Analyzing the concept of sexual self-care in preschool children: A qualitative study.

BACKGROUND: Child sexual abuse is a global concern for families and societies. Therefore, child protection from sexual harassment is of particular importance. The present study aimed to investigate the concept of sexual self-care in children. MATERIALS AND METHODS: The present research is a qualitative study conducted with a content analysis approach. The study participants include 39 child sex education specialists, parents of children aged 4-7 years, adolescents who were sexually abused in childhood, and those with no experience of sexual abuse in childhood. The participants were selected through purposive sampling method. Different people's interpretations of the concept of sexual self-care in children were explored using semi-structured and face-to-face interviews, which continued until the saturation of concepts. Data were analyzed using the Graneheim and Lundman method. Guba and Lincoln's criteria were used to strengthen the validity and transferability of the data. RESULTS: Sexual self-care in children was identified from participants' viewpoints in the study. This self-care includes three main components and six subcomponents of (1) knowledge about privacy, risk situation, and trustworthy people, (2) attitude and perception of risk, and (3) behavioral skills in self-protection (i.e., post-injury reaction). CONCLUSION: Further injuries can be prevented by improving the level of awareness, forming the right attitude, and strengthening children's behavioral skills toward sexual self-care. Such issues, which are representatives of privacy, risk situations, and self-protection ability, can improve children's sexual self-care skills.

Domestic Violence and Its Impact on Abortion in Iran: Evidence From a Nationally Representative Survey.

The objective of this article is to assess the effect of domestic violence on abortion and investigate the mediating role of unwanted pregnancy. A secondary analysis was conducted on the National Family Survey data. This survey was a cross-sectional study conducted across Iran in 2018. The association between domestic violence and abortion was analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM) with WarpPLS version 8.0. From among 1,544 married women (mean age 42.8 years) who participated in this survey, 27% (418 women) reported experiencing at-least one-lifetime of abortion. Overall, two in three women (67.3%) experienced at least one form of domestic violence. Almost half of the women with experience of abortion (49.3%) reported at least one unwanted pregnancy in their life course. The bivariate analysis showed a significant positive relationship between domestic violence and abortion, and there was a positive direct effect of domestic violence on unwanted pregnancy. Moreover, age had a negative direct and indirect effect on unwanted pregnancy and abortion. Although, the direct effect of domestic violence on abortion was not significant in the Structure Equation Model, a positive indirect effect of domestic violence on abortion through unwanted pregnancy was confirmed. The effect of unwanted pregnancy on abortion was particularly strong (ß = .395, p < .01). These results have some implications for prevention of abortion through interventions against unwanted and unplanned pregnancy and domestic violence. This study makes a unique theoretical contribution to the literature through assessing the mediating role of unwanted pregnancy between domestic violence and abortion by using the SEM model.

Qualitative study of social determinants of child marriage in Kurdish regions of Iran: Evidence for health promotion interventions.

INTRODUCTION: One of the most thought-provoking problems in the world is child marriage that is affected by various factors. Therefore, the purpose of this study is to identify the social determinants of child marriage in Kurdish regions of Iran. MATERIALS AND METHODS: This qualitative study was conducted using conventional content analysis approach. The participants of the study were 30 Iranian-Kurdish women married under the age of 18 who were selected through purposeful and snowballing sampling. Data collection was conducted through semi-structured interviews and face-to-face interviews and continued until the saturation of concepts was achieved. Graneheim and Lundman method was used to analyze the data, and Guba and Lincoln criteria were used to strengthen the research. RESULTS: In general, findings include 5 categories and 17 subcategories: 1 - economic factors (financial problems and economic benefits); 2 - sociocultural factors (social customs, cultural beliefs, community encouragement, social learning, gaining prestige, and social support); 3 - individual factors (physical characteristics, personality traits, lack of awareness of the damaging consequences of early marriage, and fear of the future); 4 - family factors (dysfunctional family, weak awareness of parents, and harm prevention); and 5 - structural factors (high demand, limited access to educational services, and the lack of supportive social and legal structures). CONCLUSION: By raising the level of awareness and attitude of girls and their families about the consequences of early marriage, creating the culture of correcting cultural beliefs and social misconceptions, passing appropriate laws, and the use of local and national media to prevent child marriage, this social harm can be reduced.

