Sexual health literacy level and its related factors among married medical sciences college students in an Iranian setting: a web‑based cross‑sectional study

BACKGROUND

Sexual health literacy (SHL) leads to the development of personal ability, understanding, evaluation and use of information related to sexual health. The purpose of this study was to assess the sexual health literacy level and its related factors among married college students at Mazandaran University of Medical Sciences (MAZUMS).

METHODS

A web-based cross-sectional online study was conducted on married college students at Mazandaran University of Medical Sciences between January and November 2020. All students were included in the study by census, and the study method was explained by telephone. If they agreed to participate in the study, the online link to the questionnaire, including sociodemographic and clinical information and Sexual Health Literacy for Iranian Adults (SHELIA), was emailed. The Statistical Package for the Social Sciences (SPSS) software version 26 was used for data analysis. Univariate and multivariate logistic regression tests were used to assess factors related to sexual health literacy.

RESULTS

The sample consisted of 277 male and 123 female students. Sexual Health Literacy Level and all subscales are at the sufficient level (66.1-88). Among the participants, 20.5% had limited sexual health literacy. Multivariate analysis found factors related to sexual health literacy among students: economic status (OR 0.03; 95% CI 0.0-0.55) and faculty (OR 0.07; 95% CI 0.01-0.52) is related to decrease and subscription to social media for sexual health (OR 3.27; 95% CI 1.53-7.01), information source of channels and cyberspace (OR 3.23; 95% CI 1.41-7.39), educational level (OR 16.39; 95% CI 2.16-32.70), Internet search information source (OR 1.91; 95% CI 1.00-3.64) is related to increase, were statistically significant factors.

CONCLUSION

In Iran, medical sciences college students, who constitute a significant portion of the country's population, are responsible for sexual health education. Government agencies, with the collaboration of all stakeholders, should develop policies and programs for implementing and evaluating integrated and comprehensive sexual health literacy promotion programs for them.

Psychosexual counseling intervention to improve women's genital self-image: Study protocol for a randomized controlled trial based on a multistage mixed method design

Background

Genital self-image (GSI) is a major barrier to reproductive and sexual health for women. This practical randomized trial aims to evaluate the effect of psychosexual counseling based on a cognitive-behavioral approach to promoting GSI for reproductive-age married Iranian women.

Methods

Married women aged 15-49 years under the coverage of health centers will be invited to join the study. The study will be conducted using a multistage mixed method design in three phases. In the first phase, semi-structured interviews with women and key informants will be conducted to understand better the GSI concept, the factors influencing it, and the interventions promoting it. Simultaneously, a literature review will be conducted by searching electronic databases to find the factors influencing GSI and the interventions to enhance it.In the second phase, the GSI-related factors, sexual and reproductive health outcomes correlated with GSI, and intervention programs for promoting GSI in women will be extracted from the integration of qualitative study and literature review. Then, based on the expert panel's priority, a suitable program will be prepared.In the third phase, at first, a cross-sectional study will be conducted to identify women with poor GSI and the factors relating to GSI, and then psychosexual counseling intervention will be performed. For the randomized controlled trial study, participants will be randomly allocated into two groups: (1) the intervention group and (2) the control group. Data will be collected using the Female Genital Self-Image Scale and sexual and reproductive health outcomes correlated with GSI at baseline, immediate, and 2-month follow-up assessments. The impact of the intervention on the promotion of GSI will be evaluated.

Discussion

This study provides a counseling program for promoting GSI. If this interventional program is successful, it has practical potential to be generalized for Iranian Women with poor GSI.

Perceived stress reduction through an infertility coaching program: a randomized controlled clinical trial

Infertility has been recognized as a distressing experience among couples worldwide, cutting across various cultures. This present study was conducted to assess the impact of a supportive stress management program led by an infertility coach for women undergoing fertility treatment. This randomized controlled clinical trial study was performed on 60 infertile women undergoing assisted reproductive techniques at Maryam Infertility Center located in Sari in 2018. After random allocation in two groups, 30 individuals were in the intervention group and 30 in the control group. The intervention program was implemented according to the infertility coach's counseling protocol in six stages. The control group received only routine ward counseling. In order to measure stress, the Newton Infertility Stress Questionnaire was used firstly before intervention and then after oocyte puncture, embryo transfer, and pregnancy testing. Data analysis was performed using SPSS statistical software version 18 and Shapiro-Wilk, Chi-square, Mann-Whitney, independent t-test, Friedman test, Wilcoxon test, GEE test, and Cohen's effect size. Our analysis approach has also been based on the analysis of (ITT). The significance level was 0.05. The mean ± SD scores of infertility perceived stress before the intervention in the control was 146.16 ± 16.90 and the intervention group was 156.53 ± 9.31, after intervention at the time of oocyte puncture in the controls was 165.36 ± 8.98 and the intervention group was 155.83 ± 10.70, at the day of embryo transfer in the control group was 156.35 ± 14.45 and in the intervention group was 123.58 ± 22.9 and in the pregnancy test day in the control group was 185.76 ± 26.56 and in the intervention group was 127.61 ± 21.57 (P < 0.001). According to Friedman test, the mean of stress in three situations after the intervention showed a significant difference in reduction of the mean of stress (P < 0.001). In the control group, the stress score of the samples had an increasing trend, which was significant during the measurement steps based on Friedman test results (P < 0.001). In the intervention group, paired t-test results showed no significant comparing mean score of Newton's infertility stress before and after oocyte puncture day (P = 0.711), comparing the mean of stress before and after pregnancy test day (P = 0.003) and also comparing of mean stress before and after pregnancy on the day of embryo transfer according to Wilcoxon test (P < 0.001). And comparing mean stress before and after pregnancy test day, paired t-test (P = 0.001) showed significant statistical differences. According to the results of the GEE test, changes in stress scores over time were significant between the two groups (P < 0.001), as well as the effect of stress on oocyte puncture day (0.41), embryo transfer day (1.69), pregnancy test day (P < 0.001) (2.46) had a significant effect on the day of embryo transfer and pregnancy test day. Based on the results of this study, the infertility coach program demonstrated the ability to decrease the perceived stress related to infertility. Additionally, it showed potential in enhancing treatment outcomes, such as oocyte count and positive pregnancy results, among infertile women undergoing assisted reproductive techniques.Trial registration: Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/33357 ). Registered 11-11-2018.

The association between early menarche and higher-risk cardiometabolic profile: a dose-response analysis of the Tabari cohort at enrollment phase

Objectives

The association between age at menarche and higher-risk cardiometabolic factors is controversial and more strands of evidence are required. Therefore, in this study, we aimed to investigate the effect of early menarche on cardiometabolic profile in a large-scale cohort population.

Study design

Data collected in the enrollment phase of the Tabari cohort study were utilized for the present study. We analyzed data from 6,103 women aged 35-70 years. Logistic regression and dose-response (trend) analyses were used to investigate the effect of early menarche on prevalence of diabetes, dyslipidemia, obesity, high waist circumference (WC), high waist-to-hip ratio (WHR), and high waist-to-height ratio (WHtR).

