Postpartum depression and its relationship with the positive and negative perfectionism.

BACKGROUND: Depression is a common mental disorder after childbirth, which has serious consequences for the mother, baby, and family. A wide range of causes, including some personality traits of mothers, are involved in its etiology. Therefore, this study was conducted aiming to determine the factors related to postpartum depression (PPD) and its relationship with positive and negative perfectionism in Qom, Iran. MATERIALS AND METHODS: This cross-sectional analytical study was conducted on 162 mothers who had been referred to health centers in Qom during 6-8 weeks after normal vaginal delivery (NVD) in 2020. After randomly classifying the health centers, the convenience sampling method was carried out. Data collection tools included social-individual information form, Edinburg Postnatal Depression Scale (EPDS), and Positive and Negative Perfectionism Questionnaire of Terry-Short. The data were analyzed using the Chi-square and Pearson correlation tests and multivariate logistic regression analysis. RESULT: The prevalence of PPD in this study was 29.6%. The results showed that with the increase in the negative dimension of perfectionism, the chance of PPD in people increases by 14% (OR = 1.14, CI = 1.06-1.21), while there was no significant correlation between the positive dimension of perfectionism and PPD (r = 0.006, P > 0.05). Furthermore, the chance of PPD was higher in student mothers, mothers who had a history of PPD, and unintended pregnancy. Moreover, some factors such as multigravidity, breastfeeding, and not worrying about body image reduce the chance of occurrence. CONCLUSION: Since mothers' negative perfectionism is associated with PPD, it is recommended to identify perfectionist individuals during pregnancy and after delivery and provide counseling service to them.

The global incidence, mortality, and burden of uterine cancer in 2019 and correlation with SDI, tobacco, dietary risks, and metabolic risk factors: An ecological study.

Background and Aim: Endometrial cancer (EC) is the sixth most common cancer among women worldwide. Since global studies are based on awareness of the incidence trend, mortality, geographical diversity, and level of social development and income of countries, this study was conducted to investigate the trend of uterine cancer (UC) in the world in 2019. Methods: Age-standardized rates (ASR) of incidence, deaths, prevalence, and disability-adjusted life years (DALYs) of UC, as well as targeted risk factors, were extracted from the Global Burden of Disease (GBD) online database 2019. Pearson correlation coefficient and SPSS 16 were used to calculate the correlation between risk factors and ASR of epidemiological indicators. Statistical significance was considered as p < 0.05. Results: In 2019, the age-specific incidence and death rate of UC was peaking at 60-64 and 65-69 years, respectively. The highest age-standardized incidence rate per 100,000 people for UC has been reported in the Northern Mariana Islands, high sociodemographic index (SDI) countries, World Bank High-Income category, Europe continent and among World Health Organization (WHO) regions were found in the European Region. The highest age-standardized death rate per 100,000 people for UC has been reported in Grenada, high SDI countries, the World Bank High-Income category, Europe continent, and among WHO regions found in the European Region. In 2019, the age-standardized DALYs rate was 53.54 per 100,000 inhabitants, of which 48.49 cases were related to years of life lost (YLLs) and 5.05 cases were related to years lived with disability. Conclusion: According to GBD-2019, the highest incidence, mortality, and DALY of UC are in Europe. The evidence and traces of diversity can be seen in the inequalities of UC. Race, ethnicity, economic status, level of education and awareness, co-morbidities, access, grade, and histological type of tumor are the most important causes of this inequality.

Developing a Culture of Civility in Nursing Students.

ABSTRACT: Incivility is a significant problem in nursing education. The purpose of the study was to determine the impact of culture management on incivility in nursing students. Nursing faculty and students participated in a quasi-experimental study. The program included the formation of a committee, development of codes of conduct, giving positive scores for civil behaviors, and setting a vision. Behavioral changes were assessed before and after the intervention. There were significant differences between the two groups for perceived level and occurrence rate of incivility ( p < .05).

Is there a relationship between assisted reproductive technology and maternal outcomes? A systematic review of cohort studies.