Adolescents and Young People's Sexual and Reproductive Health in Iran: A Conceptual Review.

This paper reviews the evidence on the sexual and reproductive health (SRH) of young people in Iran from 2001 to 2019 and maps needs, challenges, and opportunities in this area. From among 125 papers, 43 articles were examined for this review. Findings indicated that although the majority of youth abstain from sex before marriage, significant minorities are sexually active before marriage, with a huge heterogeneity based on gender and geographical region. A gender disparity is apparent in high-risk sexual behaviors. Multiple partners, inconsistent condom use, and younger age at sexual debut were more prevalent among men than women. There is a need to narrow gender disparities that expose young women to greater risks, expand health awareness and relevant skills, and enable access to SRH services. While the government has reaffirmed many commitments for young people's wellbeing, policy development falls far short of realizing these commitments. Future success requires increased evidence on the SRH of youth as well as political will and strategic commitment to SRH for young people. The challenge is to develop comprehensive and culturally appropriate SRH education and confidential and nonjudgmental youth services. Due to the importance of families and parents, such programs need to engage families.

Intimate partner violence against Palestinian women in Gaza strip: Prevalence and correlates.

CONTEXT: Intimate partner violence (IPV) affects gravely the victims and is resulting in negative physical and psychological consequences. AIMS: This paper aimed to determine the prevalence of IPV against women in Gaza strip and associated factors. Moreover, to explore women's seeking behaviors to help. SETTINGS AND DESIGN: Cross-sectional study. METHODS AND MATERIALS: Community internet-based survey was conducted using the Heart Insult Threat Scout questionnaire and the reporting behavior of respondent to violence act. STATISTICAL ANALYSIS USED: A number of 517 ever married women responded and data were entered and analyzed using SPSS software version 23. RESULTS: About 517 women participated. Of which, 23% (119/517) reported exposure to any types of IPV. Multivariate logistic regression showed factors associated with IPV were as follows: husbands who are drug user (OR = 27.577, CI95%: 5.153-147.591; P < 0.001), husband exposure to violence in childhood (OR = 9.174, CI95%: 4.753-7.727; P > 0.001), and family with a special needs child (OR = 2.956, CI95%: 1.131-8.607; P < 0.05). Approximately, two-thirds of the victims tended to keep silent toward violence and dealt with it as a private and family issue; hence, they hesitated to communicate with others or seek any help to protect themselves. CONCLUSIONS: About 23% from the study participants experience violence in their life time. Factors associated with IPV are husband's drug abuse, having a child with special needs, and husband's childhood experience of violence. Qualitative researches are needed to understand the women experience to violence and sociocultural barrier for disclosure.

Development and Psychometric Properties of The Delayed Childbearing Questionnaire (DCBQ-55).

The comprehensive assessment of delayed childbearing needs a valid and reliable instrument. Therefore, the aim of the present study was to develop an instrument to evaluate factors influencing delayed childbearing among women and to assess its psychometric properties. The current methodological study was performed in two phases of (i) qualitative instrument development, and (ii) quantitative psychometric assessment of the developed instrument. Face and content validity of the instrument was assessed by eligible women and a panel of experts. Construct validity was assessed using the exploratory factor analysis (EFA). For reliability, internal consistency reliability and intra-rater reliability analysis were used. The initial instrument developed from the qualitative phase consisted of 60 items, which were reduced to 55 items after the face and content validity processes. EFA (n = 300) using the Kaiser criteria (Eigenvalues > 1) and the scree plot led to a six-factor solution accounting for 61.24% of the observed variance. The Cronbach's alpha coefficient, Spearman's correlation, test⁻retest and intra-class correlation coefficients for the whole instrument were reported as 0.83, 0.86 and 0.81, respectively. The final instrument entitled the delayed childbearing questionnaire (DCBQ-55) included 50 items with six domains of 'readiness for childbearing', 'stability in the partner relationship', 'awareness about the adverse outcomes of pregnancy in advanced maternal age', 'attitude toward delayed childbearing', 'family support', and 'social support' on a five-point Likert scale. The DCBQ-55 as a simple, valid and reliable instrument can assess factors influencing delayed childbearing. It can be used by reproductive healthcare providers and policy makers to understand factors influencing delayed childbearing and devise appropriate strategies.

