Association of dietary inflammatory index with C-reactive protein and interleukin-6 in women with and without polycystic ovarian syndrome.

Considering that interventions related to lifestyle, especially nutrition have been proposed as the first line of prevention and treatment of polycystic ovarian syndrome (PCOS), and regarding the proven relationship between PCOS and inflammation, the present study was designed to find out the possible association of Diet Inflammatory Index (DII) with the inflammatory markers like C-reactive protein (CRP) and Interleukin-6 (IL-6), and compare the obtained results in PCOS and non-PCOS women. This case-control study was conducted on 45 PCOS and 40 non-PCOS women. Food intake and DII were measured using a 147-item Food Frequency Questionnaire. All participants were tested for the serum levels of IL-6 and CRP. Finally, the obtained results were compared between the two groups of PCOS and non-PCOS women. Significant differences were observed between the two groups in terms of age, menstrual status and number of pregnancies (P < 0.05). Comparison of DII values showed no significant difference between the two groups of women (P = 0.68), but IL-6 was significantly higher in the PCOS group than in the control group (4.94 ± 1.97 vs. 3.48 ± 1.77, P < 0.001). Also in terms of CRP, no significant difference was observed between the two groups (P > 0.05). The difference of DII between the case and control groups were not significant and Pearson's correlation test did not show a significant correlation between DII and IL-6 (P˃0.05). This result can be due to the influence of several factors affecting the determination of DII such as education level, health status, physical activity level, age, and calorie intake. It seems that diet, especially consumption of more carbohydrates plays a role in causing chronic inflammation, as well as the occurrence and exacerbation of PCOS.

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

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

The relationship between coping strategies with sexual satisfaction and sexual intimacy in women with multiple sclerosis.

BACKGROUND: Multiple sclerosis profoundly affects the sexual aspects of patients' life, especially in women. Various coping strategies are used by women with multiple sclerosis to overcome, tolerate, or minimize these sexual effects. The present study aimed to assess the relationship between sexual satisfaction, sexual intimacy, and coping strategies in women with multiple sclerosis. METHODS: This cross-sectional study was performed on a sample of 122 married women who were members of Iran's MS society in Tehran, Iran. The study was conducted from December 2018 to September 2019. Data were collected using the Index of Sexual Satisfaction (ISS), the Sexual Intimacy Questionnaire (SIQ), and the Folkman and Lazarus Coping Strategies Questionnaire. Frequency, percentage, mean and standard deviation were used to explore the observations. Independent t-test and logistic regression were applied to analyze the data using the SPSS-23. RESULTS: The majority (n = 71, 58.2%) used an emotion-focused coping strategy with the highest score for the escape-avoidance subscale [mean (SD): 13.29 (5.40)]. However, 41.8% of the patients (n = 51) used a problem-focused coping strategy with the highest score for the positive reappraisal strategy subscale [mean (SD): 10.50 (4.96)]. The sexual satisfaction in women with problem-focused coping strategies was significantly higher than women who used emotion-focused coping strategies (95.6 vs. 84.71, P-value = 0.001). There was a negative association between sexual intimacy and higher emotion-focused coping strategy (OR = 0.919, 95% CI 0.872-0.968, P = 0.001). CONCLUSIONS: Problem-focused coping strategy in women with multiple sclerosis increases sexual satisfaction, while the emotion-focused coping strategy has a significant negative relationship with sexual intimacy.

Application of a Risk Management Program Based on the Health Belief Model for Preventing Home Accidents.

