Investigating the impact of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction: a study protocol.

INTRODUCTION: Cardiovascular diseases are a common chronic illness in adults, with implications for health and psychological well-being. These implications not only affect the patients themselves but also impact family members, especially the spouses of patients. One significant issue and consequence of this disease is its impact on marital relationships and sexual satisfaction, which can also influence other dimensions of quality of life. The aim of the current study is to determine the effect of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction. METHOD: This study is a clinical randomized controlled trial. Sampling will be done on a convenience basis. Participants will be randomly allocated into two groups: control (50 couples) and intervention (50 couples). Couples in 6 groups of 8 members each will attend counseling sessions based con the CHARMS model, with sessions held weekly and lasting for 60 min. Data collection tools will include Demographic information questionnaire, Women's Sexual Quality of Life Questionnaire, Enrich Marital Satisfaction Questionnaire, Sexual Compatibility Questionnaire and Perceived Quality of Relationship Dimensions Questionnaire, which will be completed by women in both groups before and after the intervention. Data will be analyzed using appropriate statistical tests and SPSS software. DISCUSSION: This trial will evaluate whether a counseling intervention based on the CHARMS model can enhance sexual quality of life and marital satisfaction of wives of men with myocardial infarction in Urmia city. TRIAL REGISTRATION: IRCT code: IRCT20240218061046N1.

Cardiovascular diseases are a common chronic illness in adults, with implications for health and psychological well-being. One significant issue and consequence of this disease is its impact on marital relationships and sexual satisfaction, which can also influence other dimensions of quality of life.This trial will evaluate whether a counseling intervention based on the CHARMS model can enhance sexual quality of life and marital satisfaction of wives of men with myocardial infarction in Urmia city. A CHARMS-based intervention with 4 principles addresses the sexual and marital relationship empowerment of couples following a severe heart attack. These principles include: (1) Counseling and providing information on the impact of cardiovascular diseases on sexual desires. (2) Counseling and providing information on a healthy sexual life and communication skills strategies with the sexual partner. (3) Counseling on uncovering false beliefs and misconceptions regarding relationship risks and fears. (4) Providing tips and solutions for resuming sexual relations after a severe heart event, addressing sexual and interpersonal challenges. This intervention sets patients' expectations of sexual relationships based on a final focus on "sexual intimacy" as the ultimate goal of therapy.This study is a clinical randomized controlled trial. Participants will be randomly allocated into two groups: control (50 couples) and intervention (50 couples). Couples in 6 groups of 8 members each will attend counseling sessions based con the CHARMS model, with sessions held weekly and lasting for 60 min.

The relationship between sex steroids (E2, progesterone, and AMH) levels and severity and fatality of COVID-19: A systematic review.

Sex steroids are powerful modulators of the immune system and they may affect the immune response and inflammatory consequences of COVID-19. This systematic review aims to explore the impact of sex steroids on COVID-19 mortality and complications. We looked up the keywords of the study in Scopus, PubMed, and Web of Science. All related original articles published in English, as of October 16, 2021, were reviewed to be included in our research. Concerns regarding the effect of sex hormones on COVID-19, eight full texts have been identified for the conclusion. In these studies, the relationship between estradiol and COVID-19 mortality has been mentioned. The most significant findings were the higher COVID-19 mortality rate in men, compared to women; also, in menopausal women compared to younger women and who received estradiol. In two studies, oral contraceptive pills had a protective effect on the morbidity of SARS-CoV-2 infection. In a randomized controlled trial, subcutaneous injection of progesterone in hospitalized men significantly reduced their symptoms and need for oxygen therapy. Hormone replacement therapy was positively associated with reducing COVID-19 symptoms. Although the results were insufficient for a conclusion, this study represents estrogen as an appropriate pharmacological method for preventing and diminishing the inflammation related to COVID-19 disease. However, future prospective studies and clinical trials are needed to clarify and approve this protective effect.

Overcoming Reproductive and Psychological Concerns of Breast Cancer Survivors: A Randomized Controlled Trial.

Objective: After developing breast cancer, women experience changes in their sexuality, femininity, and fertility. These changes lead to poor mental health and increased psychological stress. Therefore, this study aimed to investigate the effects of Good Enough Sex (GES)-based, couple-centered group counseling on reproductive and sexual concerns of breast cancer survivors. Materials and methods: This was a quantitative randomized controlled clinical trial (RCT) conducted at Omid Hospital, West Azerbaijan, Urmia, Iran from March 2018 to October 2020. After completing the informed consent forms, 100 women were assigned to the intervention and control groups (50 individuals per group) using a randomized block design. The intervention included four 90-120-minute sexual counseling sessions with 2 and 3 month follow-ups. The data were collected using the socio-demographic and clinical characteristics, the Persian version of Depression, Anxiety and Stress Scale (DASS-21), Reproductive Concerns after Cancer (RCAC) scale, and Female Sexual Function Index adaptation for Breast Cancer patients (FSFI-BC). Data were collected, from control and intervention groups, at three intervals; before, besides two months and three months post intervention, then were analyzed in SPSS 20 using descriptive and repeated measures analysis of variance (ANOVA) test. Results: Significant reduction in the mean score of DASS-21, RCAC and improvement of FSFI-BC is reported between the intervention and control groups in favor of intervention group (P<0.001). However, no significant differences are observed within intervention group over two- and three-months post intervention (P > 0.05). Conclusion: The designed Good Enough Sex (GES)-based, couple-centered group counseling effectively reduced reproductive and sexual concerns of females' breast cancer survivors. Therefore, these training and counseling programs can be organized by relevant service centers to promote the reproductive health of women with breast cancer.

