افسانه لالویی

Objective (s): Self-efficacy is an important construct within many health education theories and models and is defined as one’s beliefs in his/her own ability to complete tasks and reach goals. This study aimed to evaluate the effect of a motivational interviewing session on self-efficacy of pregnant women in response to air pollution hazards. In this experimental study, 110 eligible pregnant women attending to prenatal clinics in 2012 in Tehran, Iran were randomly selected and randomized into intervention (55) and control group (51) who did not receive any intervention. The inclusion criteria were age between 18 and 35 years, having a normal pregnancy, not having a history of chronic disease and being satisfied to participate in the study. The women were excluded from the study if their pregnancies were complicated. Data were collected at baseline and 1-month follow up through demographic questionnaire and a designed valid measure including items on self-efficacy regarding air pollution preventive behaviors. Data were analyzed via t-test, Mann Whitney U test Wilcoxon and Chi-squre. In all, data for 104 pregnant women including 53 individuals in the intervention group and 51 ones in control group were analyzed. The mean age of women was 27.2 (±4.11) years and it was 22.89 (±8.75) for gestational age. Although before the intervention, both groups were the same in terms of demographic variables and the outcome measure, after the intervention, the mean ranks of self-efficacy were significantly better than the control group (P<0.0001). The study findings revealed that the designed educational intervention could improve the self-efficacy of pregnant women regarding air pollution preventive behaviors.

Due to the vulnerability of pregnant women and their fetuses to air pollution and the role of determining the stages of behavior change in preventing the exposure to air pollution، this study aimed at investigating the predictors of stages of changing preventive behavior among pregnant women in Tehran. In this cross sectional study، 200 pregnant women who referred to three health centers located in different geographic regions of Tehran in the fall 2011 were randomly selected and assessed. Data were gathered through a validated researcher-made questionnaire based on Transtheoretical model which included demographic as well as benefits، obstacles and self-efficacy sections. The data were analyzed using descriptive and analytic statistical tests of chi-square، spearman correlation and logistic regression. Totally، 200 eligible pregnant women with mean age of 26. 9±4. 8 participated in this study. There were significant correlation between stage of change with pros، cons and self-efficacy P<0. 0001. Additionally، self-efficacy was a significant predictor of stage of behavior change. Results showed that، only self-efficacy construct could predict air pollution exposure behavior. The findings of this study can be used as a robust basis for future educational interventions regarding air pollution preventive behaviors in pregnant women.

Objective (s): Exposure to air pollution has been associated with higher adverse pregnancy outcomes. This study aimed to investigate the stages of behavior change towards air pollution among pregnant women using the stage of change theory. In this cross sectional study a sample of pregnant women who referred to three health centers located in different geographic regions of Tehran were randomly selected and assessed. The inclusion criteria were age between 18 and 35 years، having the history of pregnancies without adverse outcomes، not suffering from chronic disease during the present pregnancy and being satisfied to taking part in the study. Data were collected by a standard questionnaire based on stage of change theory. In all 200 eligible pregnant women with mean age of 26. 9±4. 8 participated in the study. The analysis of data showed that most women (51%) were at pre-action stages. Only 16% of pregnant women were identified at action stage. The findings suggest that a relatively high proportion of pregnant women are at pre-action stages of behavior changes towards exposure to air pollution. The need for further investigation and perhaps necessary action is recommended.