Background: Pregnancy with assisted reproductive technology (ART) is accompanied by fetal and maternal outcomes. Objective: This systematic review aimed to assess the relationship between ART and maternal outcomes. Materials and Methods: In this systematic review, the electronic databases, including PubMed, MEDLINE, Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, Magiran, Irandoc, and Scientific Information Database were searched for maternal outcomes reported from 2010-2021. The Newcastle-Ottawa Scale for cohort studies was used to assess the methodological quality of studies. Results: A total of 3362 studies were identified by searching the databases. After screening abstracts and full-text reviews, 19 studies assessing the singleton pregnancy-related complications of in vitro fertilization/intracytoplasmic sperm injection were included in the study. The results demonstrated that singleton pregnancies conceived through ART had higher risks of pregnancy-related complications and adverse maternal outcomes, such as vaginal bleeding, cesarean section, hypertension induced by pregnancy, pre-eclampsia, placenta previa, and premature membrane rupture than those conceived naturally. Conclusion: In conclusion, an increased risk of adverse obstetric outcomes was observed in singleton pregnancies conceived by ART. Therefore, obstetricians should consider these pregnancies as high-risk cases and should pay special attention to their pregnancy process.

The Effectiveness of Auriculotherapy on Women's Sexual Function: A Randomized Controlled Trial.

Objective: Majority of breastfeeding women experience changes in sexual function. The present study was designed to assess effectiveness of auriculotherapy on improving sexual function in breastfeeding women. Method : In this randomized sham controlled trial, accomplished from January 2018 to May 2019 in a referral sexual health clinic in city of Qom, Iran, 60 eligible participants were assigned to either intervention and control groups via block randomization. In the intervention group, electrical stimulation was applied for 15 seconds on Shen Men, Zero, Thalamic, Master Cerebral, Libido, Relax, Excitement, Ovary, and Uterus points in 10 auriculotherapy sessions. Then, Vaccaria seeds were stuck on these points. The control group received the same procedure with the device off as a sham method. Data were gathered using the Female Sexual Function Index (FSFI) at three different time points. Results: At baseline, mean scores of sexual function dimensions were not significantly different between the intervention and control groups except for orgasm. Post-intervention, the results showed significant differences in sexual desire (P = 0.002), sexual arousal (P = 0.008), lubrication (P = 0.001), sexual satisfaction (P = 0.001), and orgasm (P = 0.009). One month after the intervention, the results showed significant differences in sexual desire, sexual arousal, lubrication, sexual satisfaction (P = 0.001), orgasm (P = 0.006), and dyspareunia (P = 0.015). Differences in mean score of sexual function in post-intervention and one-month follow-up were only significant in the intervention group (P = 0.001). Conclusion: Based on evidence from this study, auriculotherapy is an effective technique for improving sexual function in breastfeeding women.

Relationship between mindfulness and maternal stress and mother - Infant bonding in neonatal intensive care unit.

BACKGROUND: Having a baby admitted to a neonatal intensive care unit (NICU) is so stressful, has a negative impact on mother well-being, and also disrupts mother-infant bonding process because the infant spend the first several weeks or months in the NICU. Previous studies have shown the positive association of the mindfulness and various health conditions. This study investigated the relationship between mothers' dispositional mindfulness and level of stress and bonding in mothers with infants in the NICU. MATERIALS AND METHODS: A cross-sectional study was performed during 2019 on 140 mothers with newborns admitted to the NICUs in two hospitals in Qom city in Iran. The self-report measures of dispositional mindfulness, Parental Stressor Scale: NICU, and the Postpartum Bonding Questionnaire were administered to mothers on the 2nd-5th day after birth. The data analysis was carried out by using a stepwise multiple regression model. RESULTS: The mean scores of mindfulness, stress, and bonding were 3.32 ± 0.52, 2.32 ± 0.77, and 0.47 ± 0.37, respectively. There was a statistically significant inverse relationship between total mindfulness score and stress (P < 0.001). Furthermore, high scores of mindfulness were associated with better bonding (P = 0.04). CONCLUSIONS: Improvement in mindfulness helps mothers to reduce stress and make better bonding with infants. It is recommended that mindfulness interventions use during pregnancy also after birth, especially for mothers that their infants admitted to in the NICUs.

