Psychometric properties of a Persian version of respectful maternity care questionnaire.

BACKGROUND: Providing high quality and respectful care during pregnancy and birth is one of the ways to reduce complications in women. Respectful care is a type of care that requires a valid instrument to measure. This study was conducted to determine the validity and reliability of the Persian version of the Respectful Maternity Care (RMC) questionnaire in 2018. METHODS: This study was performed with 150 women (in the first 48 h after birth), who were admitted in the postpartum wards of public hospitals from 1st January until 6th April 2018 in Zanjan city in Iran. Participants were selected randomly using the Poisson distribution (Time) sampling method. After receiving permission from the questionnaire's author, the internal consistency of the tool was measured by Cronbach's alpha coefficient after the Forward translation of the Persian version of the tool under expert supervision. The reliability of the modified questionnaire was assessed using a test-retest method in 10 eligible postpartum women, who completed the same questionnaire again after 72 h. The validity of the tool was confirmed by exploratory and confirmatory factor analysis using LISREL and SPSS software. RESULTS: The original RMC tool achieved an overall high internal reliability (α = 0.839). Confirmatory factor analysis of original RMC scores demonstrated poor fit indices. In LISREL proposed paths for the model, one item was excluded and a re-exploratory factor analysis was performed with the remaining 14 items. Four new subscales were defined for the revised tool including Abusive Care, Effective Care, Friendly Care, and Respectful Communication, which explained 60% of the variance. CONCLUSIONS: The revised tool included four subscales of Abusive Care, Effective Care, Friendly Care, and Respectful Communication in 14 items which explained 60% of the variance. Given the importance of providing high quality maternity care, and the variety of cultures and birth services across different countries, further research is needed on this RMC tool to evaluate its use in other countries and regions.

Changes in sexual activities, function, and satisfaction during the COVID-19 pandemic era: a systematic review and meta-analysis.

Introduction: Little is known about the impact of the coronavirus on sexual behavior, function, and satisfaction. Aim: The aim of the present study was to systematically review people's sexual function and behaviors and their changes in sexual activities during the COVID-19 pandemic. Methods: Comprehensive searches in PubMed, Web of Science, and Scopus were conducted with keywords in accordance with MeSH terms: COVID-19, SARS-CoV-2, coronavirus, sexual health, sexual function, sexual dysfunctions, sexuality, sexual orientation, sexual activities, and premarital sex. Two reviewers independently assessed full-text articles according to predefined criteria: original design, English studies, and investigating either the general population or sexual minorities. Results: Risk of bias in the studies was assessed by the Newcastle-Ottawa Scale, and data were pooled via random effects meta-analyses. We utilized the standardized mean difference to evaluate the effects of the COVID-19 pandemic on sexual activity, functioning, and satisfaction. We included 19 studies in the analysis and 11 studies in the meta-analysis, with a sample size of 12 350. To investigate sexual activity changes, a sample size of 8838 was entered into the subgroup analysis, which showed a significant decrease in both genders (5821 women, P < .033; 3017 men, P < .008). A subgroup meta-analysis showed that the sexual function of men and women during the COVID-19 pandemic significantly declined (3974 women, P < .001; 1427 men, P < .001). Sexual desire and arousal decreased in both genders, though mainly in women. In investigating sexual satisfaction changes during the COVID-19 pandemic, a meta-analysis with a sample size of 2711 showed a significant decrease (P < .001). The most indicative changes in sexual behaviors during the pandemic were the increase in masturbating and usage of sex toys. Greater COVID-19 knowledge was associated with lower masturbation, oral sex, and vaginal sex. The more protective behaviors were associated with less hugging, kissing, cuddling, genital touching, watching porn with a partner, and vaginal sex. Conclusion: The COVID-19 pandemic led to increased challenges and changes for individuals' sexual behaviors. Efforts for preventive strategies should therefore be concentrated between pandemics, while ensuring that there is information available to the population during a pandemic for help in times of psychological distress or crisis.

The Effect of Sedation Protocol on Sedation Level and Pharmacological and Non-Pharmacological Interventions on Mechanically Ventilated Patients.

