Study protocol for promoting physical activity among women based on the MAPP process

Background

The participation of all stakeholders is necessary when a community-based intervention is designed. For running a practical intervention, it is necessary to have a framework to design the programme while considering all stages of planning, implementation and evaluation.

Aims

To describe a study protocol based on the MAPP process (Mobilizing for Action through Planning and Partnerships) for promoting physical activity (PA).

Methods

This protocol is implemented in 6 distinct phases. The goal of the first and second phase is to organize the programme and increase participation, and to determine the vision of the programme, respectively. The third phase provides a comprehensive picture of a community. The fourth and fifth phases identify strategies for the programme. The sixth phase is about the action cycle.

Conclusion

The framework considers all factors on PA improvement and, consequently, results in a culture-based programme for women.

Appropriate Interventions for Pregnant Women with Indicators of Metabolic Syndrome on Pregnancy Outcomes: A Systematic Review

Metabolic syndrome (MetS), a series of symptoms, including abdominal obesity, impaired glucose tolerance and insulin metabolism, hypertension, and dyslipidemia, is considered as the risk of developing cardiovascular disease and diabetes that can predispose a pregnant women to serious health problem, women in the developed as well as the developing countries. This study was aimed to investigate the effects of appropriate interventions on pregnant women with indicators of MetS to further improve the outcome of pregnancy. This systematic review was performed to extract articles of randomized controlled trials (RCT) on pregnant women with indicators of (MetS) and focusing on physical activity, dietary or lifestyle interventions on maternal health or perinatal outcomes, with searching in the Web of Science, PubMed, CDSR, Scopus, and Google Scholar were investigated. Two researchers independently evaluated the quality of the studies, being presented in all the articles and ranked the studies as high/low quality; the level of evidence was based on the number of high-quality studies and the coordination of the obtained results. Then, 17 articles, which met the inclusion criteria, were selected; among these, 7 articles studied the physical activity, 3 articles reviewed diets, 6 probed the lifestyle interventions, and 1 article was on counseling. In general, evidence suggested how the physical activity and proper diet impacts on proper weight gain during pregnancy, prevents maternal complications, and improves the outcome of pregnancy. According to the results of this systematic review, proper interventions during pregnancy can have a positive effect on maternal weight gain and the general health condition of pregnant women with indicators of MetS.

Learn to live with it: Lived experience of Palestinian women suffering from intimate partner violence

Background and Aim:

Intimate partner violence has become a growing concern all over the world and causes numerous consequences and provokes various reactions among women. The present study was aimed to understand the lived experience of Palestinian women who suffered domestic violence by an intimate partner.

Methods:

In this hermeneutic phenomenological study, van Manen's methodical steps were used to conduct the study. An in-depth face-to-face semi-structured interview was conducted to 11 survivors of intimate partner violence. Data were analyzed by thematic analysis method.

Results:

“learn to live with it” was the core theme, which extracted from four subthemes including “failure to change for better,” “failure to gain support,” “failure to enjoy sexual life,” and “failure to make decisions.” Learn to live with it refers to participants’ acceptance to their unpleasant situation because they could not change it.

Conclusion:

Palestinian women who suffer from violence fail to cope with appropriately due to traditional culture and lack of familial and economic dependence.

Parents' concerns regarding the growth characteristics of their adolescents: a qualitative inquiry in Iran

In recent times, parents have become increasingly concerned, both subjectively and objectively, about their adolescents' body height/weight growth. Parent-adolescent interactions about this issue and the potential socio-psychological consequences of such interactions should be considered as an important influencing factor on the future of adolescents' sexual and reproductive health. To achieve a greater understanding of such concerns, it is necessary to further elucidate parents' experiences on this topic, so as to expand the existing literature. This study aimed to explain the perceptions of parents' concerns regarding their adolescents' growth characteristics in the socio-cultural context of Iran as a transitional society. This paper is part of a larger qualitative study designed using the Constructivist Grounded Theory Methodology (CGTM). We conducted open-ended intensive interviews with eleven parents individually and recruited them through purposeful and theoretical sampling from a teaching hospital, community, and a primary school in Tehran with theoretical sampling variation in terms of teenagers' age, sex, and birth order, place of residence, parents' occupation and education, and the self-reported socio-economic status. Using the analytical procedures of the CGTM, we performed analyses. In the findings, the concept of 'living with constant sense of uncertainty' emerged from the subcategories including 'feeling existing and potential concern about expected minimum and maximum bio-positions of growth,' 'feeling potential concern about biological health consequences,' 'feeling potential concern about the emergence of early/late maturity signs,' 'feeling potential concern about adolescent's emotional threat,' 'feeling concerned about future employment, education, marriage, and fertility,' and 'feeling potential concern about the society's view'. These findings suggest that parents are living with a constant sense of uncertainty about their teens' growth characteristics throughout the transition from adolescence. All stakeholders including parents, health-care practitioners and policymakers, and anthropologists/sociologists should be focus on such concerns, in order to manage them and their possible socio-psychological burdens.