Results

The results of the adjusted logistic regression analysis showed that women who experienced early menarche had significantly higher odds of obesity (odds ratio: 1.64, 95% CI: 1.36-1.99, P for trend <0.001), high WC (odds ratio: 1.34, 95% CI: 1.07-1.67, P for trend = 0.035), high WHR (odds ratio: 1.32, 95% CI: 1.05-1.66, P for trend = 0.057), and high WHtR (odds ratio: 1.83, 95% CI: 1.22-2.74, P for trend = 0.006) compared to those aged ≥14 at menarche. The prevalence of dyslipidemia was also higher among women who experienced early menarche than in women aged ≥14 at menarche (79.9% vs. 76.6%), but the difference was not statistically significant (P = 0.098). Additionally, each year of earlier menarche was significantly associated with an increase in the chance of diabetes (by 5%), obesity (10%), high WC (5%), and high WHtR (13%).

Conclusion

The present study showed that early menarche is a strong predictor for later development of obesity and diabetes, and for high WC, WHR, and WHtR. Among all factors examined, age at menarche had the greatest predictive power for WHtR. As an age-dependent anthropometric index for central obesity, WHtR is more suitable as an index for identification of individuals with increased cardiometabolic risk.

Prevalence and predictors of sexual distress in married reproductive-age women: A cross-sectional study from Iran

Background and Aim

Although various surveys have been conducted for sexual problems, there is a lack of population-based studies on sexual distress in Iran. Thus, we sought to determine the prevalence and predictive factors of sexual distress in this population.

Methods

Overall, 1000 married women aged 16-49 years were enrolled in this study using the two-stage cluster sampling method. To identify sexual distress, the female sexual distress scale-revised (FSDS-R) was completed. The predictive factors were assessed using a checklist.

Results

A total of 318 women (31.8%) suffered from sexual distress. Among socio-demographic factors, satisfaction with marriage (p = 0.001), among personal factors history of infertility and fear of contracting sexually transmitted infections (p < 0.01), and among sexual and interpersonal factors satisfaction with the level of sexual desire (p = 0.01), pain during sexual intercourse (p < 0.01), premature ejaculation disorders in the partner (p < 0.05), and sexual satisfaction (p < 0.001) were significantly associated with sexual distress.

Conclusion

Clinicians should evaluate sexual distress comprehensively and consider all the related dimensions. The high overall prevalence of sexual distress, with or without an identifiable dysfunction, signals the importance of health professionals being adequately prepared to discuss sexual health concerns.

Design, implementation, and validation of an application for childbirth preparation classes to improve the performance of midwifery students: Study protocol

BACKGROUND

Childbirth preparation classes are incredibly useful for midwifery students as future medical personnel. Nowadays, given the outbreak of Covid-19 pandemic and as mobile applications are extensively welcomed, virtual space can be used for education in the area of childbirth preparation classes. Given the lack of an application for childbirth preparation classes, this study will be conducted to design, implement and validate such an application to improve the performance of midwifery students in the areas of pregnancy and safe delivery.

MATERIALS AND METHODS

The present study will be conducted in three phases. In the first phase, content will be provided to Information Technology experts based on the content of the national guidelines for physiological delivery in Iran, and the application will be designed and validated for the use of midwifery students, then develop app for other medical students, midwives and physicians. In the second phase, the assessment will be based on Kirkpatrick's model. In the third stage, develop app for other medical students, midwives and physicians based on the results of the first and second phase. SPSS version 17 will be used in this phase for analysis of data through descriptive and analytical tests.

CONCLUSION

Owing to the expansion of virtual space and the outbreak of Covid-19 pandemic, design, validation, and evaluation of an application for childbirth preparation classes is an exceptionally significant necessity which contributes to the process of educating midwifery students.

Complex factors related to marital and sexual satisfaction among couples undergoing infertility treatment: A cross-sectional study

Objectives

This study assesses complex factors related to marital and sexual satisfaction among couples undergoing infertility treatment.

Methods

This cross-sectional study was conducted with 140 couples who visited fertility centers in Iran, between September 2015 and July 2016. Data collection was done by Marital and Sexual Satisfaction Questionnaires and were analyzed by the IBM SPSS 26 software.

Results

There was a significant difference between wives and husbands in the MSQ total scores (p = 0.027). However, there was no significant difference between wives and husbands in the SSQ total scores (p = 0.398). Sexual satisfaction and decision-maker in life among wives and husbands were significant predictors of MSQ. The kind of treatment, cause of infertility and BMI among wives and kinds of treatment, cause of infertility, and decision-maker among husbands were also significant predictors of SSQ.

Conclusion

The findings of this study showed that there is a difference between the understanding of marital and sexual satisfaction in wives and their husbands. Healthcare providers need to pay more attention to these differences.

Explaining sexual self-care status and its predictor factors in women referring to healthcare centers of Sari, Iran, 2021

INTRODUCTION

With the increase in the prevalence of non-communicable diseases and chronic health problems along with population growth, one of the definitions that is expanding is the ability to adapt and self-manage against diseases and self-care. Although there are several studies to examine self-care in medical conditions, there are not enough concepts and data related to sexual self-care. Therefore, the present study was conducted with the aim of explaining the status of sexual self-care and its predictor factors in women of reproductive age referring to healthcare centers.

MATERIAL AND METHODS

This research was a cross-sectional study that was conducted on 400 women of reproductive age that referring to healthcare centers affiliated to Mazandaran University of Medical Sciences, Sari in 2021. Data were collected using personal-obstetric characteristics and sexual self-care questionnaires in women of reproductive age. Pearson correlation coefficients, independent t-test, one-way analysis of variance and multiple linear regression model were used to analyze the data.

RESULTS

The average total score of sexual self-care in reproductive age women participating in the research was 70.66% ± 12.52%. In addition, the prevention of women's cancers and the prevention of unintended pregnancies obtained the lowest and highest scores, respectively. Factors such as age, education, education related to medical sciences, history of HIV testing, history of HPV vaccination, source of sexual information, method of contraception and infection-related action in a person can affect the level of sexual self-care in women. Based on the final regression model, education related to medical sciences (B = 5.46, P = 0.035), family income (B = 5.58, P = 0.025), prevention method (B = 10.127, P = 0.000) and action related to infection in the person (B = 12.27, P = 0.047) were the final predictors of sexual self-care score in reproductive age women.

CONCLUSION

Based on the findings of the study, development of self-care promotion programs for reproductive aged women are necessary in all areas of reproductive health, with a priority for women's cancer prevention, and focusing on promoting education and related economic assistance. The results of this study can be available to experts and policy makers to design programs to promote sexual self-care in women.

