معصومه سیمبر

Physiologic edema in the feet can cause discomfort such as pain, muscle cramps and fatigue in the feet when walking and as a result lack of movement and increased probability of thromboembolism in pregnant women. Many non-pharmaceutical methods have been used to improve physiologic edema in pregnancy. None of these methods have been studied in a self-care context. Therefore, the present study was performed with aim to determine and compare the effects of self-care education with effleurage massage, hydrotherapy, and leg elevation on physiologic edema in pregnancy.

The randomized controlled clinical trial study was conducted in 2022 on 129 primigravid women who visited the Mahdieh Tehran Health Center. The samples were randomly divided to four groups: hydrotherapy, massage therapy, leg elevation, and control. The data collection tools included a demographic and obstetric questionnaire, investigation of complications and satisfaction from the intervention, observation checklist and examination before and after the intervention, and a non-elastic meter. After collecting information, data analysis was done using SPSS statistical software (version 24) and parametric and non-parametric statistical tests. P<0.05 was considered statistically significant.

In the intragroup comparison, leg edema decreased significantly after the intervention compared to before the intervention (p<0.001). The results of the analysis of covariance indicated a significant difference in the mean size of foot circumferences after the intervention among the groups (p<0.001). In a side-by-side comparison of the groups after the intervention, leg elevation had the greatest effect among other interventions (p<0.001).

Self-care with effleurage massage, hydrotherapy, and leg elevation were effective in improving physiologic edema in the legs during pregnancy. Furthermore, leg elevation was found to be more effective in reducing degree of leg edema compared to other self-care interventions, and effleurage massage had the least effect in improving physiologic edema.

Abstract
  Backgrounds and

Sexual-reproductive health (SRH) is considered as a major part of general health, and education in this domain can have significant effects on it. Moreover, physically disabled individuals need special healthcare and education in this respect; however, there is insufficient information about SRH in women with this disability. The purpose of the present study was to explore educational needs in SRH among women with spinal cord injury (SCI).
 Methods and Materials: In this qualitative research, content analysis method was applied. Participants included women between 18 and 55 suffering from SCI. They were clients of Social Welfare Organization and Association of Spinal Cord Disabilities and selected with purposive sampling method. In-depth semi-structured interviews were individually performed with 15 women and 8 key informants. Graneheim and Lundman’s method was used for data analysis. Furthermore, Lincoln and Guba’s evaluative criteria were applied for trustworthiness.  
 

Educational needs in SRH among women with SCI were divided into 4 categories and 10 subcategories. They included “providing education by the Ministry of Health and Medical Education”, “improving education”, “enhancing performance of healthcare staff”, and “reforming educational structure of SRH for physically disabled individuals.”    
 

Women with SCI could improve their quality of life if they get information about SRH via educational books, CDs, and Internet resources. Moreover, modifying viewpoints of medical students and healthcare providers is assumed as an important factor for this aim.

Pregnant women were a risk group needing special attention during the Covid-19 epidemic. Most studies conducted in this regard are case reports, studies with small population sizes, and conflicting results in pregnancy outcomes. The research team conducted a systematic review and summarized studies that reported adverse pregnancy outcomes in pregnant women with Covid-19 infection.

A comprehensive literature review was conducted in PubMed and Scopus with no initial time limit until September 2022 to retrieve original articles published evaluating the association between Covid-19 infection and adverse pregnancy outcomes. The appropriate keywords were used in the search process. From 1790 articles obtained in the primary search, 141 eligible studies, including 1,843,278 pregnant women were examined. The evaluation of the quality of the included studies based on the critical evaluation checklist showed that 65% have high quality, 34% have average quality, and 1% have low quality.

Pregnant women are at greater potential risk for adverse pregnancy outcomes. The most common adverse pregnancy outcomes reported were preterm birth (9 studies), premature rupture of membrane (4 studies), gestational diabetes (1 study), hypertensive disorders (4 studies), fetal distress (2 studies), intrauterine fetal death (2 studies), low birth weight (3 studies), and NICU admission (3 studies). In most studies, there was no evidence of vertical transmission of Covid-19 from mother to fetus.