The effect of training problem-solving skills for pregnant women experiencing intimate partner violence: a randomized control trial

Introduction

Intimate partner violence (IPV) in pregnancy is considered as an additional threat to the maternal/fetal health. The present study was aimed to investigate the effectiveness of training problem-solving skills on IPV against pregnant women.

Methods

The present randomized clinical trial was conducted on 125 and 132 women visiting the health centers of Tehran as the intervention and the control groups, respectively; samples were selected using random stratified cluster sampling. The intervention group underwent four problem-solving training sessions. Three months later, both groups completed the revised Conflict Tactics Scale questionnaire. Data were analyzed using SPSS v.16.

Results

The mean (SD) ages of the participants were 27.51 (4.26) and 27.02 (4.26) years, respectively, in the control and the intervention groups. The rates of the physical and psychological violence were significantly reduced after the intervention in the intervention group. Risk differences of the physical, psychological and sexual violence before and after the intervention were 3% (95% CI: -8.23 to14.13, P = 0.6), 1.5% (95% CI: -4.93 to 8.03, P = 0.6) and 4.8% (95% CI: -7.11 to 16.52, P = 0.4) in the control group and 8.8% (95% CI: -3.47 to 20.71, P = 0.1), 25.4% (95% CI: 15.77 to 34.66, P < 0.001) and 4.9% (95% CI: -7.38 to16.97, P = 0.4) in the intervention group, respectively.

Conclusion

It seems that training this skill as a part of the routine prenatal care could be effective in reducing intimate partner violence.

Creating a positive perception of childbirth experience: systematic review and meta-analysis of prenatal and intrapartum interventions

BACKGROUND

A negative experience in childbirth is associated with chronic maternal morbidities. The aim of this systematic review and meta-analysis was to identify currently available successful interventions to create a positive perception of childbirth experience which can prevent psychological birth trauma.

METHODS

Randomized controlled trials of interventions in pregnancy or labour which aimed to improve childbirth experience versus usual care were identified from 1994 to September 2016. Low risk pregnant or childbearing women were chosen as the study population. PEDRO scale and Cochrane risk of bias tool were used for quality assessment. Pooled effect estimates were calculated when more than two studies had similar intervention. If it was not possible to include a study in the meta-analysis, its data were summarized narratively.

RESULTS

After screening of 7832 titles/abstracts, 20 trials including 22,800 participants from 12 countries were included. Successful strategies to create a positive perception of childbirth experience were supporting women during birth (Risk Ratio = 1.35, 95% Confidence Interval: 1.07 to 1.71), intrapartum care with minimal intervention (Risk Ratio = 1.29, 95% Confidence Interval:1.15 to 1.45) and birth preparedness and readiness for complications (Mean Difference = 3.27, 95% Confidence Interval: 0.66 to 5.88). Most of the relaxation and pain relief strategies were not successful to create a positive birth experience (Mean Difference = - 2.64, 95% Confidence Intervention: - 6.80 to 1.52).

CONCLUSION

The most effective strategies to create a positive birth experience are supporting women during birth, intrapartum care with minimal intervention and birth preparedness. This study might be helpful in clinical approaches and designing future studies about prevention of the negative and traumatic birth experiences.

Fear of stigma: The lived experiences of Iranian women after suicide attempt

BACKGROUND

Suicide attempt is the most important predictor of completed suicide. The aim of this study was to explore the lived experiences of women after suicide attempts.

METHODS

This was an interpretative phenomenological study carried out through in-depth semi-structured interviews with 13 interviews. Data were analyzed using Van Manen method.

RESULTS

Women of this study experienced fears of stigma. Their fears were not only related to labels of being "unbelief and mentally illness but also being involved in illicit sexual affairs." On the other hand, they were afraid of labeling "mental illness" and also "doing an unacceptable action."