Psychometric Properties of the Persian Version of the Personal Meaning Profile in Iran

The Personal Meaning Profile (PMP) is a widely used instrument to measure people's perceptions of personal meaning in their lives. This study aimed to evaluate the psychometric properties of the Persian version of the PMP. First, the researchers developed the Persian version of this scale using the forward-backward procedure. Then, they examined the face and content validities by both qualitative and quantitative approaches. To evaluate the construct validity, researchers administered the instrument to a sample of 482 medical sciences students and performed exploratory and confirmatory factor analyses. The reliability was assessed using loading factors, Cronbach's alpha coefficients, and composite reliability. An average scale-level of content validity index of the PMP with 57 items was 0.80. The findings revealed that the Persian version of the PMP comprises five factors explaining 50.57% of the total variance. The confirmatory factor analysis indices showed a moderate fit for the data. Reliability of the Iranian version of PMP was demonstrated with a Cronbach's alpha of 0.893. Consistency was established with test-retest reliability with an interval of 2 weeks (Intracluster Correlation Coefficient = 0.983, p < 0.001). Moreover, the criterion validity demonstrated a significant inverse relationship between the PMP and General Health Questionnaire (r = - 0.34, p < 0.001). This study indicated that the Persian version of the PMP is an acceptable, reliable, and valid measurement to evaluate the meaning in life in Iranian medical sciences students.

A Review Of Effective Interventions To Improve Emotional Risk Factors Of Anxiety, Stress, Depression In Infertile And Infertile Patients Undergoing Treatment With Assisted Reproductive Techniques

Introduction

Infertility is a major problem in life and affects the lives of infertile couples in every way

Objectives

Infertility is associated with several negative reactions and emotional problems. Review of effective interventions for improving emotional risk factors In infertile and infertile patients undergoing treatment

Methods

A comprehensive narrative review of the studies was conducted. Databases such as Web of Science, Science Direct, Cochrane Library, Scopus, PubMed/Medline, Clinical Key, and MAGIRAN were retrieved from May 10 to August 8, 2021, with no time limit. After reviewing the abstract and the full text of the articles, 32 articles were selected for writing. The methodological quality of the article was assessed based on the Cochrane Risk of Bias

Results

Interventions were divided into two subgroups of mind-body, and web-based CBT. Mind-body interventions generally show the anxiety, stress and depression reduction and Possible improvement in pregnancy rate, but most of these programs require extensive financial resources.The results of web-based,showed that using online CBT approach can greatly reduce stress and anxiety,due to increased use of the internet, non-collaborative, cheap and private treatment of web-based interventions, this method can be used as a way along with other treatments to reduce these negative reactions.

Conclusions

According to the present study CBT methods, application and Internet-based interventions can be used as appropriate counseling methods in reducing stress, anxiety and improving pregnancy outcomes in infertile patients. This information can be used as a proper source to select appropriate counseling methods for health care providers, midwives, and treatment staff involved in infertility patients.

Disclosure

No significant relationships.

Investigation of social capital and its relationship with emotional adjustment in infertile couples: A cross-sectional study

Background: Infertility is an abnormal event in the life of families and can have various consequences on a personal and social level. Therefore, infertile couples need to manage their emotional responses. Social capital, as one of the social determinants of health, can affect mental health. Objective: This study was conducted to determine the relationship between social capital and emotional adjustment in infertile couples. Materials and Methods: This cross-sectional study was conducted from October 2018 to February 2019 with 170 infertile couples visiting infertility centers in Sari, Iran. The data collection instruments included the social capital integrated questionnaire, an emotional adjustment scale and a demographic-reproductive checklist. Results: All the social capital dimensions, except for the groups and networks dimension, had a score of higher than 50 (more than the mean score). Based on ANCOVA and the multiple linear regression results, the dimension of trust and solidarity had a significant negative relationship with emotional adjustment (p = 0.01), but no significant relationship was observed between the other social capital dimensions and emotional adjustment. Conclusion: The trust and solidarity dimension had a significant relationship with emotional adjustment in infertile couples. Accordingly, increasing mutual trust between neighborhood residents can strengthen social capital, and in turn, improve emotional adjustment in infertile couples. Key words: Social capital, Emotional adjustment, Infertility.

Psychological Interventions in Chemotherapy-Induced Nausea and Vomiting in Women with Breast Cancer: A Systematic Review

Background:

Nausea and vomiting are considered the most common side effects of chemotherapy, and they can affect different dimensions of the lives of women with breast cancer. Thus, the management of these complications is of great significance. Various interventions are drawn upon to alleviate nausea and vomiting. This review aimed to investigate the effects of psychological interventions on chemotherapy-induced nausea and vomiting among women with breast cancer.

Methods:

A systematic review of clinical or quasi-experimental clinical trials published from 2000 to 2020 on the effects of psychological interventions on nausea and vomiting induced by chemotherapy in women with breast cancer was conducted via a comprehensive search in web search engines including Google Scholar and PubMed and databases such as Web of Science, Scopus, ScienceDirect, Cochrane Library, Springer, Elsevier, Magiran, and Scientific Information Database (SID). Medical Subject Heading (MeSH) was employed with the following keywords: nausea, vomiting, breast cancer, chemotherapy, and psychological intervention. The quality of the included studies was assessed via the Jadad scale.

Results:

Nine studies were included in this systematic review. Psychological interventions in chemotherapy-induced nausea and vomiting in women with breast cancer consisted of cognitive-behavioral therapy, progressive muscle relaxation training, yoga, and guided imagery. The results indicated that in all the studies, except one, the interventions improved conditions and reduced chemotherapy-induced nausea and vomiting.

Conclusion:

The results of this study indicated that psychological interventions such as cognitive-behavioral therapy, progressive muscle relaxation training, guided imagery, and yoga alleviated nausea and vomiting induced by chemotherapy in women with breast cancer. Therefore, it is recommended that these interventions be applied by healthcare providers to ameliorate nausea and vomiting in these patients.

The abstract was presented in the 15th International Congress on Obstetrics and Gynecology, Tehran, Iran, 8–11 October 2019, as a poster and published in the congress book.

Sexual Health Needs of Women with Breast Cancer: A Rapid Review

Introduction: The number of women diagnosed with breast cancer has been rising globally over the past few decades. Upon hearing of a breast cancer diagnosis, women face many challenges including emotional distress, body image issues and sexual dysfunction. Regarding the importance of sexuality for breast cancer patients, this paper aims to validate the sexual health needs of women with breast cancer. Aim: To assess the sexual health needs of women with breast cancer and a need for further research. Materials and Methods: This research is a rapid review conducted in Iran, in April 2020. Databases of PubMed, Cochrane Library, Scopus and Web of Science as well as the Iranian Scientific Information Database (SID), were searched with mentioned keywords, “Female Breast Cancer”, “Sex Counselling”, “Female Sexual Dysfunction” and “Sexual Health Needs”. Results: This review included 16 studies with one randomised clinical trial, four cross-sectional, four review articles, three qualitative articles, three mixed-method studies and one cohort. This study highlights four major sexuality-related information needs of women with breast cancer including: informational need about sexual activity; informational need about fertility-preserving options before starting breast cancer treatment; informational need about prosthesis or breast reconstruction surgery, and informational need about physical changes caused by breast cancer treatments. Conclusion: This review highlight the importance of sexual health needs for female breast cancer patients. However, little attention has been received from women’s health professionals and researchers and further research on sexuality and breast cancer is recommended to affirm these research findings.