The Perspectives of Iranian Women on Delayed Childbearing: A Qualitative Study.

BACKGROUND: Delayed childbearing is a growing trend in Iran. PURPOSE: This study explores the perspectives of women on delayed childbearing. METHODS: A qualitative study using a content analysis approach was conducted on data acquired using private semistructured interviews with 23 women aged ≥30 years who were childless or pregnant for the first time in an urban area of Iran. RESULTS: Three main themes were developed using conventional content analysis: "personal inclination," "perceived beliefs about delayed childbearing," and "social support." CONCLUSIONS: Although women in Iran hold favorable attitudes toward childbearing, a wide range of sociocultural and economic factors encourage these women to postpone their first pregnancy. The findings of this study are relevant and important for nursing and midwifery policy making in countries with cultural and contextual backgrounds similar to Iran.

Exploring Barriers of the Health System to Rehabilitation Services for People with Disabilities in Iran: A Qualitative Study.

INTRODUCTION: The United Nations (UN) identified health as a basic human right, but, unfortunately, the evidence shows that people with disabilities (PWD) often have lower levels of health than the general population. This can be associated with problems in access to the services and programs. The aim of this study was to explore barriers of the health system to rehabilitation services for PWD in Iran. METHODS: This was a qualitative study conducted on 21 participants using semi-structured, in-depth interviews and content analysis from June 2014 to July 2015. Data analysis was performed by MAXQDA version 10. RESULTS: "Barriers" were the most prominent challenge of people with disabilities that needed access to rehabilitation services. These barriers were categorized into eight concepts of deficiency in the system that provides rehabilitation services, defect of education, deficiency in detecting and screening of people with disability, defect of stewardship in rehabilitation, ignoring socio-cultural factors, accessibility hardships, lack of identification, and financial hardships in rehabilitation. CONCLUSIONS: An efficient rehabilitation plan requires a common understanding, considering the long-term complications involved in addressing the barriers. Understanding the barriers of the health system to rehabilitation services requires comprehensive management that first should be familiar with all of PWD, providers, policy makers, and other beneficiaries. It also is necessary for policy makers to consider rehabilitation services as a main part of the health plan; especially, they must change their oversight of rehabilitation services and programs. Thus, policy makers should have need comprehensive management and recommended further research.

Factors associated with contraceptive use in Tehran, Iran.

OBJECTIVES: In spite of the government's efforts, the prevalence of contraceptive use in Iran is only 55.4%. Health concerns, side effects, failure of the methods and some demographic issues, among which education, age, and number of daughters, have a great influence on the enforcement of contraceptive measures. The aim of the present study was to identify factors affecting contraceptive use in Iran. METHODS: Data from the project 'The study of contraceptive practice in Tehran, 1999-2000' were analyzed with regard to the factors associated with contraceptive use by Iranian couples. A total of 4042 women at reproductive ages who had delivered in one of the 12 teaching hospitals of Tehran and had at least one child that lived for at least 24 hours after birth, were interviewed using a questionnaire that gathered information about their socio-demographic status, fertility history, and other characteristics. RESULTS: Using a multinomial logistic regression, it was found that the woman's age, her own or her husband's level of education, previous awareness about contraceptive methods, number of abortions, and number of sons and daughters were factors that were significantly associated with contraceptive use. CONCLUSIONS: A number of factors affect the application of contraceptive measures. It is essential that health policy makers be aware of these to promote contraception and population control.