Covid-19 infection may cause adverse pregnancy outcomes during pregnancy. Vertical transmission from mother to fetus may occur, but the immediate and long-term effects on the infant are unknown. Therefore, considering the possibility of vertical transmission of this virus, the treatment team should be aware of this and take the necessary measures and attention. Also, if the mother is seriously ill, separation from the baby should be considered. Further studies are needed to clarify the causal relationship between these outcomes and covid-19 infection.

Designing valid and reliable tool to measure the sexual self-care status of reproductive age women in order to identify the strengths and weaknesses and design appropriate interventions to improve the sexual health status of reproductive age women is considered a necessity for the society. Therefore, this study was conducted with aim of designing and psychometrically evaluating sexual self-care questionnaire in women of reproductive age.

This was a methodological study with a cross-sectional design conducted in 2021. A questionnaire was designed using a comparative approach based on the Waltz model. Then, to check the psychometric characteristics of the tool, quantitative and qualitative face validity and quantitative and qualitative content validity were investigated. Finally, the reliability of the tool was assessed by the internal consistency assessment and determining the Cronbach's alpha coefficient, and the stability assessment by the test-retest method and determining the intra-cluster correlation coefficient (ICC).

The final version of this questionnaire was designed with 40 items in four areas including prevention of sexually transmitted diseases and genital infections, prevention of gynecology cancers, prevention of unwanted pregnancy and promotion of sexual health. The psychometric characteristics of this questionnaire showed that the validity index of the total tool was 0.93 and the validity ratio of the total tool was 0.96. The relative reliability of the total tool was also shown with Cronbach's alpha of 0.94. The stability of the tool was also shown by the ICC in the total tool of 0.97 with a confidence interval of 0.94-0.98.

The Female Sexual Health Self-care (FSHS) questionnaire has acceptable validity and reliability in the Iranian population, which can measure the broad concept of sexual self-care. The results of this study can be available to experts and planners to review the current situation and design suitable interventions.

Adolescents are vulnerable groups who experience one-third of all new cases of abuse and higher rates of sexual abuse. Evidence of sexual abuse of adolescents has been shown to have short-term and long-term effects on their psychological functions. Therefore, the present study was performed to review the complications and rehabilitation of adolescent rape.

This study was conducted by searching Persian and English databases including Elsevier Proquest, UpToDate, Scopus, Magiran, Irandoc, SID, Iran medex, Sciencedirect, Ebsco, Pubmed, Google Scholar. To extract related articles, the keywords rape, adolescents, prevention, rehabilitation and their Latin equivalents were used: sexual abuse, adolescents, prevention, and rehabilitation. In this study, articles published from January 2000 to December 2016 that aimed to investigate the effects and rehabilitation of adolescent rape were considered. Criteria for inclusion in this study were writing in Persian or English, working on rape in the adolescent age group, reporting complications and rehabilitation in adolescent rape, choosing the right method in the studies. The information extracted from the study was: study location, number of participants, demographic characteristics of the participants, duration of the study, complications following adolescent rape and rehabilitation methods in them.

Out of 59 related articles, 41 articles were excluded due to lack of expression of complications or rehabilitation in adolescent rape, and finally 18 studies were included in the review study. To collect information from the studies, the articles were carefully reviewed and the results were extracted. The topics covered in the study included sexually transmitted diseases, substance and alcohol abuse, unwanted pregnancies and abortions, psychological disorders, high-risk sexual behavior, treatment and rehabilitation of raped adolescents, and sex education for adolescents.

Rape is more common among teens than any other age group and has many side effects, which can be mental or physical, short-term or long-term. Therefore, it is necessary to consider programs to prevent rape in adolescents and provide appropriate solutions to rehabilitate sexual victims, including reproductive health education in schools, comprehensive community-based awareness, and open discussion about sex and reproductive health issues with Adolescents at family and school level. In addition, to improve adolescent sexual health, sexual abuse prevention plans should be strengthened and awareness of sexual health issues should be considered.

Given the importance of sexual issues in women's lives and being affected by various factors such as pregnancy and diabetes, and the existence of limited research on sexual function in women with gestational diabetes, this study was performed with aim to compare sexual function of women with gestational diabetes and low risk pregnant women in third trimester of pregnancy.

This descriptive-analytical study was performed on 300 women with gestational diabetes  low-risk pregnant women in the clinics affiliated to Mazandaran University of Medical Sciences in 2019. Demographic data were collected using researcher-made Demographic-Midwifery Questionnaire, and data related to sexual function using Female Sexual Function Index questionnaire  Data were analyzed by SPSS software (version 23) and Independent t-test, Mann Whitney, Chi-square and Multiple linear regression. P<0.05 was considered statistically significant.