Relationship between DMFT index and number of pregnancies: a cross-sectional study on enrollment phase of the Tabari Cohort Study

Background

People of all age and gender groups are at risk of dental diseases; however, some groups, such as pregnant women, are more vulnerable than others due to their specific physiological situations. The protection of maternal and fetal is critical. Therefore, the present study intended to investigate the relationship between the Decayed, Missing, and Filled Teeth (DMFT) index and the number of pregnancies.

Methods

The present cross-sectional study was performed using the Tabari Cohort Study (T.C.S.) data. Data of 5,496 women enrolled in the T.C.S. were included in the study. After obtaining the approval of the Ethics Committee, the related data on the variables of age, age at the first pregnancy, number of pregnancies, total number of teeth at the time of examination, number of DMFT, employment status, socioeconomic status, educational level, residence location, body mass index, and the status of diabetes mellitus, hypertension, and cardiovascular diseases were extracted. Finally, data analysis was performed in the STATA software (version 14).

Results

The mean DMFT index in women with 1, 2, 3, 4, 5, 6, and more than six pregnancies were obtained at 12.74 ± 7.11, 13.09 ± 7.06, 14.80 ± 7.81, 17.07 ± 8.11, 19.82 ± 9.02, 22.89 ± 8.98, and 26.17 ± 8.01, respectively (P < 0.001). Using the multivariate linear regression and adjusting the effect of potential confounding variables, it was found that the DMFT index increased by 34% for each unit increase in the number of pregnancies (β = 0.34, P < 0.001).

Conclusions

According to our results, there was a significant relationship between the DMFT index and the number of pregnancies. The DMFT index was increased with an increased number of pregnancies. Therefore, oral healthcare promotion should receive special attention in healthcare planning and related policies by raising awareness and providing easy access to dental services for women of childbearing age, especially pregnant women.

Meaning in life as a predictor of the general health among medical sciences students: A cross-sectional study

AIM

To investigate the predictive role of meaning in life on the general health among medical sciences students.

DESIGN

A cross-sectional study.

METHODS

Four-hundred medical sciences students were selected by proportional to size sampling. The general health questionnaire and the personal meaning profile were administrated to identify the predictive role of meaning in life on the student's general health. Descriptive statistics and linear regression were administrated.

RESULTS

The mean ± SD of the total score of general health and meaning in life among students was 16.34 ± 6.73 and 71.50 ± 9.78, respectively. In the multiple linear regression model, factors such as father's educational level, and meaning in life can predict a 20% variance of general health among university students. As meaning in life thus emerges as a variable worth further in the health of university students, implementing interventional studies to assess the effect of meaning in life on students' general health is recommended.

The effect of motivational interview based on WhatsApp on the psychological domains of quality of life in infertile women with pcos: A randomized clinical trial

Introduction

Polycystic ovary syndrome(Pcos) disease significantly decreased quality of life for women. Mental health is one of the components affecting the quality of life of these patients that attention to it is necessary to improve their quality of life.

Objectives

The present study was conducted to determine The effect of Motivational Interview Based on WhatsApp on the Psychological Domains of Quality of Life in Infertile Women with PCOS.

Methods

This randomized controlled clinical trial enrolled 60 Infertile Women with PCOS from the city of Sari-Iran in 2020. Participants were assigned to MI and control groups using block randomization. The intervention group received 5 weekly of MI online via WhatsApp. While the control group received only routine care. The psychological Domains score of quality of life in these individuals was measured using the quality of life questionnaire of polycystic ovary syndrome(MPCOSQ) before and after the intervention. Then, the data were entered into the SPSS software, version 25 and were analyzed using descriptive statistics, chi-square test, t-test, and repeated measures analysis of variance.

Results

No significant difference was observed between the two groups before the intervention mean The Psychological Domains scores (p>0.05). After the intervention, mean (SD) of The Psychological Domains score was 34.8 (11.8) in the intervention group and 30.7 (11.6) in the control.No significant Increasing in the mean between the two groups. The effect size(0.35) was calculated.

Conclusions

The results of the study showed that motivational interviewing is effective in improving the quality of life of women with pcos.

Disclosure

No significant relationships.

The effect of online motivational interviewing on stress management in infertile women with PCOS: A randomized clinical trial

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, which in addition to medical aspects also affects the dimensions of women’s mental health such as stress.

Objectives

The present study was conducted to determine The effect of online motivational interviewing on stress management in infertile women with PCOS

Methods

This randomized controlled clinical trial enrolled 60 Infertile Women with PCOS from the city of Sari-Iran in 2020. Participants were assigned to MI and control groups using block randomization. The intervention group received 5 weekly of MI online via WhatsApp. While the control group received only routine care. Stress management scores in these individuals were measured using health-promoting lifestyle profile II questionnaire (HPLP II) before and after the intervention. Then, the data were entered into the SPSS software, version 25 and were analyzed using descriptive statistics, chi-square test, t-test, and repeated measures analysis of variance.

Results

No significant difference was observed between the two groups before the intervention mean The Stress management scores (p>0.05). After the intervention, mean (SD) of The Psychological Domains score was 22.5 (3.8) in the intervention group and 17.9 (4.1) in the control. The Stress management score was significantly upper in the intervention group compared to the control. (p<0.000). The effect size (1.1) was calculated. NNT (1.6) was calculated.

Conclusions

According to the results and the effect of motivational interviewing is one of the effective methods to manage stress in infertile women with PCOS.

Disclosure

No significant relationships.

A review of effective interventions to improve emotional risk factors of anxiety, stress, depression in infertile and infertile patients undergoing treatment with assisted reproductive techniques

Introduction

Infertility is associated with Several negative reaction and emotional problems

Objectives

Review of effective interventions for improving emotional risk factors In infertile and infertile patients undergoing treatment

Methods

A comprehensive narrative review of the studies was conducted. Databases such as Web of Science, Science Direct, Cochrane Library, Scopus, PubMed, including Medline, Clinical key, SID, MAGIRAN were retrieved from August 10 to December 8, 2020, with no time limit. After reviewing the abstract and the full text of the articles in terms of compliance with the purpose of the study, finally, 32 articles were selected for writing. The methodological quality of the articles was assessed based on Cochrane Risk of Bias

Results

Interventions were divided into two subgroups of mind-body, and web-based CBT. mind-body interventions generally shows the anxiety,stress and depression reduction and Possible improvement in pregnancy rate But most of these programs require extensive financial resources The results of web based, showed that using online CBT approach can greatly reduce stress and anxiety, due to increased use of internet, non collaborative,cheap and private treatment of web based interventions, this method can be used as a way along with other treatments to reduce these negative reactions

Conclusions

According to the present study CBT methods, application and Internet-based interventions can be used as appropriate counseling methods in reducing stress, anxiety and improving pregnancy outcomes in infertile patients. This information can be used as a proper source to select appropriate counseling methods for health care providers, midwives and treatment staff involved in infertility patients

Disclosure

No significant relationships.

