order to evaluate behavior change programs. For this reason, after conducting a careful literature review and a qualitative research, the questionnaire was prepared. Forward and backward translations were performed. Professionals and students were used to make sure of qualitative and quantitative content and face validity. After conducting the pilot study on 100 students and eliminating defects in performance, reliability was evaluated by test-retest and Cronbach's alpha was calculated. In this study, out of 268 questions, 198 were retained after face and content validity. Self-efficacy of communication with father and mother, self-efficacy of condom use, and self-efficacy of abstinence had the highest Cronbach's alpha. Moreover, communication with parents regarding reproductive health issues and attitude to abstinence had a high Cronbach's alpha, as well. It seems to be a good instrument for assessment of Iranian reproductive health, and we are going to assess youth reproductive health in the future.

Interpretation of opposite-sex friendship based on social ecology model in Iranian females.

OBJECTIVE: One of the main cultural issues in universities is relationships between male and female students. Due to the adverse consequences of this issue, explaining of the beyond the causes of friendship with opposite-sex, is one of the first steps in planning for youth issues. METHODS: This qualitative research was conducted based on content analysis. Nineteen female university students were enrolled. Semi-structured questions through four sessions were used to gather required data. Two themes were extracted. One was the behaviors leading friendship which consisted of 5 subsets including self and extra-self, meso, exo-, and macro-systems. The other theme was the actions against with consequences of sex which are made of 2 subsets of the quality and the consequences of sex. RESULTS: Various factors such as person attitude, felling lonely, and community atmosphere, including the university environment, family, friends, religious beliefs and media that promote the Western culture can be effective in friendship before marriage. CONCLUSION: Since the society of our country is considered a young populated one and the culture of the West through the media currently influences on our culture, reproductive health programs should be developed in a high priority focusing on youth fitted with their current needs according to Islamic-Iranian culture.

Effects of education based on the health belief model on screening behavior in high risk women for breast cancer, Tehran, Iran.

BACKGROUND: Breast cancer is the most common malignancy in women. Early diagnosis allows efficient treatment and increases survival, but the efficacy of breast self examination (BSE) is not sufficiently well established. The American Cancer Society aims to give women the opportunity to recognize the utility, limitations and adverse effects of breast cancer screening through education models based on psychological theories. With the Health Belief Model, people's health perceptions and attitudes influence their practices, for example with screening. OBJECTIVE: The purpose of this randomized controlled clinical trial was to determine the effect of education based on this model on breast cancer screening in high risk Iranian women. MATERIALS AND METHODS: Participants were women with a family history of breast cancer (mother, sister, and daughter). After explanation of the study objectives to participants, they were recruited on obtaining oral consent and each filled out the study questionnaire based on the Health Belief Model. Allocation was into two groups by computerized randomization, control and intervention, receiving education on breast cancer screening. Perceived susceptibility to and seriousness of breast cancer, perceived usefulness of and barriers to BSE, clinical breast examination, and mammography, and self-efficacy in the ability to perform these, were assessed, with comparison of scores for BSE practice before and after education and doing mammography and clinical examination by a physician in intervention and control group. RESULTS: The mean age was 37.8 ± 11.7 (range 19-60). The mean rank in the intervention group significantly differed before and after the education, but except for " perceived threat" and "perceived usefulness of breast self examination", we did not find any significant differences from the control group. After educational sessions, breast self examination and clinical examination practice rates were elevated. CONCLUSION: Health education based on well known psychological theories for breast cancer screening should be extended to the entire populations in developing countries. In addition, we should pay attention to barriers to women undergoing mammography, such as costs, shame and accessibility, and increase the target population awareness and positive attitudes towards benefits of early breast cancer screening.

Healing advantages of lavender essential oil during episiotomy recovery: a clinical trial.

Episiotomy is the most common perineal incision in obstetric and midwifery. Nowadays alternative and complementary methods such as Aromatherapy using essential oils are established as an alternative therapy. This research was carried out to assess the effect of lavender oil in wound healing. This randomized control trial was conducted on 120 primiparous women with singleton pregnancy, without any acute and chronic disease and allergy who had undergone normal spontaneous vaginal delivery and episiotomy. They were randomly allocated in case and control groups. Case group received lavender oil and controls received povidone-iodine. Incision sites were assessed on the 10th day postpartum. 25 out of 60 women in lavender group and 17 mothers in control group had no pain (p = 0.06). There was no significant difference between two groups in surgery site complications. However, redness in lavender group was significantly less than controls (p < 0.001). This study suggests application of lavender essential oil instead of povidone-iodine for episiotomy wound care.