The Effect of Good Enough Sex (GES) Model-Based Sexual Counseling Intervention on the Body Image in Women Surviving Breast Cancer: A Randomized Clinical Trial.

INTRODUCTION: Women undergoing breast cancer treatment experience a number of changes, including loss or deformity of one or both breasts, surgical wounds, skin changes, and weight gain. These changes are very closely related to physical appearance and body image and often lead to reduced mental health, marital quality and psychological stress.  Objective: This study aimed to determine the effect of Good Enough Sex (GES) model-based counseling intervention on the body image in women surviving breast cancer. PATIENTS AND METHODS: This randomized clinical trial was a kind of quantitative study with control group carried out on 100 women (50 women in the intervention group and 50 women in the control group) who randomly entered into the study after completing the informed consent form. The intervention included 4 sessions of 120-190 minute sexual counseling with 2 and 3 months follow-up. The data were collected consisting of demographic characteristics and disease-related information, Body Image Scale (BIS) and analyzed using ANOVA repeated measures. RESULTS: The results showed a statistically significant difference between the mean of body image in the intervention and control groups (P <0.001). CONCLUSION: The educational and counseling intervention program based on a socio-psychological model was effective in improving the body image among women surviving breast cancer. The inclusion of educational and counseling programs in service centers in this regard has an effective role in the reproductive health of women with breast cancer. TRIAL REGISTRATION: Registration of trial protocol has been approved in Iranian registry of clinical trials (IRCT20120609009975N8, https://en.irct.ir/trial/42030, ethical code; IR.TUMS.FNM.REC.1396.4865).
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The Relationship between Resilience with Self- Compassion, Social Support and Sense of Belonging in Women with Breast Cancer

Background: The purpose of this study was to investigate the associations among Resilience, self- compassion, social support and Sense of belonging in Iranian women with breast cancer. Materials and methods: This study was a descriptive-analytical cross-sectional study .The data of 150 patients with breast cancer were collected by convenience sampling using Demographic characteristics questionnaire, Connor-Davidson resilience scale, self-compassion scale and the multidimensional scale of perceived social support in Urmia, Iran in 2016. Results: The most age of the patients were in the range of 41-49 years, and most of them were married. The self- compassion, social support and Sense of belonging (r = all correlated significantly with resilience). Significant positive correlation was identified among self-compassion, social support, sense of belonging and resilience (P < 0.01). Conclusions: The results of this study clarified the self-compassion, social support and Sense of belonging are effective on the resilience among Iranian women with breast cancer. It is recommended to design some interventional programs to increase the aspect of resilience in these patients.

Determinants of Breast Cancer Screening by Mammography in Women Referred to Health Centers of Urmia, Iran

Background: In women, breast cancer accounts for 30 percent of all cancers and it is the second leading cause of mortality. Mammography is considered an effective procedure to detect early breast cancer recommended by World Health Organization. This study was aimed to evaluate breast cancer screening determinants in women referred to health centers of Urmia for mammography in 2017. Materials and Methods: In this descriptive-analytic cross-sectional study, 348 women referred to health centers of Urmia were selected using multistage sampling. Data were collected using a standard questionnaire for mammography screening determinants, with a checklist including demographic characteristics, family, social and economic factors and midwifery background. Analysis was with SPSS software version 20for descriptive and inferential statistic tests, P<0.05 being considered significant. Results: The proportion performing mammography was 12%. Significant relationships were noted with income, menopause status, a history of breast cancer in close relatives, beliefs, inaccessibility, knowledge, cues to action, emotions, self-care, and life priorities (P<0.05). There were no significant links with age at marriage, first age of delivery, number of children, duration of breastfeeding, status of residency, education, marital status, occupation, history of breastfeeding, and previous breast problems (P>0.05). Conclusions: The findings of this study showed that the status of breast cancer screening in participating women was not satisfactory. Therefore, promotion of screening methods by health policy makers in Iran is necessary and given that reliance solely on education is not sufficient, it is essential to pay attention to barriers and eliminate them.

Managerial Self-Efficacy for Chemotherapy-Related Symptoms and Related Risk Factors in Women with Breast Cancer

Background: Breast cancer is one of the most important diseases affecting physical, psychological and social health of women. This study aimed to determine managerial self-efficacy regarding chemotherapy-related symptoms and related risk factors in Iranian patients. Materials and methods: This descriptive-analytical cross-sectional study was conducted on 150 patients with breast cancer referred to medical centers of Urmia in 2016 with a convenience sampling method . The data collection instrument was the symptom-management self-efficacy scale-breast cancer (SMSES-BC) questionnaire whose validity and reliability was evaluated for the first time for Iranians. Data were analyzed using SPSS software version 20. Results: Most of the patients were in the age range of 41-49 years. Lowest scores were in the areas of emotional and interpersonal disorders and the highest scores in the area of managing chemotherapy-related symptoms. The mean score of self-efficacy chemotherapy-related symptoms was 168.0±25.4. There were significant relationships between age, education, economic status, marital status and life status and self-efficacy chemotherapy-related symptoms. In addition, a positive significant correlation for each of the subscales. Conclusion: It should be noted that interventional efforts for improving managerial self-efficacy of symptoms, especially management of interpersonal and emotional disorders in these patients are necessary.