Pregnancy-related anxiety and its associated factors during COVID-19 pandemic in Iranian pregnant women: a web-based cross-sectional study

BACKGROUND

Pregnancy is a risk factor for coronavirus disease 2019 (COVID-19). Pregnant women suffer from varying levels of pregnancy-related anxiety (PRA) which can negatively affect pregnancy outcomes. The aim of this study was to assess PRA and its associated factors during the COVID-19 pandemic.

METHODS

This web-based cross-sectional study was conducted in 2020 on 318 pregnant women purposively recruited from primary healthcare centers in Sari and Amol, Iran. Data were collected using questionnaires (PRAQ, Edinburg, KAP of COVID-19, CDA-Q and Demographic questionnaire), which were provided to participants through the social media or were completed for them over telephone. Data were analyzed with the linear regression and the logistic regression analysis, at the significance level of 0.05 using the SPSS software (v. 21).

RESULTS

Around 21% of participants had PRA, 42.1% had depression, and 4.4% had COVID-19 anxiety. The significant predictors of PRA were number of pregnancies (P = 0.008), practice regarding COVID-19 (P < 0.001), COVID-19 anxiety (P < 0.001), depression (P < 0.001), and social support (P = 0.025) which explained 19% of the total variance. Depression and COVID-19 anxiety increased the odds of PRA by respectively four times and 13%, while good practice regarding COVID-19 decreased the odds by 62%.

CONCLUSION

Around 21% of pregnant women suffer from PRA during the COVID-19 pandemic and the significant predictors of PRA during the pandemic include number of pregnancies, practice regarding COVID-19, COVID-19 anxiety, depression, and social support. These findings can be used to develop appropriate strategies for the management of mental health problems during pregnancy in the COVID-19 pandemic.

Body Image and Hypoactive Sexual Desire Disorder Relationship in a Representative Sample of Iranian Women

Objective: Hypoactive Sexual Desire Disorder (HSDD) among women is a complicated one which is created by various factors playing roles. One of the potential concerns related to Body Image (BI) is lack of sexual appeal in women. Body Image is often described as what a person perceives of their body encompassing the biological, psychological and social factors. The present research pursues the goal to investigate the association between BI and HSDD among the reproductive age women in Iran. Materials and methods: The current study is a cross-sectional (descriptive -analytical) research done on 1000 reproductive age included woman (15-49 years), performed by systematic random sampling method. The data collection tool includes the socio-demographics and the sexual desire scale in addition to the revised sexual distress scale to measure HSDD completed as self-report by the samples. Univariate and multivariate regression tests have been used in order to analyze the data. Results: The mean ± SD age of the women participating in the study was 32.09 ± 7.33. Having adjusted the confounder variables' effect by logistic regression multivariate analysis; the odd ratio for HSDD has been analyzed. The findings suggested that the odd ratio for HSDD in those not satisfied or slightly feeling fulfilled with their BI has been OR: 4.2 (95% CI: 1.98-9.05) and OR: 3.9 (95% CI: 2.29-6.65), respectively, times more than the ones highly satisfied with their body image. Conclusion: The present study results indicate that being dissatisfied with BI is a determinant factor of HSDD that is more probable in the people with negative image of their body structure and feeling lack of bodily appeal. Thus it is imperative to pay attention to this factor when analyzing HSDD.

Infertility Distress Management in Couples Treated with Assisted Reproductive Techniques (ART) in COVID-19 Pandemic

Background:

World Health Organization estimates that 60–80 million couple worldwide currently suffer from infertility. Recurrent pregnancy loss (RPL) is also another major concern. Chromosomal rearrangements play a crucial role in primary and secondary infertility and RPL. Underlying genetic abnormalities like chromosomal abnormalities contribute to 5–10% of the reproductive failures. The aim of the study was to evaluate the chromosomal abnormalities in infertility and RPL cases to help obstetrician/fertility experts to carry out risk assessment and provide appropriate assisted reproductive techniques for better management of the problem.

Methods:

Karyotyping was performed for 414 cases with the history of infertility and RPL over a period of one year. Samples were processed according to procedures of AGT cytogenetic laboratory manual.

Results:

Chromosomal abnormalities were observed in 15% of cases. Robertsonian translocation, reciprocal translocation, inversion, derivatives, marker chromosomes, mosaics, aneuploidy and polymorphic variants each contributed 2%, 3%, 3%, 13%, 2%, 10%, 6% and 61%, respectively.

Conclusion:

Evaluation of chromosomal abnormalities in couple is warranted prior to planning pregnancy especially for assisted reproductive management cases. Chromosomal analysis can be used as one of the diagnostic tools by OBG/IVF specialists in association with geneticist/genetic counselor for proper reproductive counseling and management.

Diagnostic value of serum HER2 levels in breast cancer: a systematic review and meta-analysis

BACKGROUND

Measurement of serum human epidermal growth factor receptor-2 (HER-2/neu) levels might play an essential role as a diagnostic/screening marker for the early selection of therapeutic approaches and predict prognosis in breast cancer patients. We aimed to undertake a systematic review and meta-analysis focusing on the diagnostic/screening value of serum HER-2 levels in comparison to routine methods.

METHODS

We performed a systematic search via PubMed, Scopus, Cochrane-Library, and Web of Science databases for human diagnostic studies reporting the levels of serum HER-2 in breast cancer patients, which was confirmed using the histopathological examination. Meta-analyses were carried out for sensitivity, specificity, accuracy, area under the ROC curve (AUC), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR).

RESULTS

Fourteen studies entered into this investigation. The meta-analysis indicated the low sensitivity for serum HER2 levels (Sensitivity: 53.05, 95%CI 40.82-65.28), but reasonable specificity of 79.27 (95%CI 73.02-85.51), accuracy of 72.06 (95%CI 67.04-77.08) and AUC of 0.79 (95%CI 0.66-0.92). We also found a significant differences for PPV (PPV: 56.18, 95%CI 44.16-68.20), NPV (NPV: 76.93, 95%CI 69.56-84.31), PLR (PLR: 2.10, 95%CI 1.69-2.50) and NLR (NLR: 0.58, 95%CI 0.44-0.71).

CONCLUSION

Our findings revealed that although serum HER-2 levels showed low se nsitivity for breast cancer diagnosis, its specificity, accuracy and AUC were reasonable. Hence, it seems that the measurement of serum HER-2 levels can play a significant role as a verification test for initial negative screening test results, especially in low-income regions due to its cost-effectiveness and ease of implementation.

Exploring the relationship between health concerns and high-risk behaviours in Medical Sciences' students

Aim

The need to cope with life concerns may drive an individual to resort to high‐risk behaviours. This study aimed to determine the relationship between health concerns and high‐risk behaviours.