Relationship between coronavirus disease 2019 in pregnancy and maternal and fetal outcomes: Retrospective analytical cohort study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has caused many deaths and complications worldwide. However, limited data are available about COVID-19 during pregnancy. This study aimed to assess the epidemiological and clinical features of COVID-19, and the adverse maternal and fetal outcomes. DESIGN: This retrospective analytical cohort study was conducted on all pregnant women with confirmed COVID-19 at Nekouei-Hedayati-Forghani Hospital in Qom, Iran from 15 March 2020 to 15 November 2020. For the same period, 165 pregnant women who did not have COVID-19 were selected at random and included in this study. All epidemiological and clinical features were collected from the medical records of the participants. A logistic regression model was used to determine associations between COVID-19 in pregnancy and maternal and fetal outcomes. FINDINGS: The most common symptoms reported by pregnant women with COVID-19 were shortness of breath (60.9%), dry cough (59%) and fever (42.9%). After adjustment for potential confounding factors, COVID-19 in pregnancy was associated with a significantly higher risk of admission to the intensive care unit (ICU) [odds ratio (OR) 6.16, 95% confidence interval (CI) 1.23-31], caesarean section (OR 0.45, 95 CI 0.25-1.03), preterm birth (OR 3.01, 95% CI 1.4-6.54), fetal distress (OR 5.7, 95% CI 2.13-15.59) and admission to the neonatal intensive care unit (NICU) (OR 3.04, 95% CI 1.21-7.70). KEY CONCLUSIONS: COVID-19 is associated with adverse maternal and fetal outcomes, including ICU admission, caesarean section, fetal distress, preterm birth and NICU admission.

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

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

Explaining the perception of spiritual care from the perspective of health personnel: A qualitative study.

BACKGROUND: Spiritual care is one of the important and essential aspects of healthcare. The impact of spirituality on healing, health-related states, and the ability to cope and adapt to the disease is undeniable. Thus, this study is aimed to explain the perception of the spiritual care of patients by health-care providers. MATERIALS AND METHODS: The present study was performed with a qualitative approach using content analysis by the conventional method in hospitals of Qom University of Medical Sciences. The data were collected through in-depth semi-structured interviews with 11 participants through a purposeful sampling method and analyzed simultaneously. The consistency of the data was confirmed by the participants. RESULTS: Data analysis provided four main categories as follows: "Observing the patient's rights" with subcategories of respect, right to choose, preserving the patient's privacy, proper communication with the patient, "professionalism" with subcategories of responsibility, acceptance of mistakes, development of technical skills and knowledge, "supportive behaviors" with subcategories of paying attention to emotional and psychological needs and "Strengthening the patient's religious dimension" with subcategories of honoring religious beliefs and providing healthcare along with trust in God. CONCLUSIONS: According to the study findings, spiritual care from the perspective of health-care providers was explained as attention to emotional and psychological needs, reverence for patients' religious beliefs, respect for human dignity, and sense of responsibility.

Developing a charter of spiritual care for patients.

BACKGROUND: Spirituality is recognized as an important issue in health care, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed-upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both health-care providers and patients within the Iranian social, cultural and overall contexts and present a charter for providing spiritual care. METHODS: The first phase of the study was a systematic literature review. The next phase consisted of two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion. RESULTS: The review of literatures led to the identification of two main themes and 10 themes. Perspectives of health-care providers were categorized into four main themes and 10 themes, and patients' opinions were classified into three main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements. CONCLUSION: The charter of spiritual care for patients is intended to present an agreed-upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve health-care delivery system.

Investigation of the relationship of perceived social support and spiritual well-being with postpartum depression.

BACKGROUND: Postpartum depression is a significant common health problem that has negative effects on mental and physical health of mothers and their infants. The main purpose of this study was to investigate the relationship between spiritual well-being (SWB) and perceived social support with postpartum depression in new mothers. MATERIALS AND METHODS: Using a descriptive survey design, 200 mothers in the 4th-8th weeks after delivery, who referred to selected therapeutic centers in Qom Province, were selected by a convenience sampling method. They were asked to answer the question of the Edinburgh Postnatal Depression Scale, Multidimensional Scale of Perceived Social Support, SWB Scale, and Farhangestan Spiritual Health Questionnaire. Data were analyzed using Pearson correlation and Chi-square. RESULTS: The prevalence of postpartum depression in this group was 22%. Pearson correlation test showed that there was a negative correlation between high level of perceived social support and SWB with postpartum depression. CONCLUSION: The findings of this study suggest that perceived social support and SWB have an important role in low depressive symptom in mothers during postpartum. This result can help health-care professionals to pay much attention to social support and SWB as a protective factor against postpartum depression in postpartum or pregnancy care programs.