In this study, 131 (87.3%) of women with gestational diabetes and 52 (34.67%) of low-risk pregnant women had sexual dysfunction. Gestational diabetes causes a significant decrease in sexual desire score (P< 0.001), lubrication score (p=0.006), satisfaction score (P< 0.001) and a significant increase in pain score (p=0.01).

Most women with gestational diabetes had sexual dysfunction; gestational diabetes predicts sexual function in pregnant women. Therefore, evaluation of sexual function should be a part of the usual assessment of women with gestational diabetes.

Vaginismus is an involuntary contraction of the vaginal muscles that makes sexual intercourse difficult or impossible. Various treatment strategies have been proposed for vaginismus, such as sex therapy and desensitization. There is no sufficient evidence on the efficacy and effectiveness of vaginismus interventions. This review study was performed with aim to evaluate the effects of different interventions for vaginismus.

In this review study, to find the related articles, the databases of SID, Pubmed, Google scholar, and Science direct were searched using the key words of vaginismus, treatment, and clinical trial from 2002 to 2020. Criteria for selecting a controlled clinical trial were comparison of vaginismus treatments with other treatments, placebo treatment, and routine treatment, or waiting list for treatment.

In this study, 15 studies with a total of 655 participants were reviewed. The results of this study showed that cognitive-behavioral therapies, the use of dilators, Botox, sex therapists, and hypnotherapy could successfully treat vaginismus. Regarding the effectiveness of strategies, Cognitive Behavioral Therapy (CBT) with the highest number of trials has been very successful. After that, the use of dilators was very popular.

This study showed that Cognitive Behavioral Therapy (CBT), the use of vaginal dilators, hypnotherapy, Botox and physiotherapy led to successful and satisfactory intercourse.

Vasomotor symptoms occur in approximately 75% of menopausal women. Hot flash is the main reason of women's referring to receive menopausal care. Estrogen therapy is the most effective way to treat symptoms; given the known risks of hormone therapy, many women are interested to use herbal medicines for treatment of menopausal symptoms including hot flushes. Therefore, this study was performed with aim to evaluate the clinical trials conducted to evaluate the effectiveness of herbal medicines for treatment of hot flashes.

In this review study, to find the related articles, the databases of SID, Pubmed, Scopus and Web of Science were searched using the keywords of Menopause, Herbal medicine, medicine and Hot flash from 2002-2019. The articles which were performed as clinical trial were selected.

31 randomized clinical trials were identified. These studies had investigated Vitagnus (2), soybean (4), Black cohosh (3), Ginkgo biloba (2), sage (4), Valerian (2), Flaxseed (2), red clover (5), Hypericum perforatum (1), evening primrose (2), fenugreek (1) and passion flower (1), and one study was also done as combination. It seems that phytoestrogens and lignans found in these plants can reduce the severity and duration of hot flashes with minimal side effects.

Overall, the findings of this study showed that herbal medicine which belongs to phytoestrogens or lignans like as Vitagnus, licorice, soy, red clover, flax seeds, sage, passion flower, valerian, Hypericum and evening primrose can lead to improvement of hot flashes, but further studies in larger populations are needed.

Pregnancy and childbirth is one of the most important events in the life of every woman that can be a memorable experience with positive consequences for the mother and the baby, under support of others, especially the spouse. Numerous interventions to promote men's participation have been conducted during this period. Therefore, this study was conducted with the aim of a systematic review of men's participation in prenatal care.

  This study is a systematic review of published articles on strategies to promote male participation, during pregnancy, childbirth and after childbirth (from 2000 to 2019), based on PRISMA guidelines, and the search was conducted by two scholars on the valid databases. Experimental and quasi-experimental studies, published on strategies for increasing male participation during perinatal period, published in national and international journals, were included in the study. Qualitative assessment of the articles was done using the Jadad and CONSORT checklist and the data extraction was based on the researcher's checklist.

In this systematic review, 4808 articles were identified. After reviewing the titles, and considering the inclusion and exclusion criteria, 15 articles were included in the study. The promotion strategies were categorized into four groups: female-centered, couple-centered, community-centered, and facility-centered.