Background: Accidents are the main cause of mortality in children aged less than 5 years throughout the world. The present study was conducted to empower mothers with children aged less than 5 years in preventing home accidents through the implementation of a risk management training program based on the Health Belief Model (HBM). Materials and Methods: The present pretest-posttest, quasi-experimental study was conducted on 70 mothers with children aged less than 5 years who referred to Community Health Centers of Shahid Beheshti University of Medical Sciences, Iran, in 2019. The subjects were selected through multistage random sampling and were randomly assigned to intervention (n = 35) and control (n = 35) groups. The data were collected using a two-part questionnaire for demographic characteristics and HBM constructs before, immediately after, and 45 days after the implementation of the risk management training program at a significance level of <0.05. Results: No significant difference was observed between the two groups before the intervention in terms of HBM constructs (p>0.05). However, they significantly differed between the intervention and control groups after the intervention. Moreover, scores of HBM constructs were significantly different immediately and 45 days after the intervention (p <.05). Conclusions: The study results showed the effectiveness of the HBM-based risk management training program; thus, it is essential to design and implement such programs in community health centers to prevent and reduce injuries caused due to home domestic accidents.

Sexual function among women with vaginismus: a biopsychosocial approach.

BACKGROUND: Vaginismus is known as a type of sexual pain disorder. Regarding the multifactorial nature of vaginismus, the biopsychosocial model is one of the best models to describe this sexual disorder. AIM: The present research was conducted to study the determinants of sexual function in women with and without vaginismus based on the biopsychosocial model. METHODS: This case-control study was conducted in Iran on 420 women with and without primary vaginismus who met the inclusion criteria. All eligible people were included in the research once their eligibility was verified and their informed permission was acquired; convenience and purposive sampling techniques were used continually. Data collection tools included the demographic and obstetric information form and multiple published scales and questionnaires. Structural equation modeling with LISREL 9.2 software (Scientific Software International) was used to evaluate the determinants of the sexual function of vaginismus. OUTCOMES: Participants rated their determinants of sexual function based on the biopsychosocial model. RESULTS: The mean ages of the case and control groups were 27.67 and 28.44 years, respectively. The direct, indirect, and total effects of the dimensions of sexual health on sexual function and the diagnostic score of vaginismus of the women with vaginismus were significant (P < .001). Furthermore, based on the results, the diagnostic score of vaginismus in women with vaginismus was significantly affected by the direct, indirect, and cumulative impacts of vaginal penetration cognition and fear of sex (P = .016, P = .005). Women with and without vaginismus were able to accept the models' excellent fit. CLINICAL IMPLICATIONS: This study helps inform health planners and policy makers about the sexual function of women with vaginismus, the factors related to this disorder, and the multidimensional nature of this sexual problem. STRENGTHS AND LIMITATIONS: This study attempted to offer a more comprehensive and complete view of present knowledge via surveying different aspects of sexual health and by means of valid and reliable tools and path analysis. The study's merits include the use of the biopsychosocial model to evaluate sexual function in women with vaginismus, the use of a variety of questionnaires to compare women with and without vaginismus, and the size of the sample. The research was limited by the fact that electronic sampling was conducted because of the COVID-19 epidemic. CONCLUSION: Based on the findings of the present study for the group of women with vaginismus, the direct, indirect, and overall effects of the majority of dimensions of sexual health were significantly correlated with sexual function and vaginismus.

Relieving care burden and promoting health-related quality of life for family caregivers of elderly people with Alzheimer's disease via an empowerment program.

BACKGROUND: Effective strategies should be adopted to reduce care burden (CB) and improve health-related quality of life (HRQoL) in family caregivers (FCGs) of elderly people with Alzheimer's disease (AD). Therefore, the purpose of this study was to determine the impact of empowerment program (EP) on CB and HRQoL of FCGs. METHODS: The present two-group experimental study was conducted on 70 FCGs of the elderly with AD who were selected by convenience sampling and randomly assigned to the empowerment program group (EPG, n = 35) and control group (CG, n = 35). Data collection tools were 12-item Short Form Health Survey and Zarit Burden Interview. The EP was held for 5 weeks, one session of 20 to 30 min each week. Data were collected before, immediately and 3 months after EP and analyzed by SPSS version 25 software at a significance level of 0.05. RESULTS: The results showed a significant decrease in the mean CB score in FCGs of elderly with AD in EPG before, immediately and 3 months after EP (p < 0.001). The result also revealed that there was a significant increase in the mean HRQoL score in EPG immediately and 3 months after EP (p < 0.001). CONCLUSIONS: According to the results of this study, EP can reduce CB and increase HRQoL in FCGs of elderly with AD. Policymakers and planners active in the field of healthcare for the elderly can benefit from the results of our study to improve the health of FCGs of the elderly with AD.