In the recent few years endometriosis has been identified as the third common gynecologic disease among the women aged 15 to 44 years old having been discharged from the hospitals. Not only does this disease cause pains, dysmenorrheal, abnormal bleeding and infertility, but also it reduces the quality of life and produces depression leading to expending much more on thetreatment. In this study we tend to evaluate the common complaints about the disease and find out about the most engaged sites through reviewing our laparoscopic findings. Our descriptive cross-sectional study was conducted prospectively. The study group were selected among the patients of Najmieh Hospital from March, 1996 to March, 2006. Those patients with the chief complaints about chronic pelvic pains, dysparonia, dysmenorrheal and infertility, as diagnosed by a surgeon, underwent the laparoscopy surgery. Then, a pathologist confirmed the diagnoses through biopsy. Those patients with only clinical diagnosis or without any pathology results recorded were excluded from the study. For each one of the subjects, data on surgical and demographical findings were collected using a questionnaire that contained questions about demographical background, the chief complaints, the engaged site and the surgeon’s findings. The average age of the participating patients was 28.7±6.2 with a minimum of 17 and a maximum of 49 years old. The chief complaints were recorded about: 43% primary infertility, 24% chronic pelvic pains, 14% having a cyst resistant to the treatment, 8% secondary infertility, 7% dysmenorrheal, 4% recurrent abortion and vaginal hemorrhage. The incidence of endometriosis was found to be 28% in this study. The most affected sites by endometriosis were anterior and posterior choledosac in 12 and 16 cases, respectively; the right ovary and the left one in 7 and 11 cases, respectively; and the left and right tubes were respectively affected in 10 and 6 cases. According to the findings of this study, pelvic pains are the most prevalent incident of the clinical complications related to endometriosis. So, it is recommended here that those women complaining about pelvic pains undertake laparoscopic surgery to avoid the negative consequences on their married life as well as on the quality of their social life. Also, further studies are needed to confirm the unlikelihood of the effect of endometriosis on infertility.

One of the most common causes of fear from the surgery in patients is post operative pain. Opioid analgesic and NSAIDs are commonly used to relieve pain in patients. Both groups have some side effects. In this study we evaluated the local anesthetic effect of bupivacain in pain relieving after cesarean section. This clinical-trial study was performed on 100 pregnant women who were referred to the Najmiyeh hospital in Tehran, Iran, for cesarean delivery. Pregnant women were randomly divided into two equal groups. Case group was injected bupivacaine 0.5% (10 ml subcutaneously) after the cesarean delivery. Pain Intensity was evaluated in 1st, 2nd, 4th, 6th, 9th and 12th hours after caesarean operation using Visual Analogue Scaling (VAS). Sedative (Petedin) consumption was measured and was compared in both groups. Results were analyzed using student t-test and Mann- whiney test. The results of this study demonstrated that mean analgesic consumption in case group was 25.63±16 (mg) and it was 35.05±13.6 (mg) in control group (P<0.05). Mann- Whitney test demonstrated that pain intensity is significantly lower in case group in 4th, 6th and 9th hours after cesarean operation compared to the control group. The data of this study shows that bupivacaine 0.5% can have a good sedative effect after cesarean operation.

The prevalence of cesarean section in our country is growing. Our aim was to investigate the education and attitudes of obstetrics team toward the preferable delivery method in some selected educational hospitals in Tehran. The population under investigation in this descriptive cross-sectional study was a group of interns, gynecology residents, obstetricians, midwifery students, and midwives working in delivery wards of Baqiatollah, Najimeh, Shariati, Imam Khomeini, and Bouali hospitals in Tehran. The questionnaire included patient's demographic data, individuals’ attitudes toward delivery methods and their willingness to cesarean section, their knowledge about delivery methods, and their satisfaction with the education they received during academic years. Data was analyzed by SPSS software using Chi², Fisher exact test, ANOVA, and Mann Whitney. Fifty two cases of cesarean out of total 103 deliveries, provides an approximate rate of 50.5% cesarean among the medical population. The amount of education received during academic period was reported as perfect and comprehensive by 17.7% of them and 26.4% mentioned normal delivery as a better method for delivery. The increase in the willingness of medical society toward cesarean section compared to other countries in an unbelievable manner, counts for their poor level of knowledge about benefits and deficiencies of cesarean as well as the dissatisfaction of students and graduates of medical disciplines with received educations. Medical and midwifery education administrators should regard this matter seriously.