Design

A cross‐sectional study.

Methods

We sampled 926 Medical Sciences' students from the North of Iran from September–December 2017 using the stratified sampling method.

Results

The most and less common high‐risk behaviour was physical inactivity (97.5%) and high‐risk sexual behaviour (15.7%), respectively. In multivariate logistic regression analysis, participants' concerns about human sexuality (AOR: 1.39; CI: 1.22, 1.57), injury prevention and control (AOR: 1.12; CI: 1.01, 1.20), nutrition (AOR: 1.13; CI: 1.02, 1.26) and emotional health (AOR: 1.08; CI: 1.02, 1.15) increased the odds of risky behaviours. Among Medical Sciences' students, health concerns are linked with risky behaviours. The result of this study can be used to develop relevant interventions targeting mental health to reduce risky behaviour among youth.

Socio-demographic determinants of low sexual desire and hypoactive sexual desire disorder: a population-based study in Iran

Background

Various socio-demographic factors have been introduced as the determinants of Low Sexual Desire (LSD), but whether these variables can also contribute to the Hypoactive Sexual Desire Disorder (HSDD), remains uncertain. In this study, we sought to identify the socio-demographic determinants of LSD and HSDD in Iranian women of reproductive age.

Methods

This was a population-based, cross-sectional study of 1000 married Iranian women of reproductive age (16–49 years) who met the inclusion criteria. The participants were chosen using the systematic random sampling method from all the healthcare centres in the city of Sari, Iran. LSD was defined as a score no higher than 33 on the Sexual Interest and Desire Inventory-Female (SIDI-F). The sexually-related personal distress was considered as a score of at least 11.0 on the Female Sexual Distress Scale-Revised (FSDS-R), and HSDD was determined based on the sum of those scores. Descriptive statistics were used to describe the socio-demographic characteristics and a chi-square test was run for data analysis using grouping variables. Multivariate logistic regression test was also employed to adjust the effect of confounding variables.

Results

The mean score of sexual interest/desire among women was 30.6 ± 10.5. After adjusting the effect of confounding variables, logistic regression showed that socio-demographic variables including age at first intercourse, length of marriage and the level of satisfaction with income were significantly associated with both LSD and HSDD (P < 0.01). While advancing age (P < 0.001) and body mass index (P < 0.01) were just predictors of LSD.

Conclusion

Some socio-demographic factors could predict LSD in women, while they were not associated with HSDD. In other words, some factors associated with LSD do not instigate sexually-related personal distress, which is one of the criteria necessary for the diagnosis of HSDD.

Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women

Introduction

A person's sexual satisfaction reflects their judgment and analysis of their own sexual behavior. Factors that affect sexual satisfaction vary in different societies and cultures.

Aim

This study investigated the determinants of sexual satisfaction in women referred to health centers in Sari, north of Iran, in 2016.

Methods

This cross-sectional study investigated 490 women who had been referred to health centers in 2016 and who were qualified for the study; the population was selected using convenient sampling method.

Main Outcome Measure

The main outcome of this study was sexual satisfaction that assessed by the Larson's sexual satisfaction questionnaire. Other Data were 2 questionnaires: the general health questionnaire–28 and a researcher-made questionnaire developed on factors related to sexual satisfaction. Data were analyzed with IBM SPSS software using the one-way analysis of variance, Pearson correlation coefficient, and t-test. To determine the predictors of sexual satisfaction, all the significant independent variables were incorporated into a linear regression model.

Results

The average age of the women in this study was 33.6 years, and average sexual satisfaction score was 99.26. The results of the linear regression model showed that the spouse's job as a laborer (P = .003), a low income (P < .002), insufficient income of the spouse (P < .001), and dissatisfaction with being a woman (P < .001) were the main social determinants of sexual satisfaction (r² = 0.54).

Conclusion

It can be concluded from the findings of this study that several factors influence women's sexual satisfaction. The main social determinants of women's sexual satisfaction were dissatisfaction with their gender, the spouse's job as a laborer, low income, and insufficient income. Sexual healthcare providers can play a prominent role in increasing women's sexual satisfaction, thereby, improving the quality of their sexual life by identifying and discussing ways to control them.

Afzali M, Khani S, Hamzehgardeshi Z, et al. Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women. Sex Med 2020;8:290–296.

Reproductive health issues in female patients with beta-thalassaemia major: a narrative literature review

β-thalassaemia major (BTM) has a high prevalence worldwide and is associated with considerable morbidity and mortality. The aim of this review is to provide an illustrative overview of the reproductive health and pregnancy related issues in females with β-thalassaemia. A literature search was performed in four international databases (1980-2018) to identify the potentially relevant articles. Common reproductive health disorders are hypo-gonadotrophic hypogonadism, infertility, delayed or absent sexual development, diabetes, hypothyroidism, hypoparathyroidism, osteopenia, preeclampsia, gestational hypertension, polyhydramnios, oligohydramnios, thrombosis, renal failure, peripheral vascular resistance, placenta previa, pleural effusion and pulmonary hypertension. Many of those aspects are related to iron overload and to ineffective erythropoiesis. Foetal complications include neural tube defects, abnormalities in different organs, spontaneous abortion, foetal loss, preterm birth, foetal growth restriction and low birth weight. Antenatal screening and accurate genetic prenatal examinations are effective measures to early diagnosis of thalassaemia and a detailed plan for management of pregnancies in BTM is important for favourable maternal and foetal outcome.

The Effects of CarumCarvi (BuniumPersicumBoiss) on Early Return of Bowel Motility after Caesarean Section: Double-Blind, Randomized, Placebo-Controlled Trial

Objective: To investigate the effect of the Carumcarvi (BuniumpersicumBoiss) plant, a gas solvent, on resumption of bowel motility after caesarean section. Materials and methods: A randomized controlled trial was done on a group of 98 women undergoing elective caesarean section under general anesthesia in a university hospital. Patients in the intervention group (Group A) drank 10 ml of a syrup containing 8 g of BuniumpersicumBoiss in 20 ml of syrup 6 to 7 hours after surgery. The control group (Group B) comprised 10 patients who drank 10 ml of placebo syrup 6 to 7 hours after surgery. Demographic characteristics, time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement, and length of hospital stay were compared between the two groups. Results: Compared with the control group, the intervention group had a significantly shorter mean time to hearing the first intestinal sounds (10.66 ± 2.38 vs. 19.54 ± 3.85 h), mean time to first flatus (13.91 ± 3.73 vs. 24.82 ± 5.83 h), mean time to first bowel movement (19.31 ± 4.63 vs. 30.70 ± 10.21 h), and mean length of hospitalization (31.70 ± 7.70 vs. 49.20 ± 10.16 h) (p < 0.05). No patients developed serious side effects associated with consumption of the syrup. Conclusion: The use of a gas solvent such as BuniumpersicumBoiss after caesarean section can speed the resumption of postoperative bowel motility.