CONCLUSION

The women tried to hide their suicide attempts because they fear of being labeled by others. It is recommended that societies and families progress toward becoming free of stigma of suicide and suicide attempt.

Claims about Medical Malpractices Resulting in Maternal and Perinatal Mortality Referred to Iranian Legal Medicine Organization During 2011-2012

Background:

Obstetricians, gynecologists, and midwives are the most common specialists of the medical sciences group against whom medical malpractices are claimed, many of which are avoidable and preventable. Therefore, the present study was conducted to investigate the causes of claims regarding medical malpractices resulting in maternal and perinatal mortality.

Materials and Methods:

A descriptive cross-sectional study was conducted and 7616 claims of medical malpractices in the field of obstetrics, gynecology, and midwifery that were referred from all 31 provinces to the central commission of legal medicine were studied during 2011–2012. Therefore, the present research is a national inclusive study covering all the provinces across Iran. To collect information from the transcript of medical malpractices cases, a researcher-made checklist was used, and the collected data were analyzed.

Results:

The results of the present study showed that among all the medical malpractice claims regarding pregnancy and childbirth (42.24%), the majority concerned perinatal death (71.82%) and maternal death (28.16%).

Conclusions:

Medical malpractice complaints are increasing; although, most of these claims are preventable. To achieve this aim, it is necessary for obstetricians, gynecologists, and midwives to try to reduce the complaints by paying more attention to the signs and symptoms of diseases, performing all the diagnostic and therapeutic measures according to the scientific criteria, and fully document patients' records. In addition, patients' acquaintance with the importance of measurements and examinations, before and during pregnancy care and even after childbirth is crucial.

The psychometric properties of exercise benefits/barriers scale among women

Background and objective

Despite the numerous health benefits of regular physical activity (PA), physical inactivity is a major health issue among women. The goal of the current study was to measure the validity and reliability assessment of the exercise benefits/barriers scale among women between the ages of 18 and 65 years. This study was carried out among women residing in Khoramroudi neighborhood in Tehran between December 2013 and February 2014.

Methods

In this descriptive, methodological study, 278 women residing in Khoramroudi neighborhood in Tehran between December 2013 and February 2014 completed three questionnaires: the demographic data form, the Exercise Benefits/Barriers Scale. The construct validity, internal consistency, and stability of the study were measured by confirmatory factor analyses, Cronbach’s alpha, and Spearman Brown correlation coefficient by using SPSS 21 and LISREL 8.80, respectively.

Results

The confirmatory factor analysis showed the Persian version of EBBS was structured well. The Cronbach’s alpha coefficients for the total scale and its subscales were 0.927, 0.94 and 0.82, respectively. Spearman Brown correlation coefficient also showed good test-retest reliability.

Conclusion

The results of this study verified the reliability and validity of the applied instrument and introduced it as a tool to measure the benefits and barriers of physical activity among Iranian women.

Difference in Perception of Pregnancy Risk in Two Maternal Age Groups

INTRODUCTION

Various health risks and complications may happen during pregnancy for both the mother and her child. Women should be informed of the risk associated with their pregnancy.

AIM

To compare the differences of perception of pregnancy risk of two maternal age groups of healthy nulliparous women.

MATERIALS AND METHODS

In an analytical, descriptive cross-sectional study, 240 nulliparous pregnant women (160 women aged 18 to 35 years as a normal age group and 80 women < 18 years as a high risk age group) were randomly selected. Women were asked to complete questionnaire which included sociodemographic characteristics, pregnancy history, perception of pregnancy risk and pregnancy related anxiety.

RESULTS

Overall, women of < 18 years (high-risk group) perceived the risks of pregnancy higher than those of 18-35 years age women (reference group). Women in high-risk group rated their risks for herself, having haemorrhaging, having a cesarean birth and dying during pregnancy to be significantly higher than reference group. There was a statistically significant relationship between maternal age and perception of pregnancy risk (p<0.003). There was also a statistically significant relationship between pregnancy related anxiety and perception of pregnancy risk (p<0.002).

CONCLUSION

Women's perception of pregnancy risk is different in various maternal age groups. Maternal age can be considered as one of the important factors affecting perception of pregnancy risk. By routine screening of perception of pregnancy risk during prenatal care more effective risk consulting model could be designed.