Reducing care burden and improving adherence to health-promoting behaviors among family caregivers of patients with multiple sclerosis through a healthy lifestyle empowerment program.

BACKGROUND AND AIM: The chronic, progressive nature of multiple sclerosis (MS) demands long-term family-centered care for patients. In view of that, inadequate education and support provided for the family caregivers (FCGs) of MS patients increase their care burden (CB) and affect their lifestyle. This study aimed to investigate the impact of a healthy lifestyle empowerment program (HLEP) on CB and adherence to health-promoting behaviors (HPBs) in the FCGs of patients suffering from MS. METHODS: In this experimental study with parallel groups, conducted in Iran in 2020, a total of 60 FCGs of MS patients were recruited, and then randomized into intervention (n = 30) or control (n = 30) groups. The intervention program, the HLEP, was thus implemented virtually via WhatsApp in the intervention group upon coordinating with the MS Association in the city of Yasuj, Iran, and selecting the participants. The data were collected at three stages, including baseline, follow-up 1 (immediately after the HLEP), and follow-up 2 (three months after HLEP). The research tools were a 14-item demographic survey questionnaire, the 24-item Caregiver Burden Inventory, and the 52-item Health-Promoting Lifestyle Profile-II. Independent-samples t-test, repeated measures analysis of variance, and a linear mixed model were further used for statistical analyses, considering the significant level of 0.05. RESULTS: The study results revealed a significant decrease in the CB scores from the baseline to the follow-up 2 (77.03 ± 15.76 to 42.33 ± 12.37), and a significant increase in the values of adherence to HPBs from the baseline to the follow-up 2 (123.53 ± 14.01 to 148.06 ± 15.04) were obtained in the intervention group (p < 0.001). The linear mixed model also showed that the significant absolute changes in the scores of CB and adherence to HPBs during the follow-ups in the intervention group, compared to those in the controls, were - 8.92 and 16.47 units, respectively (p < 0.001). CONCLUSION: Health care managers, planners, and providers are highly recommended to start developing and implementing various HLEPs for reducing CB and improving adherence to HPBs among the FCGs of patients with MS.

The impact of the evaluations made by Mini-CEX on the clinical competency of nursing students.

INTRODUCTION: Clinical competency is defined as one's capabilities in terms of knowledge, attitude and practice, and is a necessity for nursing practice. Evaluation is the inseparable part of the education process, without which the quality of education could not be measured. Considering the characteristics of clinical education and its impact on the clinical competency of students, as well as the importance of making precise evaluations of them using scientific, modern and efficient approaches, this study aims to investigate the impact of the evaluation made using Mini-Clinical Evaluation Exercise on the clinical competency of the nursing students of the School of Nursing and Midwifery Shahid Behesti University. METHODS: This is a quasi-experimental study with a control group conducted on students who were taking courses "Nursing care for a sick child". The students were classified into the intervention and control groups using complete enumeration. The evaluations were made using Mini-Clinical Evaluation Exercise in the intervention group and the portfolio approach in the control group. The skills regarding patient (mother-child) education, IV therapy and medication were evaluated by checklists. FINDINGS: The results showed that the mean score of clinical competency in the intervention group was significantly higher than that of the control group. CONCLUSION: Considering the improvement of clinical competency in the intervention group, it is recommended to use Mini-Clinical Evaluation Exercise for the evaluation of students.

Predictors of Perceived Family Sense of Coherence in Parents of Children with Cancer.

