Anxiety, depression, and stress: a comparative study between couples with male and female infertility.

BACKGROUND AND AIM: Although infertility as a significant cause of marital crises is prevalent almost equally in men and women, infertile women are under more pressure and distress than infertile men. Therefore, this study was conducted aiming to compare anxiety, depression, and stress between couples with male and female infertility. METHODS: In this descriptive-analytical cross-sectional study, 40 couples (n = 80) with male infertility and 40 couples (n = 80) with female infertility were referred to the infertility clinic of Al-Zahra Educational and Medical Center, Rasht, Iran. Eligible infertile couples were selected by convenience sampling method. The data collection tool was a two-part questionnaire consisting of a demographic information form and a short form of the standard Depression Anxiety Stress Scale-21 (DASS-21). Data analysis was carried out using descriptive and inferential statistical tests at a significant level of p < 0.05. RESULTS: The severity of depression, anxiety, and stress also had a statistically significant difference between men and women. The severity of depression was mild in 57.5% of infertile women and moderate in 40% of infertile men. The severity of anxiety was moderate in 42.5% of infertile women and mild in 57.5% of infertile men. The severity of stress was Severe in 37.5% of infertile women and mild in 40% of infertile men. There was a statistically significant difference between infertile women and men in terms of depression (t=-4.213, df = 1619, p < 0.001), anxiety (t=-7.261, df = 2274, p < 0.001), and stress (t=-9.046, df = 2308, p < 0.001) subscales, and the total scores (t=-7.709, df = 2315, p < 0.001). The depression, stress and anxiety levels were higher in infertile women than in healthy women with infertile spouses. This difference was statistically significant (p < 0.01). The depression, anxiety, and stress levels were significantly different between infertile men and healthy men with infertile wives (p < 0.001). CONCLUSION: The results of this study indicated that depression, anxiety, and stress were more prevalent in infertile women than in infertile men. The severity levels of depression, anxiety, and stress in the wives of infertile men were higher than those in the spouses of infertile women.

Factors affecting sexual-self-esteem among Iranian women.

Introduction: The quality of marital relationships is positively impacted by women's sexual self-esteem. This study aims to determine the factors that affect sexual self-esteem among Iranian women. Methods: A total of 1176 eligible women who have been referred to comprehensive healthcare centers of Rasht, participated in this analytical cross-sectional study. A stratified two-stage cluster sampling methodology was applied to achieve samples. Data were collected using a validated Persian version of the Sexual Self-Esteem Inventory in Women-Short Form and related factors checklist. Results: The mean sexual self-esteem score of the respondents was 103.97(SD =5.29) in this study. Education level of the woman (B = 2.622, P < 0.032), employment status of the woman (B= 9.24, P < 0.01), duration of the marriage (B = 11.47, P < 0.01), body image (B = 3.446, P < 0.01), childhood sexual abuse experiences (B = -0.363, P < 0.01), was related with sexual self-esteem. The sexual self-esteem score increased with an increase in higher levels of education, employment of women, an increase in the duration of the marriage, and a positive body image. However, there was an inverse relationship between the experience of childhood sexual abuse and sexual self-esteem. Conclusions: The findings revealed that sexual self-esteem in women is influenced by background, intrapersonal, and interpersonal factors that should be approached in education, counseling, and therapy.

Approaches and styles of mothers in sex education process of children and the related factors.

INTRODUCTION: Sex education supports the development of suitable sexual behaviors in children. However, due to the limitations of sexual issues in Iran, parents may have different sex education styles. This study aimed to assess the styles of mothers in the sex education process of children and the related factors. METHODS: In a cross-sectional study, from March to May 2021, 306 mothers with a 4-12-year-old child who were referred to the comprehensive health service centers in Rasht city were entered into the study by a convenience sampling method. The tool was a questionnaire of parents' sex education styles. Data analysis was performed with independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and the multiple linear regression model using SPSS software version 16. RESULTS: The majority of the mothers had a mean age of 36.2 ± 6.4 years. The score of the authoritarian sex education style was significantly higher than the other styles (P < 0.001). According to the multivariate analysis, 40.6% of the changes in the strict style (R2 = 0.406), 32.7% of the changes in the permissive style (R2 = 0.327), and 36.1% of the changes in the authoritative style (R2 = 0.361) were explained by the personal characteristics of the participants. CONCLUSION: The authoritative style was a dominant sex education style. Identifying the factors associated with types of child sex education styles has an important role in promoting the health of children and the community. It is recommended that nursing policymakers identify related factors of sex education styles in mothers of different cultures, and therefore, implement training programs for empowering mothers.

Quality of sleep in women with menopause and its related factors.