According to the results of the study, in order to promote the participation of men in perinatal care, it should be planned on four areas of female-centered, couple-centered, community-centered and facility-centered.

Pain in the lower back and pelvic pain are one of the most common problems in pregnancy. Appropriate and low-cost diagnostic and validated measurements are required. Therefore, there is a need for a reliable, valid and responsive measurement tool.

This descriptive study was performed on 135 pregnant women with pelvic pain referring to Shahid Beheshti University of Medical Sciences in Tehran in 2017. The data collection tool was a participant's personal information form, pelvic pain questionnaire, and brief pain inventory. The results were analyzed by descriptive, correlation and regression tests using SPSS 22. The P-value>0.05 was considered significant.

The mean and standard deviation of age in women were 29.43±5.7 years. The mean pain based on the pelvic belt tool was 37.00±18.00 and the mean pain was 4.25 ± 1.87, respectively. There was a significant positive correlation between the two tools in the sensory evaluation of pregnant women (r=0.818, P=0.001). The pelvic girdle questionnaire, according to R2 = [0.669, BPI=1.109+ 0.085(PGQ)], predicts the amount of pain in the pain relief tool.

Considering the importance of pelvic girdle and a significant correlation between these two questionnaires, it seems useful to use a questionnaire and a tool with a high degree of accuracy which requires shorter time to complete. Therefore, it can be concluded that a brief pain instrument is a useful tool for measuring pain and its effects in the life of patients with pelvic girdle.

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, especially in people with age of under 25 years. It is often caused due to lack of awareness and misconception. Given the precancerous role of this virus and the importance of its prevention, HPV vaccination has been considered in all countries; so it is necessary to improve the knowledge and attitude of adolescents. Therefore, awareness and attitudes among high-risk groups need to be improved, especially among the vulnerable teens. This systematic review was conducted to evaluate the effect of educational interventions on knowledge and attitude of adolescent girls about HPV vaccine.

All quantitative studies, which were published without time limit, were entered in this systematic review article. The investigation was performed in the English and national databases such. Keywords were as Knowledge, Attitudes, Papillomavirus Vaccines, Gardasil, and Intervention study combined with the Boolean OR and AND operators. Finally, two researchers independently reviewed the articles for the quality appraisal and extracted their main findings.

Finally, 21 articles with a total sample size of 10086 were entered the study. Articles were interventional types and were published from 2008 to 2019. Educational interventions were based on Health Belief Model, Peer Education Model, School-Based Interventions, and other Educational Interventions. The Health Belief Model and School-Based Interventions were the most common frameworks for designing educational interventions for the HPV vaccine among adolescents. In all studies, educational interventions had a positive effect on increasing adolescents' knowledge and attitude toward the HPV vaccine.

Educational interventions can lead to increased knowledge and attitudes towards HPV vaccine. Considering the effectiveness of educational interventions based on the Health Belief Model and School-Based Interventions to increase adolescents' knowledge and attitude about this vaccine, designing and implementing such interventions in school are recommended.

Quality assessment of newborn care is essential to achie desirable and affecting future health outcomes. This study aimed to review the criteria used to evaluate the quality of healthy newborn care in different studies systematically based on the Donabedeian model.

PubMed, Google Scholar, Scopus, Science Direct, Iranmedex, Magiran, and Scientific Information Database (SID) databases were searched oncerning relevant studies with the keyword of "healthy newborn" and "quality of care" and "quality assessment" and their equivalent in Mesh and Persian synonyms. All quantitative, qualitative, English, and Persian-language articles ranging from the beginning of 1998 to the end of September 2019, which examined quality in healthy neonatal care, were included in the study. Of the 2219 articles obtained, 25 were finally included.

After reviewing the studies, the criteria for quality assessment of healthy newborn care were divided into three groups according to the Donabedian model: structure (physical infrastructure, essential drugs and equipment, competent human resources, policies, and clinical guidelines), processes (immediate newborn care and first two hours of birth, delayed newborn care, and neonatal resuscitation), and outcomes (maternal satisfaction, reduction of newborn mortality and complications).

The results of these systematic review showed that currently, there is not a defined comprehensive quality assessment method to take care of a healthy newborn. The development of a comprehensive and reliable tool to assess the quality of these care, which encompasses all the criteria extracted from this study, is essential as a health system requirement to improve the quality of care for healthy newborns.