Objectives: Despite improvement in childhood cancer survival in recent decades, it is still an extremely challenging health condition for parents. The impacts of childhood cancer on the family as a whole are recently interested by researchers. Family coherence is one of these concepts and health-care providers need to understand the perception of parents of family coherence. This study aimed to assess the correlation between perceived family sense of coherence (SOC) in parents of children with cancer; with socio-demographic, psycho-emotional and family-related variables. Materials and Methods: This cross-sectional correlational study recruited 125 parents of children with cancer attending hospitals in Tehran in 2020, selected by convenience sampling method. The correlation between family SOC and demographic variables, chronic sorrow, coping behaviours, family functioning and social support was investigated using regression analysis. Results: The mean score perceived sense of family coherence in parents of children with cancer was higher in fathers (Beta = 0.17, P = 0.02), urban residents (beta = -0.2, P = 0.01) and homeowners (beta = -0.27, P = 0.001). The sense of family coherence had positive correlations with income grade (beta = 0.27, P = 0.006), coping behaviours (beta = 1.28, P = 0.002), social support (beta = 0.67, P = 0.001), negative correlations with the disturbance in family problem-solving (beta = -0.28, P = 0.006) and chronic sorrow (beta=-0.39, P = 0.001). Conclusion: The present study expanded the concept of family SOC in nursing knowledge and attracted the attention of the providers of family-centred care to the parents of children with cancer and their concerns, which directly and indirectly affect the entire family's health.

Educating fathers to improve exclusive breastfeeding practices: a randomized controlled trial.

BACKGROUND: Fathers' involvement is crucial for promoting breastfeeding. There are a few studies on the effectiveness of fathers' educational programs to promote exclusive breastfeeding. This study aims to assess the effectiveness of a fathers' educational program on their support for breastfeeding, mothers' breastfeeding practice, and exclusive breastfeeding status. METHODS: This was a randomized controlled trial on 76 fathers who were randomly assigned to two groups of intervention and control, in a selected health center in Iran, 2018. The tools for data collection were: 1) a questionnaire for "Demographic and Maternal-Infant Information"; 2) a questionnaire to assess "Fathers' support for Breastfeeding", and 3) an observational checklist to assess "Mothers' Breastfeeding Practice"; and 4) a questionnaire to assess "Exclusive Breastfeeding Status". The questionnaires were filled up through an interview. The checklist was completed through observation by the researcher. The fathers (with the mothers) of the intervention group were educated using individual face-to-face education and counseling, in two sessions, with the duration of about 40 min and one-week interval, whereas, the fathers of the control group did not receive any education and only mothers were educated with the same instruction. The content of the education was: fathers' education about "benefits of breast milk" and "the supporting ways for breastfeeding including the women encouragement". Then, the scores of "father's support for breastfeeding", "mothers' breastfeeding practice" and "exclusive breastfeeding status" were compared before and after 4 months of intervention in each group, and also between groups. Data were analyzed using SPPS-23, and t- and paired-tests, Chi-square, and Generalized-Estimating-Equations (GEE) tests. RESULTS: The results showed two groups were not significantly different regarding the demographic and any other possible confounding variables before the intervention (P < 0.05). The before and after comparisons also demonstrated significant improvements in the two variables including "father's support for breastfeeding", and "mothers' breastfeeding practice after 4 months, in the intervention group (Paired t-test: P<0.001 and P<0.0001, respectively) however, there was a significant decrease in "father's support for breastfeeding" and no improvement in "mothers' breastfeeding practice" after 4 months in the control group (Paired t-test: P < 0.001 and P = 0.07, respectively). Between groups comparison showed also significant higher scores for "father's support for breastfeeding", "mothers' breastfeeding practice" and "exclusive breastfeeding status" in the intervention group comparing to the control group, after 4 months (T-test: P < 0.001 and P < 0.0001; Chi2: P < 0.001, respectively). The interaction effects of time and group were significant in the GEE test for the fathers' support for breastfeeding (B-group = 31.93, B-time = 22.15, p < 0.001) and mothers' breastfeeding practice (B-group = 26.32, B-time = 12.86, p < 0.0). CONCLUSION: The results showed that the father's education improves mothers' breastfeeding practice and increases the rate and continuity of exclusive breastfeeding. TRIAL REGISTRATION: IRCT201508248801N10. "31/08/2016".