AIDS has been regarded as a great health problem in many countries in the recent years.By the end of year 2003 about 44 million people were reported to be infected by HIV. There are about 14000 patients in Iran who have been identified with the virus and it is estimated that there might be about …… more who haven’t been identified, yet. Regarding a change of the population being infected by the disease from IV drug abuser to those involved in high risk sexual relations, this study tends to pay attention to the population of women who are at risk. Furthermore, there are not many studies that have examined women‘s knowledge about the disease; therefore, we decided to carry out this study because of the important role of women as mothers in Iranian sociality who play an educating role in their families. We conducted a cross sectional study on 500 women who came to the hospital for gynecologic/ obstetrics periodic checkups. A questionnaire was developed after pre-testing and standardization, which asked the participants about their gender, age and occupation as well as whether they knew someone close to them with HIV/AIDS. A five-ranking scale was used to score the answers. Using SPSS software version 14, the data were analyzed and a test of logistic regression revealed significant results in terms of their age, education and knowledge about AIDS (p<0.01). The average age of the participants 500 was 33.4±5/6 with Confidence Interval of 95%, ranging from 14 to 62 years old. Most of the participants were married (80.1%; N=407). In terms of their knowledge about AIDS on a 5-level scale, the results ranked as: excellent (12.2%), good (24.6%), moderate (43.4%), weak (43,2%) and bad (5,6%). There were significant relations between the level of knowledge and education level (p=0,000) as well as that and age (p=0.00). There was not any relation between the participants’ job and their level of knowledge about AIDS (p>0.1). In our study, juvenile showed to have more knowledge about AIDS that can attribute to the education they have received. With a special attention to this age group, their knowledge about sexual relations and using the same needle as the most frequent ways of spreading the infection was good. With respect to the Participants’ ideas, it seems TV is the best way of education. Thus, it is recommended that a medical team, including physicians educate women in occasions such as a pre-natal care period and pregnancy visits.

Prevalence of breast cancer was increased in recent 50 years and it affects Iranian women at least one decade younger than their counterparts in other developed countries. With awareness and ingoing to breast cancer screening prognosis will be better. Our study is intended to highlight the extent women knowledge their practice of self breast examination (SBE). [Evaluation of their awareness about SBE] In a cross-sectional descriptive study a written questionnaire was distributed to 376 women aged 12-70 years in women clinic ward of Baqiyatollah and Najmieh Hospitals to assess their attitudes to knowledge and practice of SBE (It was an unelected population study). Their responses were then collected analyzed with SPSS version 11.5 Data was analyzed using descriptive statistics. 64.6% of respondents had different kinds of education about SBE. 49.4% of them had practiced it occasionally but 27.4% do it regularly and 23.7% do it on time and only 3% of them practiced it both regularly and on time. In the women on our study there is either no awareness about SBE or do not practice it regularly and / or on time. Then we suggest establishing breast self examination education programs and encouraging women to SBE. There is need for a regular vigorous education program and encouragement our women to pay attention to SBE rather than before. It is hoped that this will help to reduce morbidity and mortality associated with breast cancer. Also it can improve treatment and promote health and welfare.

After Iraq-Iran war the community encountered with many of the war wounded who suffer from the outcome of the chemical gases which were used by Iraq.These outcomes are divided into early and late complications. Reproductive outcomes such as spontaneous abortion, low birth weight and preterm labor are delayed outcomes there are limited stuies about these outcomes. The aim of this study was to survey pregnancy outcome in wives of the chemical war Wounded and to determine the relation between chemical gas exposure and such results as low birth weight, preterm labor, intra uterine fetal death, fetus abnormality and altered sex ration. We randomly sampled 50 chemically injureds from 2100 chemically injureds in Keman and obtained questionnaire data concerning chemical gas exposure and reproductive health experience. In these 50 selected chemical victims, there were 120 pregnancies, there were 19% LBW, 13% Preterm labor and 8% abortion, low birth weight, Abortion and preterm labor correlation with mothers and fathers age, education and severity of chemical injuries were analyzedin SPSS system. Except for parent’s age, in other variables P were less than 5% suggesting that the relationship is significant.