Effect of the EX-PLISSIT model on sexual function and sexual quality of life among women after hysterectomy: a randomised controlled trial

Background After hysterectomy, most patients experience psychological problems and sexual dysfunction that can affect their sexual quality of life (QOL). This study determined the effects of counselling based on the Extended Permission-Limited Information-Specific Suggestion-Intensive Therapy (EX-PLISSIT) model on sexual function and sexual QOL after hysterectomy among women attending hospitals in Sari, northern Iran.

METHODS

A randomised controlled trial was conducted between 2016 and 2017. Of 354 women undergoing hysterectomy, 80 women without anxiety, stress or depression who showed signs of sexual dysfunction were selected and, using blocked randomisation, were assigned to the intervention and control groups. The intervention group received two 1-h counselling sessions each week based on the EX-PLISSIT model. The control group received no counselling. Mood and sexual function and quality of life were measured using established tools (i.e. Depression, Anxiety and Stress Scale, Female Sexual Function Index (FSFI), and the Sexual Quality of Life - Female (SQOL-F)). Eight weeks after completion of counselling, outcomes were compared between the intervention and control groups using independent t-tests and Chi-squared, Mann-Whitney U, Wilcoxon, and Fisher tests.

RESULTS

There were no significant differences between the two groups in terms of demographics and most other outcome variables. However, there were significant differences between the intervention and control groups in terms of sexual functioning (median (interquartile range (IQR) FSFI score 32.45 (28.47-33.52) vs 23.85 (20.52-26.45) respectively) and sexual quality of life (median (IQR) SQOL-F score 107.50 (91-108) vs 87 (62.75-96.25), respectively) at the 8-week follow-up (P < 0.001 for both).

CONCLUSION

Use of the EX-PLISSIT model is recommended to sexual health care professionals.

The efficacy of group counselling on perceived stress among infertile women undergoing in vitro fertilization treatment: An RCT

Background

One of the stressful and critical experiences that threat the individual, family, marital, and social stability is infertility.

Objective

To identify the effects of midwifery-led counselling programs on the perceived stress of the women undergoing assisted reproductive treatment.

Materials and Methods

In this randomized clinical trial, 50 infertile women who underwent in vitro fertilization treatment for the first time were enrolled in two groups. The intervention group received six sessions of group counselling by M.Sc. midwifery of counseling student and the control group received only the routine care. All participants filled Newton's standard questionnaire before and at the time of puncture, embryo transfer and the pregnancy test.

Results

The mean ± SD scores for the perceived infertility stress before the intervention in the control and the intervention groups were 167.92 ± 12.14 and 166.75 ± 13.27, respectively. The mean of perceived stress after intervention at the time of oocyte puncture in the control and case group were 177.12 ± 19.37 and 115.75 ± 13.88, at the time of embryo transfer were 179.40 ± 18.34 and 118.08 ± 15.37, and at the time of pregnancy test was 183.76 ± 14.97 and 120.50 ± 16.24, respectively. The perceived stress of infertility after intervention were statistically significant in the two group (p ≤ 0.001).

Conclusion

Group counselling is one of the effective methods for reducing the perceived stress in the women undergoing assisted reproductive treatment.

The Effects of Carum Carvi (Bunium Persicum Boiss) on Early Return of Bowel Motility After Caesarean Section: Double-Blind, Randomized, Placebo-Controlled Trial

Objective: To investigate the effect of the Carum carvi (Bunium persicum Boiss) plant, a gas solvent, on resumption of bowel motility after caesarean section. Materials and methods: A randomized controlled trial was done on a group of 98 women undergoing elective caesarean section under general anesthesia in a university hospital. Patients in the intervention group (Group A) drank 10 ml of a syrup containing 8 g of Bunium persicum Boiss in 20 ml of syrup 6 to 7 hours after surgery. The control group (Group B) comprised 10 patients who drank 10 ml of placebo syrup 6 to 7 hours after surgery. Demographic characteristics, time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement, and length of hospital stay were compared between the two groups. Results: Compared with the control group, the intervention group had a significantly shorter mean time to hearing the first intestinal sounds (10.66 ± 2.38 vs. 19.54 ± 3.85 h), mean time to first flatus (13.91 ± 3.73 vs. 24.82 ± 5.83 h), mean time to first bowel movement (19.31 ± 4.63 vs. 30.70 ± 10.21 h), and mean length of hospitalization (31.70 ± 7.70 vs. 49.20 ± 10.16 h) (p < 0.05). No patients developed serious side effects associated with consumption of the syrup. Conclusion: The use of a gas solvent such as Bunium persicum Boiss after caesarean section can speed the resumption of postoperative bowel motility.

Stress Management in Patients with Breast Cancer Using a Supportive Approach: A systematic Review

Background: Stress is a reaction to physical, psychological and emotional events. Respective to other chronic diseases, breast cancer (BC) is a dire stressful situation greatly disheartening the patients. Therefore, patients with BC need long lasting physical and emotional support to cope with the stress. The purpose of this study was to systematic studies concerning with supportive stress management interventions in patients with BC. Methods: In this review, the literature search was performed in scientific databases including Google Scholar, Scientific Information Database (SID), Magiran, and Irandoc,  Web of Science, Science Direct, PubMed [including Medline], and Elsevier. The keywords were retrieved from Medical Subject Headings (Mesh). The articles published from 1997 to 2017 were included. Accordingly, 440 articles were initially retrieved. After reading titles and abstracts, 152 articles were selected for reading full-texts.  Finally, 54 articles including 3 books were used to structure the review. Results: All the included studies had an interventional design focusing on stress management approaches and their related covariates in women with BC. The findings were assessed regarding two distinct approaches.   First, the studies assessing stress management interventions were scrutinized. Next, the impacts of the duration of the interventional sessions, the number of the participants and the contents of sessions were explored. Of the selected articles, 6 were about mindfulness, 2 about relaxation, and 7 about stress-related cognitive-behavioral therapy. In addition, one study was related to resilience training and 2 studies investigated problem-based approaches. Conclusion: Stress management interventions can be helpful in reducing stress in BC patients. Therefore, it is advisable to incorporate stress management strategies along with  routine pharmaceutical therapies in these patients.

Factors Related to Breast Cancer Screening in Women in the Northern Part of Iran: A Cross-Sectional Study

BACKGROUND

Breast cancer is the most common type of cancer in women and affects many women around the world each year. Breast cancer screening is one of the best strategies that can be used to reduce the death rate from the disease. Different factors influence the breast cancer screening rate.

AIM

This study aimed to investigate the factors that affect the screening of women for breast cancer in the northern part of Iran.

MATERIAL AND METHODS

This cross-sectional study was conducted in the Mazandaran Province of Iran in 2016 on 1,165 women who participate in breast cancer screening programs, using a cluster-sampling method. A valid and reliable researcher-made questionnaire was used to collect the data. The collected data were analysed using descriptive and inferential statistics via SPSS 21.