The effect of PLISSIT based counseling model on sexual function, quality of life, and sexual distress in women surviving breast cancer: a single-group pretest-posttest trial.

BACKGROUND: Diagnosis and treatment of breast cancer potentially leads to sexual dysfunction and sexual distress in women and negatively affects their quality of life (QoL). This study aimed at determining the effect of PLISSIT based counseling on sexual function, sexual distress, and QoL in women surviving breast cancer. METHODS: In this pre-test, post-test, single-group semi-experimental study, 65 women surviving breast cancer who were referred to the selected centers were included in the study via the available sampling method. Data gathering tools included a researcher-made demographic questionnaire, female sexual function index, beck depression inventory-II, State-Trait Anxiety Inventory, World Health Organization QoL-Brief, and Female Sexual Distress Scale-Revised. The counseling program (7 sessions 60 min each) was designed based on the PLISSIT model. The sexual function, sexual distress, and QoL were evaluated before, and 2 and 4 weeks after the intervention. To compare the mean scores of variables before and after the intervention, repeated-measured ANOVA was used. RESULTS: The findings showed that PLISSIT based counseling significantly reduced sexual distress and increased the scores of QoL and all its domains, as well as sexual function and all its domains in women surviving breast cancer (p < 0.05). There was no significant difference in the mean scores of variables 2 and 4 weeks after the intervention. CONCLUSIONS: It seems that PLISSIT based counseling reduces sexual dysfunction and sexual distress and improves the QoL of women surviving breast cancer. So, it is recommended that these counseling programs be integrated into the health care program of this group of women. TRIAL REGISTRATION: TCTR202103170010, 17 March 2021, Retrospectively registered, at https://www.thaiclinicaltrials.org/ .

Bio-psychosocial factor of vaginismus in Iranian women.

BACKGROUND AND AIM: Various physical, psychological, social and cultural factors contribute to vaginismus. Therefore, given the multidimensionality of this disorder and the need to pay more attention to all biological, psychological and social dimensions in its treatment, the present study was conducted to investigate the bio-psychological factors contributing to vaginismus. METHODS: This descriptive cross-sectional study was conducted on 180 Iranian women with vaginismus who had been referred to sexual health clinics of Tehran province in 2020. Multistage random sampling method was used in this study, and vaginismus was diagnosed in women by a specialist through using a questionnaire. Data collection tools included demographic and obstetric information form, valid and reliable Sexual Function Questionnaire, Depression Anxiety Stress Scales (DASS), Sex Fear Questionnaire, Vaginal Penetration Cognition Questionnaire, Sexual Self-Efficacy Scale, Sexual Knowledge and Attitude Scale, Sexual Quality of Life-Female, Inventory of Sexual Satisfaction, ENRICH Marital Satisfaction Scale, Sexual Intimacy Scale and Questionnaire for Diagnosis of Vaginismus. In order to determine the factors related to vaginismus, multiple linear regression model was used through SPSS software version 25 (SPSS Inc., Chicago, IL). RESULTS: Based on the results of the present study, the mean age of women and the mean duration of their marriage were 27.77 ± 5.36 and 4.07 ± 3.87 years respectively. As the results of multiple linear regression revealed, the variables of fear of sex (B = 0.141, P = 0.036), positive cognition (B = 0.197, P = 0.046), self-image (B = 0.651, P = 0.001), sexual intimacy (B = -0.116, P = 0.021), quality of sexual life (B = 0.115, P = 0.002) and education (B = 2.129, P = 0.024) from the bio-psychosocial model were the final predictors of vaginismus diagnosis score in women with this disorder. According to the results of multiple linear regression, 45.5% of the variance of vaginismus diagnosis total score was explained by these variables (R = 0.706, R2 = 0.498 and ADJ.R2 = 0.455). CONCLUSION: The results of the present study showed that the variables of fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education were the final predictors of vaginismus diagnosis score. This disorder is, thus, considered to be multidimensional.