Basic educational needs of midwifery students for taking the role of an assistance in disaster situations: A cross-sectional study in Iran

BACKGROUND

After disasters, the disaster medical assistance team composed of skilful healthcare staff should be available at the disaster site for providing care to disaster's victims. It is believed that midwives are at the front line of the disaster management team and should be prepared for providing care to mothers and children.

OBJECTIVES

To investigate the midwifery students' basic educational needs for taking the role of an assistant in disaster situations.

DESIGN

A cross-sectional study was conducted in an urban area of Iran, in year 2015.

PARTICIPANTS

Two hundred and thirty-one final-year midwifery students with bachelor and master degrees in midwifery participated in this study.

SETTING AND SAMPLES

The samples were chosen using a census method from four nursing and midwifery schools affiliated with four medical sciences universities in Tehran, Iran.

METHODS

The informed consent form was signed by the samples before data collection. The samples were asked to fill out the researcher's made questionnaires consisting of the demographic data form and the basic educational needs for taking the role of an assistant in disaster situations. The later was consisted of two parts: 'coping with disaster situations' and 'performing the triage'. The data were analysed using descriptive and inferential statistics via the SPSS software for Windows.

RESULTS

The mean score of coping with disaster situations was 31.3±8.2 (out of 45). Also, the mean score of performing the triage was 14.6±11.8 (out of 20). It was found that 68.8 and 74% of the students in coping with disaster situations and performing the triage, respectively had high and very high educational needs. The highest educational need was reported in the areas of 'time management' and 'the use of equipment in disaster situations'. About 86.8% of the students declared that academic education did not prepared them for taking roles in disaster situations. Only 10.6% passed educational courses about disasters before and 11.5% had the work experience in disaster situations. There was a statistically significant relationship between the students' age (P=0.01), participation in educational courses (P=0.005) and the work experience in disaster situations (P=0.04) and educational needs.

CONCLUSIONS

Our findings showed that the midwifery students had high needs for education regarding disaster situations. Therefore, the incorporation of disaster management content in the midwifery degree curricula is suggested.

Patterns of marriage and reproductive practices: is there any relationship?

Today, a transition from traditional to modern marriages can be observed in many countries. This shift in patterns of marriage has evidently affected childbearing and reproductive practices. This study aimed to examine the relationship between patterns of marriage and reproductive practices in Iran. Hence, 880 married women, aged 15-49 years old, living in the North of Iran were selected using a multi-stage cluster sampling strategy and their patterns of marriage and reproductive practices were cross sectionally studied. The results revealed that there were no significant differences in the reproductive practices by three main patterns of marriage in Babol, Iran. The study also indicated that there were no significant differences in reproductive practices in three patterns of marriage after controlling for socio-economic variables. It seems that apart from the patterns of marriage, other influencing factors are the determinants of fertility in women, and the policy-makers of Iran need to pay attention to these determinants before making any decisions in this area.

Relationship of work-family conflict with burnout and marital satisfaction: cross-domain or source attribution relations?

Background: The present study was conducted to examine the relationship between two dimensions of work-family conflict (WFC) with marital satisfaction and burnout in a society in which few studies have been done about the consequences of WFC.

Methods: A cross-sectional study was conducted in 2015. Surveys were distributed to 420 employed married women with various jobs living in Bushehr province, Iran. Data were collected using a questionnaire for demographic characteristic, the Netmeyer’s WFC questionnaire, Maslach Burnout Inventory: General Survey (MBI-GS), and Enrich maritalsatisfaction questionnaire. The data were analyzed using descriptive and inferential statistics.

Results: There was a negatively significant association between work interference with family(WIF) and overall burnout as well as emotional exhaustion (P < .01). Family interference with work (FIW) was significantly associated with depersonalization (P < .01). The overall marital satisfaction and its subscales were significantly associated with WIF (P < .01) and FIW (P < .01 for overall marital satisfaction and P < .05 for its subscales).

Conclusion: In terms of practical implication, to avoid creating disadvantages of WIF and FIW,facilitation in two domains of improving work and family conditions can be a useful means to prevent WFC and its consequences.