Some women, throughout their life cycle, experience unintended pregnancy and had to decide on continuing or terminating it. Although the decision-making process always recurs, few studies have so far shed light on this complex, and context-based process. The aim of the present study was to explore Iranian women’s decision-making process to abort or continue an unintended pregnancy.

Methods & Materials:

 This was a qualitative study using grounded theory approach. Data were collected through unstructured, in-depth interviews with 29 participants in Tabriz from March 2016 to May 2017. The participants were selected through the purposeful sampling method and data collection were continued until reaching data saturation. Data analysis was carried out concurrently with the data collection, using the MAXQDA software version 10.

Data analysis gave rise to four axial categories: “perceived threats”, “resistance mixed with indecision”, “values and supportive resources”, as well as “acceptance and confirmation of decision”. This means that the decision-making process among women with unintended pregnancy initially starts with a perceived threat as a main concern leading to their resistance towards accepting such a pregnancy, then exposure to threats arising from abortion can cause indecision and uncertainty in practicing abortion. In this respect, given the social support, women affected by religious values make efforts to choose the procedure with the least harm and threats and maximum acceptability and confirmability. “Confirmation of decision” is as well the outcome of the interactive process of decision-making.

What can differentiate the theory of decision-making on abortion or continuation of an unintended pregnancy from the general theories of decision-making is its sociocultural confirmability. Social acceptance of abortion and childbearing in line with moral evaluation of fetal development directs the confirmability process of decision-making about unintended pregnancy.

Due to repeat emergency patients, the high quality obstetrics and gynecology triage is essential in the obstetrics and gynecology department. Given the importance of improving the healthcare quality, clarifying the aspects and features of the concept of obstetric triage quality would be helpful for determining criteria and standardization of obstetric triage quality. Therefore, the aim of the study was to explain the quality index of obstetric triage.

Methods & Materials: 

This qualitative study was conducted using a directed content analysis method on 15 participants. Participants included obstetric triage service providers and key specialists in obstetric triage. The data were collected through in-depth, semi-structured interviews. Data analysis was performed using the MAXQDA software version 10.

At this stage of the study, conducted with in-depth, semi-structured interviews, 824 initial codes and 97 merged codes were extracted. The quality of obstetric triage was explained by three main themes, including process quality, structure quality and outcome. The concept of process quality included 35 codes in two sub-categories: actions and care, interactions and communications. Structure quality included 51 codes in five sub-categories: routine and process of triage, pattern and standard, equipment, physical space, and manpower. Outcome included eleven codes in five sub-categories: waiting time, satisfaction, physical implication, psychological implication, and cost.

The index of obstetric triage quality is influenced by the quality of the process (actions and care, communications), the quality of the structure (routine and process of triage, pattern and standard, equipment, physical space, manpower), and outcome (waiting time, satisfaction, physical implication, psychological implication and cost).

Puberty is the period of developmental changes from childhood to adulthood and the acquisition of fertility. The time of puberty likely affects future risks such as cancer, metabolic syndrome and cardiovascular diseases. Many evidences point to the role of environmental exposure in changing the time of puberty. This review article was performed with aim to investigate the effect of lead on pubertytime in girls and boys based on the studies performed in this field.

In this review article, English and Persian articles related to observational studies which were indexed in databases of Embase, PubMed, Scopus, ISI Web of Science, SID, and Google Scholar during 2000-2018 with different combinations of the keywords of "lead” and "Puberty" were selected from Medical Subject Headings (MESH). From 182 reviewed articles, 12 articled related to the aim were selected based on inclusion and exclusion criteria and quality of reporting articles according to STROBEchecklist. 

12 articles were classified in two domains of lead effects on the puberty of girls and boys. The results of most studies showed that there was a statistically significant association between blood lead levels in girls, especially high levels, with delayed appearance of menarche, development of breast and growth of pubic hair. In boys, there was a statistically significant association between blood lead levels, especially high levels, with a delay in the process of puberty, including increased testicular mass and growth of pubic hair.

Lead can affect the natural process of puberty, and especially is effective in delaying puberty of girls and boys.