Exploring medical teachers' and interns' experiences regarding professional ethics.

CONTEXT: Medical ethics is a practical subject as well as a branch of ethical philosophy and an integral part of the proper practice in medicine. However, the ethics changes in places and over time and is variable. Furthermore, many issues that have occurred as a result of advances in technology add to the complexity of the ethical issues. Therefore, the objective of this research was to explore medical teachers' and interns' experiences regarding professional ethics. METHODS: This study was a qualitative content analysis conducted on 10 professionals and 10 interns of the surgery and internal departments of medical and educational centers in Qom University of Medical Sciences to discover their experiences of the medical professional ethics. The sampling method was purposive, and data were collected through semi-structured interviews. Data analysis was performed using a qualitative content analysis method with a conventional approach. RESULTS: Three main categories were obtained from the data analysis, including adherence to professional values, organizational conditions, and individual characteristics. CONCLUSIONS: Adherence to professional values, paying attention to individual characteristics, and organizational conditions are among the factors affecting the promotion of medical professional ethics; therefore, it seems that appropriate interventions on these important components can help promote the professional ethics training in the clinical practice.

Experiences of Fathers with Inpatient Premature Neonates: Phenomenological Interpretative Analysis.

BACKGROUND: Birth and hospitalization of premature neonates create enormous challenges for the family with serious impacts on parents' mental and emotional health. The present study was designed to explore the experiences of fathers with premature neonates hospitalized in a neonatal intensive care unit (NICU). MATERIALS AND METHODS: In this interpretative phenomenological study, data were collected using in-depth interviews guided with a semi-structured questionnaire and analyzed by interpretative phenomenological analysis. Totally seven interviews were conducted with six participants. RESULTS: The mean age of the fathers was 32 (23-42) years, and all of the fathers lived with their wives. Experiences of the fathers were categorized into 13 subordinate and three superordinate themes: "abandonment and helplessness" (lack of financial support, lack of informational support, and indignation and distrust toward the hospital staffs); "anxiety and confusion" (family disruption, shock due to the premature birth of the neonate, uncertainty, the loss of wishes, feeling of guilt and blame, and occupational disruption); and "development and self-actualization" (emotional development, spiritual development, independence and self-efficacy, and responsibility). CONCLUSIONS: The present study showed that the fathers with premature neonates hospitalized in NICU encounter both positive (development and self-actualization) and negative experiences (lack of financial and informational supports, distrusting toward the hospital staffs, family disruption, and occupational disruption). Planning to manage adverse experiences can help fathers to cope with this situation.

Pregnancy through the Lens of Iranian Women with HIV: A Qualitative Study.

To explore the experience of pregnancy among Iranian women with HIV, 12 HIV-infected pregnant women who referred to counseling center for behavioral diseases in Imam Khomeini Hospital were recruited through purposive sampling. Data were collected by face-to-face, semi-structured interview and were analyzed using conventional content analysis method. Four main themes emerged from the data: fear and hope, stigma and discrimination, marital life stability, and trust in God. Despite concerns about mother-to-child transmission of HIV, and uncertain life span, HIV-infected women tended to continue their pregnancy, and having children was viewed as a window of hope for them.

Domestic Violence During Pregnancy and Women's Health-Related Quality of Life.

Domestic violence during pregnancy is a major health problem with significant psychological and physical impairments for pregnant women. To assess the relationship between domestic violence during pregnancy and women's health-related quality of life (HRQoL), a cross-sectional study was conducted on 341 postnatal women who referred to urban health care centers in Gachsaran, Islamic Republic of Iran. Domestic violence was assessed using a questionnaire modified from the Abuse Assessment Screen (AAS), and Iranian version of Short Form-36 questionnaire was used to assess women's HRQoL. The findings of the study showed 44.5% of women reported experiencing domestic violence during pregnancy. All the SF-36 subscales including both physical and mental health dimensions scored lower in the abused women compared to the non-abused women, and differences between the groups in the six subscales of SF-36 except 'physical functioning' and 'bodily pain' were statistically significant (P<.05). These results suggest that domestic violence during pregnancy is associated with poor HRQoL in abused women.