Background: Menopausal period is one of the most critical stages of a womans life. Complications of the menopausal period including sleep disorders can affect the physical and mental state of women. As sleep disorder has a determinant role in the quality of life, this study was conducted to evaluate postmenopausal womens quality of sleep and its related factors. Material and Methods: This cross-sectional-analytical study was conducted on 323 postmenopausal women based on convenience and consecutive sampling. The data-gathering tool consisted of two parts; sociodemographic characteristics and the Pittsburgh Sleep Quality Index (PSQI). Data analysis was performed using descriptive and inferential statistical tests at a significance level of p<0.05. Results: Sleep disorder was determined in 49.9% of participants. The mean PSQI score was 5.32 ± 3.881. There was a significant correlation between PSQI and age (ß = 0.29, p < 0.001) indicating that sleep disorder increased with an increase in age. There was a significant correlation between body mass index (ß = 0.599, p < 0.001) and undesired sleep quality. Conclusions: Regarding the presence of sleep disorder in almost half of the study participants, and the relationship between sleep quality and body mass index and age, it is recommended that decision and policymakers design educational consultation interventions to improve the quality and quantity of sleep in menopause women.

Factors associated with the reproductive health of women living with HIV in Iran.

BACKGROUND: Insight on reproductive health status in women living with HIV is associated with improved psychological well-being, health behaviors, and physical wellness. The overall aim of this paper is to gain insight into the reproductive health of women living with HIV and related factors. METHOD: An analytical cross-sectional study was carried on women living with HIV (N = 112) attending high-risk behavior consultation centers in Rasht and Tehran, Iran. The sampling of respondents was in the form of consecutive and available. The data gathering including questionnaires that were divided into three parts: sociodemographic and health characteristics, reproductive behaviors information, and reproductive health assessment tool for women living with HIV. RESULT: The sub-dimension of responsible behavior received the highest total mean score (54.27 ± 22.18). The mean scores in the sub-dimension of coping with the diagnosis, life instability, disease disclosure, disease-related concerns, and support needs for self-care were 50.14, 49.23, 44.27, 40.08, 38.25, and 33.25 respectively. CONCLUSION: The results clearly showed that the reproductive health situation of women living with HIV needs particular attention. Strategic planning and context-specific interventions are needed to improve women's access and utilization of reproductive health services.

Relationship between Primigravid women's awareness, attitude, fear of childbirth, and mode of delivery preference.

INTRODUCTION: Fear of childbirth is the main factor, which has decreased the tendency toward selecting natural birth. The immoderate increase in the number of C-sections has increased maternal and neonatal morbidity and mortality. The present study investigates the relationship between awareness, attitude, fear of childbirth, and mode of delivery preference in Primigravid women referring to healthcare centers in Khorramabad, Iran. METHOD: In this descriptive-analytic study, 179 nulliparous pregnant women with the gestational age of> 2,0 weeks who visited selected healthcare centers in Khorramabad for routine pregnancy care in 2020 were selected in two stages and studied. The data were collected via the childbirth attitude questionnaire (CAQ), awareness, attitude, demographic characteristics, current pregnancy characteristics, midwifery history, and history of infertility treatment questionnaires. The data were analyzed via the Chi-squared test. RESULTS: The participants had a mean gestational age of 33.73 ± 4.71 weeks. There was a significant different between the level of awareness, and mode of delivery preference (p = 0.005). The majority of the participants (57.5%) had a moderate level of awareness about the mode of delivery. There was a significant different between the level of, attitude, and mode of delivery preference (p = 0.001).) Most of the participants (71.5%) had a negative attitude towards the mode of delivery. There was also a significant different between fear of childbirth and mode of delivery preference (p < 0.001), and most of the participants (71.5%) showed fear of childbirth. CONCLUSION: According to the results of this study, the majority of participants had afraid of childbirth, moderate awareness of mode of delivery, and negative attitudes. So, the healthcare providers should pay special attention to the fear of childbirth and the relevant factors during pregnancy.

Exploring the Structure of a School-Based Sexual and Reproductive Health Education Program: A Qualitative Study.

OBJECTIVE: Training programs on sexual and reproductive health rank among the most effective strategies to empower individuals and engage in self-care in this field. This study aimed to explore the structure of a school-based sexual and reproductive health education program. METHODS: A qualitative, inductive, content-analysis approach was used in this study. Participants were selected through a purposeful sampling method. Data were collected through individual in-depth interviews with 21 students; 7 key informants; and 3 focus group discussions with parents. Interviews were recorded and transcribed into text manually. Data analysis was carried out using the content analysis method and the MAXQDA11 software. RESULTS: Three categories of health services emerged from the analysis of participant experiences: 1) empowerment-based education model; 2) optimal educational characteristics; and 3) adolescent-friendly sexual and reproductive health services. CONCLUSIONS: The study found that sexual and reproductive health education programs for adolescent girls should be based on empowerment, desirable educational characteristics, and adolescent-friendly mechanisms.