In obstetric triage, women who referred with obstetric complaints and those with acute or emergency situation are first evaluated. Waiting time is one of the important factors that should be considered in the management and organization of the healthcare section. So far, the exact waiting time for emergency care and obstetric triage in Iran has not been estimated. Therefore, this study was performed with aim to determine mean waiting time for obstetrics triage in Tehran.

This cross-sectional study was performed in 2018 on 9238 patients referred to obstetric triage of educational and medical hospitals in Tehran. Triage was actively performed using 5-level obstetric triage form (level 1: require immediate intervention, level 2: high risk requiring, levels 3: aassessment at the earliest opportunity, level 4: no acute problem, level 5: requires only one visit or consultation), In this research, a checklist containing personal, obstetrics, and also recording the time of triage and obstetric triage form was used. Data were analyzed by SPSS software (version 20) and descriptive statistical tests and ANOVA. P<0.05 was considered statistically significant.

Mean total waiting time in morning, evening and night shifts were 22.35 ± 3.60, 18.12 ± 3.67 and 19.15 ± 3.67 min, respectively. ANOVA test showed no significant difference between mean waiting time based on working shifts per day (p = 0.122) and month (p = 0.473). Mean waiting time in level 2,3,4 and 5 of obstetric triage were 2.73±0.40, 5.3±1.13, 5.76±1.69, 5.96±1.20 min, respectively.

Mean total waiting time for obstetric triage clients is somehow higher than the recommended rate. It is recommended to modify the process of service delivery to the clients of obstetrics triage in order to reduce the waiting time and achieve to the standard.

Female orgasm is a subjective phenomenon that has been wrongly introduced to people and therapists in the halo of exaggeration and perfectionism made by sexual films. This study was conducted to explore the Iranian women's experience of achievement of or failure to achieve orgasm and its consequences in sexual relationship < span dir="RTL">.
This qualitative study was conducted using content analysis method. Individual in-depth interviews with 20 married women were continued until data saturation. Sampling was performed using purposive sampling in the environment of two public clinics in Tehran. Data were analyzed using conventional content analysis method. Trustworthiness of data was achieved through Lincoln and Guba criteria.
The results of data analysis were categorized into 3 categories, 8 subcategories, and 46 codes. The main categories include feeling of success to achieve orgasm, feeling of failure to achieve orgasm, and husband companionship. Successful orgasm in Iranian women led to the feeling of successfulness with pleasant emotions such as relief, excitement, or love and positive outcomes such as relaxation, intimacy, freshness, and vitality. Women's descriptions of orgasm were mainly psychological and emotional. Failure to achieve orgasm led to the feeling of failure with physical and psychological symptoms such as pain, nervousness, aggressiveness, and negative consequences such as being jealous of husband’s orgasm and regret for getting married.
To prevent and treat orgasm disorders in women, it should be noted that successful female orgasm can mainly be accompanied with pleasant emotional states and physical changes may beunclear or intangible, while failure to achieve orgasm in women can lead to vague physical or psychological symptoms. Couples training for sexual talk with spouse, as well as more interaction and companionship between wife and husband have effective roles in achieving female orgasm.

Sexual problems are prevalent in women with multiple sclerosis (MS), and sexual self-efficacy as an effective variable plays an important role in sexual health and sexual quality of life of these women. The aim of this study was to determine the predictors of sexual self-efficacy in women with multiple sclerosis. This descriptive analytical study was conducted in Tehran, Iran, with participation of 200 women with MS, who referred to the Iranian MS society, had Expanded Disability Status Scale (EDSS) ≥ 7, and met the inclusion criteria in year 2019; they were selected using convenience sampling method. For data collection and assess the predictor factors of sexual self-efficacy in women with MS, related standard questionnaires were used. Data were analyzed using Pearson correlation coefficient, t-test, one-way ANOVA, and multiple linear regression model via SPSS software. The mean age of participants was 36.33 ± 5.22 years, and the mean score of sexual self-efficacy was 16.54 ± 7.27. After entering the significant variables derived from measuring the relationship between each variable individually with the score of sexual self-efficacy in multiple linear regression model for controlling confounders, sexual dysfunction (P = 0.001), anxiety (P = 0.024), stress (P = 0.006), and the number of sexual intercourse (P < 0.013) were significantly predictor factors of sexual self-efficacy in women with MS. The sexual dysfunction, anxiety, stress, and the number of sexual intercourse significantly predicted sexual self-efficacy in women with MS. Therefore, considering these factors in the treatment process of these patients can help to promote sexual self-efficacy and empower them in sexual life.