As a sexual dysfunction, Vaginismus prevents sexual penetration through involuntary and frequent spasms of the muscles in the one-third of vagina's outer part. Factors such as negative beliefs about sex, cultural factors, fear of pain, injury, bleeding and so forth play significant roles in the prediction of vaginismus. Therefore, given the multidimensionality of vaginismus and the need to pay attention to all biological, psychological and social dimensions in treating it, and since the bio-psychosocial model is a strong framework for the factors contributing to sexual problems whose recognition will lead to the design of multidimensional treatments, the present study was conducted on 180 Iranian women with vaginismus to investigate the bio-psychological factors associated with vaginismus. The present study showed that the fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education from the bio-psychosocial model were the final predictors of vaginismus diagnosis score. Therefore, this model can be used in designing interventions for the treatment of vaginismus, especially in the psychological and interpersonal domains.

Sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause: a comparative study.

Sexual self-efficacy is essential for appropriate and desirable sexual function and sexual quality of life. This study aimed to compare sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause. This was a cross-sectional study of a sample of Iranian women. The sexual quality of life-female (SQOL-F) scale was used to measure sexual quality of life (SQOL) and sexual self-efficacy (SSE) was measured using the sexual self-efficacy questionnaire (SSEQ). Data were compared between the study groups using multiple linear regression. In all 340 women (170 in reproductive-menopausal transition stages and 170 postmenopause) were studied. The mean ages of reproductive-menopausal transition stages and postmenopausal women was 30.8 ± 6.55 and 56.3 ± 3.54 respectively (P < 0.001). Sexual self-efficacy and sexual quality of life were found to be significantly higher in reproductive-menopausal transition stages compared with postmenopause women (P < 0.001 and P = 0.017 respectively). Sexual and relationship satisfaction and sexual repression subscales differed significantly between the two groups (P = 0.001 and P < 0.001 respectively). Higher sexual self-efficacy contributed to higher sexual quality of life (P < 0.0001). Reproductive-menopausal transition stages women appear to enjoy higher levels of sexual self-efficacy and sexual quality of life. Given the importance of sexual quality of life, it is recommended to pay greater attention to sexual self-efficacy among postmenopausal women in order to improve sexual quality of life in this population.

The Effect of Oketani Breast Massage on Successful Breastfeeding, Mothers' Need for Breastfeeding Support, and Breastfeeding Self-Efficacy: an Experimental Study.

BACKGROUND: The negative effects of cesarean section on breastfeeding are a major global concern. PURPOSE: This study aimed to determine the effect of Oketani breast massage on the maternal need for support during breastfeeding, breastfeeding success, and breastfeeding self-efficacy. SETTING: Three hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran, from April to July 2019. STUDY DESIGN: The participants in this experimental study were 113 pregnant women who were candidates for cesarean section. The mothers were selected using convenience sampling and randomly assigned. In addition to routine care, the mothers in the intervention group received Oketani breast massages twice. However, the mothers in the control group received routine care. The data were collected using the Infant Breastfeeding Assessment Tool (IBFAT), LATCH Assessment Score, and the Breastfeeding Self-Efficacy Scale (BSES). The data were analyzed with SPSS 20 software via the independent samples t test, the Mann-Whitney U test, and the chi-square test. RESULTS: The results of the study suggested that the breastfeeding success rate, which was evaluated with IBFAT in both the first two breastfeeding stages and the last pre-discharge breastfeeding, was significantly higher for the mothers in the intervention group (p < .001). In addition, the mother's need for support, which was evaluated with LATCH in the first two breastfeeding stages (p = .044) and the last pre-discharge breastfeeding (p < .001) in the intervention group, was less. The total number of breastfeeding sessions from birth to discharge was higher in the intervention group (p = .002). Furthermore, the mothers in the intervention group breastfed their infants in a significantly shorter time interval (p = .002). Breastfeeding self-efficacy, according to the BSES, was significantly higher in the mothers of the intervention group (p < .001). CONCLUSION: Oketani massage can be used as a care intervention by nurses to improve breastfeeding in mothers who undergo cesarean sections.