Mother-infant relationship and its Predictors.

OBJECTIVE: Creating attachment between mother and infant is an extremely sensitive process in the postpartum period. In this regard, understanding the predictive features of the mother-infant relationship (MIR) can help health care providers in designing and implementing MIR enhancement interventions. Therefore, we ran this study to determine the degree of attachment between mother and infant and its predictors. METHODS: This was a cross-sectional study on 406 mothers referred to comprehensive healthcare centers in Rasht. We used the multi-stage cluster random sampling. Our data collection tools included: a data collection form to determine the predictors of maternal and infant attachment, which was designed by researchers and the standard MIRscale. The significance level of the test was considered less than 5%. RESULTS: The mean MIR score was 12.7±8.1. The highest score of attachment between mother and infant was in the area of risk of infant harassment and the lowest score was in the field of the mother-infant bond. The results of the logistic regression test showed that the MIR scores were statistically significant with spouse age, spouse education, number of deliveries, and breastfeeding problems (p<0.05). CONCLUSIONS: The findings showed that there was a significant relationship between MIR and spouse age, spouse education, number of deliveries, and breastfeeding problems. Therefore, attention to these issues should be considered in planning to improve the MIR.

Tool for the assessment spiritual care after the COVID-19 pandemic: a sequential exploratory study.

Background: The present study aimed to develop a tool to assess spiritual care after the COVID-19 Pandemic. Materials and methods: This study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative phase, through 14 in-depth semi-structured individual interviews with clerics, specialists in Islamic jurisprudence and principles, specialists in education and health promotion, and using the content analysis approach, tool items were designed. Purposeful sampling was performed with maximum diversity of experts and enthusiasts in the field of spiritual health. Results: Content analysis of the data obtained from interviews led to explaining the concept of spiritual care after the COVID-19 Pandemic in four main themes: spiritual care needs, spiritual care characteristics, outcomes of spiritual care, and the challenge of providing spiritual care. The average content validity index of the tool was 0.94. Exploratory factor analysis showed 4 factors that explained more than 62.83% of the variance. The correlation of spiritual cares scale score for COVID-19 Pandemic with spiritual care tool was (0.86, p <0.001). Conclusion: Spiritual care tool is a valid and reliable tool, with 38 items to assess the spiritual care after the COVID-19 Pandemic.

The effect of mobile-based training on maternal breastfeeding self-efficacy: a randomized clinical trial.

Background: The Aim of this study is to determine the effect of mobile-based training on maternal breastfeeding self-efficacy. Materials and Methods: This trial was conducted from November May to December 2020 on 198 women referring to healthcare centers in Guilan, Iran. The samples of this study were selected using the convenience sampling method, and random block sampling was used for the allocation of groups. The data collection tool was a two-part questionnaire including questions about demographic data and Dennis's self-efficacy. The questionnaires were completed before and 8 weeks after the intervention in both groups. Results: The mean and standard deviation of self-efficacy before the education in the experiment and control group were 48.26+ 6.49 and 49.11 + 7.36, respectively. After the education, the experimental group was 53.78 + 12.61 and control group was 41.90 + 17.98. The difference between the pretest and posttest scores indicated that the breastfeeding educational intervention increased the women's self-efficacy in breastfeeding (p<0/001). Conclusion: The results showed that mobile-based training could improve maternal breastfeeding self-efficacy. It is therefore recommended, this training program as an available and convenient method to improve breastfeeding self-efficacy.

Determinants of maternal role adaptation in mothers with preterm neonates.

OBJECTIVE: Becoming a mother is an innate process, without any culture-dependent instruction. While it is a pleasant experience, it can sometimes be associated with problems resulted from baby caring. Preterm birth can be a challenge for the maternal role adaptation (MRA). Therefore, the present study was conducted to determine the maternal role adaptation in mothers with preterm neonates. METHODS: The present study is cross-sectional, with a sample including 114 mothers of preterm infants in the NICU. We collected the data using a two-section questionnaire. The first section was a demographic questionnaire and the second section was a standardized questionnaire? "Maternal role adaptation scale in mothers with preterm neonates admitted to neonatal intensive care units" (MRAS: NICU). We ran the statistical analysis using descriptive and inferential statistical methods with the SPSS 21 software. RESULTS: The total MRA score was strong in half of the participants. The participants had a university education, were employed and satisfied with their economic status, and had a high score on adaptation to the maternal role. There are different domains to the MRA, the highest score was allocated to the participation in care (56.24±0.13), and the lowest score was allocated to growth and development (3.12±0.28). CONCLUSIONS: According to the results of this study, the most important factors associated with MRA are the mother's age, education, and economic satisfaction. Determining the factors related to the mothers' adoption of premature infants could increase the ability of mothers to cope with problems and negative emotions, and enhance the adoption of maternal roles.