Gestational diabetes, in addition to increased risk for mother and fetus, can affect all aspects of the mother's life. Therefore, the purpose of this study is to describe the experiences of mothers with gestational diabetes mellitus. This was qualitative study. Semi-structured open-ended interviews were conducted with 25 women with gestational diabetes mellitus and by 8 healthcare providers. All interviews were recorded and transcribed. The content analysis approach was used to analyze data. Participants understood their limitations in social and recreational activities as well as their roles as a mother or a spouse. In addition, treatment of the disease caused limitations in their daily lives. Based on the data analysis, the concerns of pregnant women with gestational diabetes involved concerns of mothers with their health, fetal and neonatal health, as well as concerns about treatment and care. Midwives and other health care providers should be aware of the impact of the diagnosis of gestational diabetes on the lives of mothers and provide them with appropriate personal and cultural advice recommendations, especially on treatment, in addition to useful and useful information to reduce their concerns.

Nowadays, as a result of urbanization and change in lifestyle, teenagers' health is increasingly at risk. Adolescents do not have the correct knowledge, attitude, and performance in the field of reproductive health. The challenge is parents' lack of awareness of their important role in information transmission to adolescents. This study was conducted to evaluate the articles related to the educational needs of parents about sexual and reproductive health of adolescents inside and outside Iran. In this systematic review study, published articles in Google Scholar, Pubmed, ScienceDirect, Scopus, Iranmedex, Irandoc, Scientific Information Database (SID), and Magiran were searched. Using keywords of reproductive health, sexual health, educational needs, parents, and adolescents for Persian and English articles. After evaluating the articles, 45 articles conducted inside and outside Iran from 2010 to 2017 were included in this study. The findings of 45 studies were categorized in four main domains of parents’ needs to proper knowledge and attitude about adolescents’ reproductive and sexual problems (14 studies), parent-adolescent communication barriers (15 studies), appropriate educational content (10 studies), and factors affecting parent empowerment in teaching reproductive and sexual problems to teenagers (12 studies); 6 studies were shared in all 4 domains. Discussion on the issues of reproductive health in the family increases the knowledge of reproductive and sexual issues, and reduces the high risk of sexual behavior in adolescents. To empower parents, designing and implementing appropriate interventions is required.

Objective (s): Several studies have showed associations between anxiety during pregnancy and adverse maternal and child health outcome. This study aimed to explore this relationship among Iranian pregnant women. This was a qualitative study. To collect data purposive sampling and face-to-face semi-structured in-depth interviews were used. Women were asked to explain their experiences and perceptions on socioeconomic issues and induced anxiety during pregnancy. A conventional content analysis approach was used for analyzing the data. Data analysis was conducted using MAXQDA software. Twenty eight pregnant women from different social backgrounds, educational levels and ethnicity aged 18-41 years old participated in this study. Socioeconomic determinants of induced anxiety were found to be:  pregnancy interference with the social role, gender discrimination, financial responsibilities of raising a child, unnecessary interfering of significant others, quality of support. The findings suggest that timely screening of at risk mothers and strengthening prenatal related education specially trying to change incorrect believes are essential for reducing anxiety during pregnancy.

Women spend more than a third of their lives in menopause and estrogen deficiency. These neuroendocrine changes affect the woman’s sense of health and mental health through the loss of fertility and menstrual function. Therefore, the present study was conducted to investigate the association between anxiety, stress and depression with women’s experiences in menopause. This was a descriptive-correlation study conducted on 250 postmenopausal women who met the inclusion criteria in 2016 in Mashhad. A convenience quota sampling method was used. The data gathering tool was a demographic questionnaire, DASS21, measuring the experiences of menopause women. Data analysis was performed using SPSS 16 software by Pearson correlation coefficient and regression model at a significant level of 0.05. The mean age of menopause was 48 ± 4.56 years. The mean and standard deviation of anxiety score, stress and depression in postmenopausal women were 5.43 ± 4.8, 4.37 ± 7.7 and 4.33 ± 5.35, respectively. The mean total score of menopausal experiences was 33.5%. Pearson correlation showed a direct and significant association between stress, anxiety and depression score with the experiences of women in menopause (P = 0.001, r = 0.68). with increasing the scores of depression, anxiety and stress, the score of women’s experiences in menopause increased. Therefore, these changes require counseling and supportive program to improve adaptation to menopausal psychosocial changes.