Exploring Iranian married working women's experiences regarding sexual health challenges.

BACKGROUND: Considering that the quality of personal life and the quality of sexual life of working women interact with each other and considering that job as one of the dimensions that can play a direct role in the quality of life and also due to increasing women's participation in professional activities in today's society, this study was designed and conducted to explain the experiences of working women considering sexual health challenges. MATERIALS AND METHODS: This research was a qualitative study that the information of which was obtained through face-to-face interviews with semi-structured and open-ended questionnaires. Interviews were conducted with 32 working women working in public and private offices in Tehran, Iran, to explore their experiences of the role of jobs in sexual challenges. The sampling method was purposive. Data analysis was performed using a qualitative content analysis method with a conventional approach by MAXQDA software version 10, and to establish the reliability and validity of findings, Graneheim and Lundman criteria were considered. RESULTS: Data analysis from 32 interviews resulted in the formation of 223 primary inferential codes and 1 main category and 4 subcategories. The results of data analysis were presented in one main category, including sexual health challenges among working women. This main category consisted of four subcategories such as sexual problems due to employment, job harassment, the essential needs for sexual relationship, need for the better job management, and married sex life. CONCLUSIONS: Explaining the experiences of working women showed that sexual problems due to employment and job harassment are among the factors that cause sexual health challenges in working women. It also seems that meeting the essential needs for sexual relationship and the better management of job and married sex life can interact with the sex lives of working women.

Investigating and Comparing the Effect of Teach-Back and Multimedia Teaching Methods on Self-Care in Patients With Diabetic Foot Ulcers.

This study evaluated the effect of teach-back and multimedia teaching methods versus routine care on the self-care of patients with diabetic foot ulcers. Patients receiving either the teach-back or multimedia interventions had greater improvement in self-care scores than those receiving routine care. Both the teach-back and multimedia teaching methods were found to be effective in enhancing the self-care of people with diabetes.

Prevalence of postpartum dyspareunia: A systematic review and meta-analysis.

BACKGROUND: Dyspareunia is one of the most common postpartum sexual dysfunctions. OBJECTIVE: To estimate the prevalence of postpartum dyspareunia. SEARCH STRATEGY: Web of Science, Scopus, PubMed, and Embase databases were searched to July 2019 using keywords including 'perineal pain,' 'dyspareunia,' and 'sexual pain'. SELECTION CRITERIA: Observational studies on the prevalence of postpartum dyspareunia were included. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed articles and extracted data. Study heterogeneity was evaluated by I2 index; publication bias by Egger and Begg tests. MAIN RESULTS: Twenty-two studies enrolling 11 457 women were included. Based on meta-analysis, the overall estimated prevalence of dyspareunia was 35% (95% confidence interval [CI], 29%-41%). The prevalence was 42% (95% CI, 26%-60%) at 2 months, 43% (95% CI, 36%-50%) at 2-6 months, and 22% (95% CI, 15%-29%) at 6-12 months postpartum. Begg test showed no significant bias in data related to the prevalence of postpartum dyspareunia (p = 0.466). CONCLUSION: The prevalence of postpartum dyspareunia was 35% and decreased with increasing postpartum duration. Given the high prevalence and its impact on a woman's quality of life, special attention should be paid to this common complaint during the postpartum period.

Relationship between electronic health literacy, quality of life, and self-efficacy in Tehran, Iran: A community-based study.