Sexual self-efficacy and its related factors among married women of reproductive age.

Sexual self-efficacy (SSE) has also been cited as an important factor for healthy and satisfying sex. The purpose of this study was to determine SSE and its related factors among married women of reproductive age. The present study is a cross-sectional, descriptive-analytical study. The research samples were 588 married women of reproductive age. A cluster sampling method is used to select participants. Data collection instruments were the socio-demographic form and the Sexual Self-Efficacy Scale-Female Functioning (SSES-F). Data analysis, Friedman, Multiple Linear Regression was performed through SPSS software version 16. The highest and lowest score was related to body acceptance (77.78) and communication (69.66), respectively. The results showed that age (B= 0.471, P<0.001), marital satisfaction (B= 0.11.3, P<0.001), life satisfaction (B= 3.5, P<0.03) and the economic-social welfare satisfaction were related to SSE. We've found that Women with a higher Education, Employment, higher income, and Younger husbands had the highest SSE score. The components of age, marital satisfaction, life satisfaction, and economic status affect the SSE of married women of reproductive age. The results of this study can be useful in the design and implementation of sexual health promotion interventions.

Effects of lifestyle on sexual function among postmenopausal women.

Background: A healthy lifestyle has a key role in reducing health problems. Since one of the most common problems in Postmenopausal women has been sexual dysfunction (SD). The specific purpose of the present study was to identify the effects of health-promoting lifestyle (HPL) on sexual function among postmenopausal women. Methods: The present cross-sectional, descriptive, and analytical study was conducted on 405 Postmenopausal women aged 45-60 years, using the convenience sampling method.Data collection was done using three questionnaires of demographic, health-promoting lifestyle profile-II (HPLP-II) and female sexual function index (FSFI). Data were analyzed in the SPSS-16 using Pearson's correlation coefficient. The statistical significance level was regarded as less than 0.05. Results: In general, the result of this study identified a 68% prevalence of SD among participants. The mean score obtained from the HPLP II was 2.27 (SD = 0.42), the highest score of its sub-scales was spiritual growth and the lowest score was physical activity.The mean score of FSFI among the studied women was 23.16 (SD = 0.29), the highest score of six sub-scales was satisfaction and the lowest score was lubrication among participants. A strong correlation was found between the total FSFI scores, and spiritual growth (r=0.048), interpersonal relations (r=0.02), stress management (r=0.000), (p<0.0001). Conclusion: The results of the study revealed that a healthy lifestyle affects sexual function. Given that a healthy lifestyle is one of the most important ways to help women overcome SD, a healthy lifestyle promoting interventions necessary for Postmenopausal women.

Participatory Action Research Approach to improve Adolescent Girls' Reproductive Health.

OBJECTIVE: School-based reproductive health education programs (RHEP) motivate adolescent girls to maintain and improve their health, and prevent diseases. The purpose of this PAR was to design, implement and evaluate RHEP to strengthen adolescent girl's reproductive health. METHODS: The PAR process was selected as an RHEP strategy, and it has four main phases, including: 1) assessment to explore the reproductive health education needs (RHEN) of adolescent girls. We collected data through in-depth individual interviews with 11 adolescent girls (12-18 years) in high school, 2 focus group discussions (FGD), and 4 interviews with the key informants. 2) Intervention design involved a Delphi approach to design an intervention that would address each need using 7 expert participants with a background in primary health, health promotion and other youth-focused professions. 3) In the action plan phase, the workshops, lecture meetings, counseling, and FGD were organized by the research team. 4) The impact of the intervention was evaluated through a mixed evaluation methodology, a semi-structured interviews with stakeholders and key informant, quasi-experimental assessment and FGD. RESULTS: There were three themes we extracted from the data: (a) the need for RHP for adolescent girls, (b) sources of information about RH, and (c) the need to empower teachers to provide RHEP to their students. a) Workshops, (b Counseling, c) Lecture Meetings, d) Focus Group. The study showed that the level of knowledge about RH in more than half of the participants was poor and only in nearly half of them it was moderate. CONCLUSION: Results suggest that Iranian adolescents do not have adequate education regarding RH, and RHEP by PAR can be effective in improving the knowledge and behavior of female students.