BACKGROUND: The use of analgesics and sedatives to provide sedation for Patients in Intensive Care Unit (ICU) is inevitable. The present study aimed to determine the effect of sedation protocol using the Richmond Agitation- Sedation Scale on sedation level and amount of pharmacological and non-pharmacological interventions on patients under mechanical ventilation. MATERIALS AND METHODS: This randomized clinical trial was conducted on 79 patients under mechanical ventilation in Zanjan. The patients were recruited using the blocking randomized sampling method. In the experiment group, the sedation was provided hourly, using the Richmond sedation Protocol, during the mechanical ventilation period. The level of sedation and pharmacological and nonpharmacological interventions were compared in the two groups using Fisher exact test. RESULTS: Totally, 40 patients in the experiment and 39 patients in the control groups were evaluated. No significant difference was found between the two groups in terms of confounding variables (age, sex, level of consciousness, Acute Physiologic and Chronic Health Evaluation (APACHE) II criterion, underlying disease, and cause of hospitalization). The level of sedation in the experiment group was significantly closer to the ideal score of the Richmond Scale compared to the control group (p < 0.001). The experimental group received significantly more non-pharmacological interventions and fewer pharmacological interventions compared to the control group (P < 0.001). CONCLUSIONS: Using a sedation protocol could provide better sedation levels in patients under mechanical ventilation, and reduce the use of sedative medications, and consequently, the cost of hospitalization. Further research is suggested.

The Effect of Sedation Protocol Using Richmond Agitation-Sedation Scale (RASS) on Some Clinical Outcomes of Mechanically Ventilated Patients in Intensive Care Units: a Randomized Clinical Trial.

Introduction: Providing for patients' comfort and reducing their pain is one of the important tasks of health care professionals in the Intensive Care Unit (ICU). The current study was conducted to determine the effect of a protocol using a Richmond Agitation-Sedation Scale (RASS) on some clinical outcomes of patients under mechanical ventilation (MV) in 2017. Methods: This single-blind clinical trial was conducted on 79 traumatic patients in the ICU who were randomly allocated into the intervention (N=40) and the control groups (N=39). The sedation was achieved, using a sedation protocol in the intervention group and the routine care in the control group. The clinical outcomes of the patients (duration of MV, length of staying in ICU, final outcome) were measured. As the participants had different lengths of MV and staying in ICU, the data were restructured, and were analyzed, using proper statistical methods. Results: The patients' level of sedation in the intervention group was significantly closer to the ideal score of RASS (-1 to +1). The duration of MV was significantly reduced in the intervention group, and the length of stay in the ICU was also significantly shorter. There was no difference in terms of final outcome. The ICU cost in the control group was twice as high as the cost in of the intervention group. Conclusion: The applied sedation protocol in this study would provide better sedation and could consequently lead to significantly better clinical outcomes, and the cost of caring as a result.

The Effect of Group Counseling Using Ellis's A-B-C Technique on Irrational Beliefs and Self-Efficacy About Breast Self-Awareness of Women Health Volunteers.

PURPOSE: This preliminary pilot effort assessed the effect of group counseling using A-B-C technique on irrational beliefs and self-efficacy for women health volunteers (WHVs) in breast self-awareness. DESIGN: In this randomized controlled trial, 40 WHVs from three health centers (Abhar, Iran) were randomly allocated into two groups. METHOD: Seven weekly group counseling sessions were held for the intervention group. Data about cancer fatalism belief, dissatisfaction of body, anxiety, and self-efficacy were collected through validated questionnaires 1 month before and 2 weeks after the intervention. RESULTS: Mean scores of anxiety ( p = .036), body dissatisfaction ( p = .002), cancer fatalism belief ( p ≤ .0001), and self-efficacy ( p ≤ .0001) were improved in the intervention group compared with control group. DISCUSSION/CONCLUSION: Group counseling using A-B-C technique was effective in improving irrational beliefs and self-efficacy of the WHVs about breast self-awareness. IMPLICATIONS FOR PRACTICE: The findings may help in further development of strategies and cultural programs to improve health-related irrational beliefs.