BACKGROUND: The concept of electronic health literacy has become a main focus of health-care professionals along with the increasing use of the Internet. In Iran, the Internet not yet has much impact on providing health services, and the physicians' and patients' community are now more willing to use the traditional method for diagnosing disease and prescribing medicines. This study aimed to determine the correlation between electronic health literacy, quality of life (QoL), and self-efficacy among Tehran citizens. MATERIALS AND METHODS: The present study is a descriptive, cross-sectional study with a correlation approach that was conducted on 400 clients of community health centers of Shahid Beheshti University of Medical Sciences in 2019. Samples were selected by stratified random sampling method. Data were collected using E-Health Literacy Questionnaire (α = 0.88), 12-item Short-Form Health Survey (α = 0.73), and General Self-Efficacy Scale (α = 0.87). Analytic statistics were using by descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation coefficient and regression analysis) at the significant level (P < 0.05). RESULTS: Correlation between electronic health literacy and QoL was 0.14 and with self-efficacy was 0.10, which was positive and statistically significant (P < 0.05). In addition, the correlation between QoL and self-efficacy was 0.33, which was positive, statistically significant, and moderate (P < 0.05). CONCLUSION: According to the findings of this study, it is possible to improve the QoL through the promotion of electronic health literacy and self-efficacy. The results of this study can be used as a basis for health service providers and policymakers in designing and implementing health-related interventions.

Effectiveness of emotional intelligence training program on marital satisfaction, sexual quality of life, and psychological well-being of women.

CONTEXT: Emotional communications play an important role in having a satisfying relationship and a more successful marriage. If marriage does not provide suitable conditions to satisfy couple's needs, not only it does not help to mental health but also results in negative and irreversible effects. AIMS: This research was performed with the aim of determining the impact of emotional intelligence training on marital satisfaction, sexual quality of life, and psychological well-being of women. SETTINGS AND DESIGN: The present research is an experimental study conducted on 70 women referring to community health centers of Shahid Beheshti University of Medical Sciences in 2019. SUBJECTS AND METHODS: The sampling was performed using multistage cluster sampling. Before implementing the training intervention, the research instruments (general questionnaire, Kansas Marital Satisfaction Scale, Iranian version of Sexual Quality of Life-Female questionnaire, and World Health Organization Five Well-Being Index) were provided to the participants in order to complete them. All participants recompleted the instruments immediately and 1 month after the training intervention. STATISTICAL ANALYSIS USED: The significance level was considered as P < 0.05. RESULTS: The mean scores of marital satisfaction in the control group had no significant difference before, immediately after, and 1 month after the intervention (P = 0.895). However, in the intervention group, over time, the mean scores of marital satisfaction increased (P = 0.001), and the difference between the two groups was significant (P < 0.001). The mean scores of sexual quality of life and psychological well-being had no significant differences before, immediately after, and 1 month after the intervention in the control group. However, in the intervention group, over time, the mean scores of sexual quality of life and psychological well-being firstly increased and then decreased (P < 0.001), and the difference between the two groups was significant (P < 0.001). CONCLUSIONS: Training the components of emotional intelligence can be effective on enhancing marital satisfaction, sexual quality of life, and psychological well-being of women.

A sex education program for teachers of preschool children: a quasi-experimental study in Iran.

BACKGROUND: Sex education is an important educational dimension. Together with families, teachers play a significant role in providing sex education to children. However, in most cases, they do not have enough information on this topic. The present study aimed to determine the effects of a preschool sex education program on preschool teachers' knowledge and attitude. METHODS: In this quasi-experimental study, 80 teachers working at preschools in Tehran, Iran, were randomly allocated to experimental and control groups. The educational program was provided in two 90-min sessions for the experimental group while the control group received no intervention. A self-designed knowledge and attitude questionnaire was completed by both groups before and 1 month after the intervention. This questionnaire evaluated knowledge and attitude in six domains of principles of sex education, sexual identity, stages of development and proper methods of sex education, sex-related questions, masturbation, and sexual abuse. Data were analysed in SPSS 18 using descriptive statistics as well as independent samples t-test, paired-samples t-test, chi-squared test, and ANCOVA at p < 0.05. RESULTS: Mean scores of knowledge and attitude in all dimensions showed a significant increase in the experimental group following the educational intervention. However, no difference was observed in the control group. Following the educational intervention, mean scores of teachers' knowledge and attitude in all six domains showed a significant difference with that of the control group (p < 0.001). CONCLUSIONS: Results revealed that the sex education program can promote the knowledge and attitude of preschool teachers in all domains. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT2016122320854N5. Registered on 9 March 2017. "Retrospectively registered".