Thyroid peroxidase antibody (TPOAb) is the main risk factor for thyroid dysfunction during pregnancy and can be a marker of these disorders during pregnancy. This study was performed with aim to evaluate the frequency of positive thyroid peroxidase antibody and its related factors during pregnancy. This study is a secondary analysis which was performed based on the data available in prospective population based study of The Tehran Thyroid and Pregnancy Study. This study was performed on 2233 pregnant women (at first trimester of pregnancy) who referred to prenatal care centers under coverage of Shahid Beheshti University of Medical Sciences. Serum concentrations of T4، T-uptake، TSH and TPOAb were measured in pregnant women. Mother age، body mass index، parity، gestational age، individual or family history of thyroid dysfunctions، goiter، diabetes type 1 or other autoimmune disorders، history of infertility، abortion، preterm labor، or stillbirth were selected as probable risk factors. Data analysis was performed using STATA software (version 12). In this study، 214 cases (7. 9%) were TPOAb positive. Based on the logistic regression model، the chance of positive TPOAb in women with individual history of thyroid disease was 4. 48 times (95% CI: 2. 26- 8. 85) higher than those without this history (p <0. 05). No significant relationship was found between other factors (maternal age, BMI, parity, gestational age, thyroid medication, family history of thyroid dysfunction, history of infertility, history of abortion and history of preterm labor) and positive TPOAb (P>0. 05). The history of thyroid disorders is associated with positive TPOAb in pregnant women and this factor can be considered as a risk factor for the detection of thyroid autoimmune disorders

The main focus of social construction is on the procedures by which individuals and groups participate in developing meaning and social products. Since infertility leads to the inability to properly play social roles, it is often associated with socio-psychological consequences. The present study aimed to perform a constructivist analysis of the process of managing infertility in Iranian women. This qualitative study was based on the constructivist grounded theory. Purposive sampling was initiated at Valiasr and Avicenna fertility centers in Tehran, Iran and continued theoretically. Data were collected via semi-structured interviews with 30 infertile women, as well as observation and field notes. Data analysis was performed using the MAXQDA10 software and the method developed by Charmaz. Based on the principles of social constructivism by the changes in each of the elements of the social construction of infertility, changes in the other factors and their effects on each other lead to various experiences of infertility. The constructivist analysis of the management process of infertility in the present study indicated that infertility has a complex interaction with social relations, expectations, and social needs. Therefore, social feedback is of paramount importance to infertile women. According to social constructivism, the most important decisions regarding infertility (e.g., treatment and its type, terminating treatment, adoption, and other relevant issues) reflect the ideology and social structure of the community where infertile women live. From the perspective of social constructivism, the process of managing infertility is a social construct that is influenced by several factors. In addition, the elements of social and cultural structures play a pivotal role in developing, maintaining, and changing this process. Therefore, all the influential factors and elements of infertility must be considered in the codification of supportive systems for infertile individuals.

Pregnancy is one of the most important stages of women's life, which results in significant physical, mental and social changes. Therefore, empowering pregnant women to adapt to these changes is necessary. Child birth preparation classes have been designed and conducted for this purpose. This study conducted to review the studies on the effect of child birth preparation classes on empowering Iranian pregnant women. By using keywords in 12 valid databases and the Google Scholar search engine, relevant articles published up to the beginning of April 2017 were selected and reviewed. A total number of 96 potential papers were identified. The abstracts and full-text of identified papers were screened to determine eligibility. Finally, ten studies were selected for systematic review. The results showed that there exist statistically significant difference between interventional group and control group for tiredness, daily activities, back and pelvic pain during pregnancy, postpartum depression and duration of admission. In addition, there was a significant statistical difference between the two groups in duration of active labor and the second stage of labor, Intensity of anxiety, self-efficacy, birth weight, satisfaction rate and normal vaginal delivery rate. Totally, 81.46% of women in the intervention group and 55.88% of women in the control group had normal vaginal delivery. This systematic review showed that education in child birth preparation classes were effective in empowering pregnant women. Therefore, encouraging mothers to participate actively in these educational classes and also development of these classes are recommended.