Marriage Patterns and Childbearing: Results From a Quantitative Study in North of Iran

Social changes have rapidly removed arranged marriages and it seems the change in marriage pattern has played a role in childbearing. On the other hand, there is a great reduction in population in many countries which requires a comprehensive policy to manage the considerable drop in population. To achieve this goal, initially, the factors affecting fertility must be precisely identified. This study aims to examine the role of marriage patterns in childbearing. In this cross-sectional quantitative study, 880 married women 15-49 years old, living in the north of Iran were studied using a cluster sampling strategy. The results showed that there are no significant differences in reproductive behaviors of three patterns of marriage in Bobol city of Iran. It seems there is a convergence in childbearing due to the different patterns of marriage and Policymakers should pay attention to other determinants of reproductive behaviors in demographic planning.

Reproductive practices by patterns of marriage among Iranian women: study protocol for an explanatory sequential mixed methods design

Background

Nowadays, nearly half of the world population lives in societies with low fertility or the below-replacement fertility. This potentially grounds the critical situation of reduction in the workforce and causes the aging of population due to an overall increase in life expectancy and standard of living. Hence, population and its transitions including the issue of fertility decline has become a topic of intense debate in the agenda-setting and policy-making processes in both the developed and developing countries. In this view, what can practically be done to respond to the fertility decline that entails effectively addressing the determinants of fertility change? In line with the literature, how people form their marriages or patterns of marriage is amongst influencing factors which potentially affect their reproductive practices as diverse societies recognize different conventions for marriage. This study is to examine women’s reproductive practices by the various patterns of marriage using the explanatory sequential mixed methods design.

Methods/design

This study has an explanatory sequential mixed methods design, the follow-up explanations variant model, with two strands. This design will be implemented in two distinct phases. In the first phase, a cross-sectional quantitative study will be done using a cluster sampling strategy on 850 married women 15–49 years old living in Babol city, Iran. In order to obtain a deeper understanding of the results of the quantitative phase, researchers will implement a qualitative research in the second phase of this study. This design will provide an explanation of the quantitative research results using the qualitative evidence.

Discussion

As patterns of marriage have implications for the status of women, their health and fertility, the result of this study can provide a rich source of information for the required health-related interventions and policies are required to put the demographic changes on the right track at micro and macro level and improve the reproductive practices of women at micro level.

Lavender Fragrance Essential Oil and the Quality of Sleep in Postpartum Women

Background:

Objectives:

Patients and Methods:

Results:

Conclusions:

Community-based physical activity interventions among women: a systematic review

OBJECTIVE

Review and assess the effectiveness of community-based physical activity interventions among women aged 18-65 years.

DESIGN

Systematic review

METHODS

To find relevant articles, the researcher selected reports published in English between 1 January 2000 and 31 March 2013. Systematic search was to find controlled-trial studies that were conducted to uncover the effect of community-based interventions to promote physical activity among women 18-65 years of age, in which physical activity was reported as one of the measured outcomes. The methodological quality assessment was performed using a critical appraisal sheet. Also, the levels of evidence were assessed for the types of interventions.

RESULTS

The literature search identified nine articles. Four of the studies were randomised and the others studies had high methodological quality. There was no evidence, on the basis of effectiveness, for social cognitive theory-based interventions and inconclusive evidence of effectiveness for the rest of interventions.

CONCLUSIONS

There is insufficient evidence to assess the effectiveness of community-based interventions for enhancing physical activity among women. There is a need for high-quality randomised clinical trials with adequate statistical power to determine whether multicomponent and community-based intervention programmes increase physical activity among women, as well as to determine what type of interventions have a more effective and sustainable impact on women's physical activity.

Iranian mothers' perception of the psychological birth trauma: A qualitative study

OBJECTIVE

Childbirth is one of the most vulnerable moments and the most important and memorable events in the lives of women that despite of bringing happiness, it can be associated with psychological trauma and endanger the mother and neonate health. Mothers' perception of the psychological birth trauma is a highly subjective process that depends on the cultural, social and biological conditions of mothers that is not achievable except with examination of their views. This study aimed to understand psychological birth trauma from the perceptions of Iranian mothers.

METHODS

A qualitative research design using in-depth interviews of 23 Iranian mothers was conducted from Tehran and Isfahan health centers. The interviews were transcribed and analyzed using conventional content analysis.

RESULTS

Two themes were extracted from the data: impact of psychological birth trauma and trends of psychological birth trauma. Several categories and sub-categories also emerged from the data. Feelings of fear, anxiety, helplessness and sense of impending death (collapse) were reported by the mothers.

CONCLUSIONS

By considering the unforgettable experience of mothers from the psychological birth trauma, a plan for supportive care before, during and after birth is critical.