Do Chamomile effect on duration, amount of bleeding, and interval of menstrual cycles?

OBJECTIVES: Heavy menstrual bleeding has a significant effect on women's daily life and health consequences for theirs. Attention to women's and girls' menstrual health is critical for their health. This study presents the results of a novel research on the effect of chamomile capsule on the amount of bleeding, and the duration and interval of menstrual cycles. METHODS: The current study was a randomized, double-blind, clinical trial, which was carried out on 118 female students living in dorms of Guilan University of Medical Sciences. The participants were divided into two groups of 59, each receiving either chamomile capsule 250 mg or placebo three times a day, for an interval beginning from 7 days before the starting menstruation till the next onset. Higham chart is the pictorial blood loss assessment to determine the amount and duration of menstrual bleeding. Data were analyzed using SPSS version 20. Alpha was set at 0.05 for all analyses. RESULTS: The average amount of bleeding in the chamomile group decreased after taking the capsule (p = 0.001). However, statistical tests did not show any significant difference in terms of duration and interval between two bleeding in both the experimental and control groups (p > 0.05). CONCLUSION: The present study showed that the chamomile capsule decreases the amount of menstrual bleeding and can be used as a therapeutic method.

The importance of depression during pregnancy.

OBJECTIVE: Today, the high prevalence of depression is one of the major health problems of pregnant women. This study aimed to assess the relationship between antenatal depression, pregnancy and neonatal outcomes. METHODS: This cohort study involved 394 pregnant women referred to the prenatal care clinic at the Al- Zahra Hospital, affiliated to Guilan University of Medical Sciences, Iran. We used a convenient method for sampling. We collected data using questionnaires on demographic and obstetric characteristics, the CES-D scale for depression evaluation and a checklist for recording pregnancy outcomes. RESULTS: According to the results, preeclampsia, premature membrane rupture, preterm delivery, cesarean section, intrauterine fetal death, and intrauterine fetal growth restriction were higher among mothers with depression during their pregnancies, compared to those who did not have depression. In addition, the mean birth weights of depressed mothers' infants were lower than the infants of mothers who did not have depression. CONCLUSION: Results from the present study showed that depression during pregnancy is associated with pregnancy and neonatal outcomes. Healthcare planners and mental health counselors should regard screening mothers with risk of depression and following them up and, in the necessary cases, referring to psychiatrists.

Female adolescent health needs and determinants.

OBJECTIVE: Adolescence is a critical developmental period with characteristic health risks and needs. Assessing adolescent health needs helps to improve the planning and implementation of effective interventions. This study aimed to describe the health needs and determinants of female adolescents. METHODS: This analytical descriptive study included 850 female students. The sampling method was multistage cluster sampling. Data were collected from a questionnaire consisting of two parts, the first probing into socio-demographic matters and the second into respondent health needs. Data analysis was performed via the Mann-Whitney and Kruskal-Wallis tests, and Mann-Whitney, Kruskal-Wallis, and Pearson correlation coefficients. RESULTS: The results showed that individuals attending private high schools not living with their parents had higher health needs than other students. Students with older fathers - particularly fathers aged 50+ years - had increased health needs. Psycho-emotional care topped the list of health needs, whereas services in the field of spiritual belief were in last place. CONCLUSION: Our study found that the most important factors related to healthcare needs were level of education, type of school (private vs. public), and living with parents. The results of this study can be useful in designing and implementing interventions to prevent high-risk behaviors and promote adolescent health.

The impact of menopause on sexual function in women and their spouses.

BACKGROUND: The purpose of this study is to evaluate the impact of menopause on sexual function in women and their spouses. METHODS: This is a cross-sectional study that was conducted from January 2018 to May 2019 in Rasht (North of Iran). The participants included 215 menopausal women and their spouses. Data were collected using the demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and the International Index of Erectile Function (IIEF) questionnaire. RESULTS: On the basis of the FSFI and IIEF scores, 36.28% (78/215) women reported female sexual dysfunction (FSD) and 17.2% (37/215) men reported erectile dysfunction (ED) with 8.37% (N = 18) being mild, 5.58% (N = 12) mild to moderate, and 3.25% (N = 7) moderate ED. After adjusting differences in the female age distribution, the total score and scores of the IIEF subscales were also not significantly lower in the spouses of women with FSD than women without FSD. CONCLUSION: Although, significant correlations between male erectile function and menopausal female sexual function have not identified; but, low scores of the subscales of FSFI in female participants mostly impaired sexual satisfaction and overall satisfaction in their spouses.