RESULTS

In this study, 62% of the women had a history of breast self-examinations, 41.1% had breast examinations by healthcare staff, and 21.7% received mammography. The woman's age, age at first marriage, age at onset of sexual intercourse, occupation, spouse's occupation, household income, health status, history of infertility, smoking, and decision-maker on issues of sexual and reproductive health (SRH) were the best predictors of participation in screening for breast cancer (P < 0.05).

CONCLUSION

To encourage participation in breast cancer screening programs, women should be encouraged to seek preventive care. Also, factors that.

The Effect of Hysterectomy on Women's Sexual Function: a Narrative Review

BACKGROUND

Regarding the contradictions about positive and negative effects of hysterectomy on women's sexual functioning, this study was conducted to review the studies on the effect of hysterectomy on postoperative women's sexual function.

METHOD

This study was a narrative review and performed in 5 steps: a) Determining the research questions, b) Search methods for identification of relevant studies, c) Choosing the studies, d) Classifying, sorting out, and summarizing the data, and e) reporting the results.

FINDINGS

The review of the studies yielded 5 main categories of results as follows: The effect of hysterectomy on Sexual desire, the effect of hysterectomy on sexual arousal, the effect of hysterectomy on orgasm, the effect of hysterectomy on dyspareunia, and the effect of hysterectomy on sexual satisfaction.

CONCLUSION

According to the studies reviewed in this study, most of the sexual disorders improve after hysterectomy for uterine benign diseases, and most of the patients who were sexually active before the surgery experienced the same or better sexual functioning after the surgery. An important solution for making these women ready to face with postoperative sexual complications is to train them on the basis of needs assessment in order that the patients undergoing hysterectomy be ready and capable of coping with the complications, and their sexual functioning improves after the surgery.

Counseling-supportive interventions to decrease infertile women's perceived stress: A systematic review

BACKGROUND

Infertility all around the world and in every culture is recognized as a stressful and critical experience that threatens individual, familial, marital, and social stability. Thus, in accordance with the importance of a woman's mental health and the possible impact of mental health on treatment outcome, finding a way to deal with perceived stress in women can help improve pregnancy outcomes.

METHODS

This study is a systematic review on reducing perceived infertility stress in infertile women. The current study was undertaken using multiple databases such as SID, Irandoc, Magi ran, Google Scholar, PubMed, Science Direct, Scopus, Cochrane library, and CINAHL selected from articles pertinent to the study. The selection of papers was undertaken from 1990 through May 2016. The methodological quality was assessed.

RESULTS

The initial search yielded a list of 725 papers, and then reviewers studied titles and abstracts. Thereafter, 68 papers were incorporated, and researchers reviewed summaries of all of the searched articles. Finally, the researchers utilized the data gained from 29 full articles so as to compile this review paper. Reviewing the studies conducted on reducing infertility perceived stress, the researchers classified related findings into two main categories: supportive and counseling intervention.

CONCLUSION

Considering the fact that there is an international agreement that fertility centers need to offer counseling programs for psychological problems of the infertile, it is especially important to recognize counseling-supportive interventions for decreasing infertile women's perceived stress and to program plans for decreasing women's perceived stress. By investigating counseling-supportive stress, we hope that this study has stepped forward toward health care agent's familiarity with decreasing infertile women's perceived stress and, therefore, improving treatment consequences.

Factors contributing to intentional injuries in Iranian university students

Background Intentional injuries refer to injuries resulting from purposeful human action, whether directed at oneself or others. This study was performed to assess intentional injuries in Iranian university students. Methods This cross-sectional study was carried out with 430 female and male university in three higher education institutions located in the northern part of Iran in the year 2015. Samples were chosen through the stratified cluster random sampling method. They were requested to fill out the demographic data form and the Persian version of the Youth Risk Behavior Survey Questionnaire. Descriptive and inferential statistics were used for data analysis via the SPSS v.13 software. Findings Intentional injuries were more frequent in the male university students than female (p < 0.05). Also, 9.1% and 6.7% of the university students were physically injured or sexually assaulted by a boy/girl friend. No statistically significant difference was reported in dating violence between the male and female university students. The logistic regression test showed that the history of stealing money from parents without their permission, son's preferences in the family and gender are the most important predisposing factors for the university students' intentional injury. Conclusion It is suggested that health policy makers consider the role of family in programs that have been designed for improving the health of young people.

Effect of Midwifery-Based Counseling Support Program on Body Image of Breast Cancer Women Survivors

Background:

Treatment for breast cancer can give rise to complications with important psychological impact. One change in patients regards body image. The aim of this research was to study the effect of a midwifery-based counseling support program on the body image of breast cancer survivors.

Materials and Methods:

In this randomized clinical trial, the study population was constituted by 80 breast cancer patients referred to Tuba Clinic in Sari, north of Iran, randomly assigned to two groups. Inclusion criteria included breast cancer diagnosis, mastectomy experience, age of 30 to 60 years, primary school education or higher, being married, and receiving hormone therapy. The Body Image Scale and Beck Depression Inventory were completed by intervention and control groups prior to the intervention and again afterwards. This program was implemented to the intervention group (two groups each consisting of 20 patients) for six weekly sessions, each lasting 90 minutes. The collected data were analyzed suing SPSS through Mann-Whitney U and Wilcoxon tests.

Results:

The results showed that the average age of participants in the intervention and control groups were 46.8 ± 6.85 and 48.9 ± 5.86, respectively. Body image scores in the intervention and control groups before the support program were respectively 21.82 ± 1.66 and 21.7 ± 1.48, and after the support program they were 7.05± 2.70 and 22.92 ±1.49, respectively. Therefore, the results indicate that the support program was effective in improving body image.

Conclusion:

This study showed that the support program had a positive effect on the body image of patients. Therefore, it is suggested that it should be used as an effective method for all breast cancer survivors.

Influencing factors on high-risk sexual behaviors in young people: an ecological perspective

Background In recent years, high-risk sexual behaviors due to their negative consequences both for the individual and society have received more attention than other high-risk behaviors. Objective The aim of this study was to review the influencing factors of high-risk sexual behaviors among young people from an ecological point of view. Methods This review was conducted through searching databases including PubMed, Web of Science, Scopus, Google Scholar and the Cochrane Library with keywords such as sexual risk-taking behavior, high-risk sex, unprotected sex and unsafe sex. The relevant papers published between 1995 and 2016 were extracted. After reviewing the abstract and full text of the articles, 45 papers were used to write this article. Results From an ecological theory approach, factors which influence high-risk sexual behaviors are divided into three categories - the microsystem, the mesosystem and the macrosystem. The microsystem includes factors such as age, gender, race, marital status, place of residence, religion, level of education, personality traits, psychological problems, childhood experiences, body image and coincidence of high-risk behaviors; the mesosystem includes factors such as family structure, peers and sex education; in the macrosystem, the impact of culture and traditions of the society, economic status and the media are presented. Conclusion Given that high-risk sexual behaviors often have multiple causes, it seems that health policymakers must consider multi-dimensional interventions to influence high-risk sexual behaviors based on the ecological approach.