دکتر مهناز اکبری کامرانی

It is apparent that telemedicine will only be a useful health service when individuals start using it. Therefore, the general attitude of end-users toward the acceptance of telemedicine services will play a significant role.

The present study is the first step in designing telemedicine services for pregnant mothers, with theaimof investigating the views of pregnant women regarding receiving tele-pregnancy care using the technology acceptance model (TAM).

This cross-sectional study was conducted during the year 2021 on 200 pregnantwomenwith gestational age of more than 12 weeks selected through simplerandomsampling in Karaj, Iran. The telemedicine acceptance questionnaire based on an extended TAM containing 25 questions in nine constructs was used to collect data. Descriptive statistics, including frequency, percentage, mean, and standard deviation (SD), were reported.

In this study, the mean age of the participants was 25.29 (SD = 5.62) years. A significant majority, specifically 95.5% of the participants, displayed a high level of acceptance toward incorporating telemedicine into their healthcare routine. In addition, the lowest mean scores of domains were related to technology anxiety, 26.18 (SD = 16.17), and perceived risk, 26.83 (SD = 16.26), respectively.

Based on the TAM, the results of this study highlight the readiness and acceptance of pregnant women toward receiving tele-prenatal care.

 Despite a lower teenage pregnancy rate in Iran compared to the global average, there is an anticipation of increased teenage pregnancy rates by 2025 due to changes in population policy programs.

 This study aimed to compare the challenges faced during the transition to motherhood and the quality of infant care between adolescent mothers and young mothers in Karaj, Iran.

 This descriptive-analytical study was conducted in 2020, involving 160 adolescent and young mothers selected through multistage sampling in Karaj, Iran. The data were collected using demographic characteristics, a modified questionnaire assessing the challenges of the transition to parenthood, and an infant care checklist. Descriptive statistics, including frequency, percentage, mean, and standard deviation (SD), were reported. Data analysis was carried out using the chi-square test and Mann-Whitney U test.

 The study showed no significant differences between adolescent and young mothers in terms of mean scores related to the challenges of the transition to parenthood, such as responsibility and commitment, pleasure and satisfaction, fondness and stability, and self-commitment (P ≥ 0.05). However, significant differences were observed between the 2 groups in the total score of infant care (33.07 ± 2.77 and 34.57 ± 2.65, P = 0.002), child disease care (10.63 ± 0.73 and 11.03 ± 1.20, P = 0.034), routine child care (5.38 ± 1.23 and 5.83 ± 1.28, P = 0.039), and maternal health (13.37 ± 1.60 and 14.29 ± 1.29, P < 0.0001) for adolescents and young mothers, respectively.

 Based on the study’s results, teenage mothers might benefit from support programs provided by healthcare providers, particularly midwives and doctors, to enhance their abilities to care for their children.

Changing the type of care in the family health internship curriculum towards continuing care programs can lead to the development of the professional identity of learners. This study was conducted with the aim of designing, implementing and evaluating a tele-continuous care program after delivery for midwifery students.

In this educational process, each student under the direction of the support team was responsible for the continuing care of his client for 6 weeks after delivery. The program was designed based on Taylor's curriculum development model and the evaluation of learners was done by qualitative interviews and completion of portfolios during the course at two levels of reaction and learning Kirkpatrick's model.

Data in the three main categories was categorized as  "learning", "continuous care" and "health provider" with sub-categories include new concept of postpartum period, knowing more about the profession of midwifery, improving communication skills with the client, strengthening the student's self-confidence, eagerness to learn, new experience of taking history, not being judged by others, daring to ask questions, synergy of knowledge, walking in mother's shoes, increasing intimacy, anticipating upcoming issues, availability, ability of follow-up, sense of pleasantness, sense of support,  earlier familiarization of the client with the conditions ahead, trust of the client and more motivation to provide service.

It appears that placing midwifery students in a continuing care model will provide them the opportunity to experience a rich holistic learning.

Birth represents an influential moment in women’s lives that can be a powerful or traumatic experience. Therefore, the aim of this study was to assess the relationship among maternal perception of childbirth experience, spiritual health, and maternal‑infant relationship in the postpartum women.

This descriptive‑analytical study was conducted on 305 postpartum women referred to Health Centers in Karaj. The data were collected using the Perception of Birth Scale (POBS), maternal postnatal relationship scale, and spiritual health questionnaire.

In this study, the mean (standard deviation (SD) age of the participants was 27.50 (5.56) years. The Spearman’s correlation test results showed that there was a significant positive relationship among the maternal perception of childbirth experience, the general maternal‑infant relationship (r = 0.34, p </em>< 0.001), quality of relationship (r = 0.17, p </em>= 0.002), pleasure with interaction (r = 0.32, p </em>< 0.001), and absence of hostility (r = 0.28, p </em>< 0.001). In addition, a positive relationship was observed among spiritual health and general maternal‑infant relationship (r = 0.21, p </em>< 0.001), pleasure in interaction (r = 0.08, p </em>= 0.164), absence of hostility (r = 0.15, p </em>= 0.008), and the maternal perception of childbirth experience (r = 0.11, p </em>= 0.039).

It seems that to promote maternal‑infant relationship, health care providers should not only try to promote physical intimacy between mother and infant but also create a positive emotional state for the mother during birth.

During the postpartum period, due to the lack of knowledge about postpartum complications and care, women, especially primiparous women, lack the adequate skills to adapt to new conditions and have no confidence to care for themselves and their infants. The early mothers’ assessment, education, counseling, and nursing interventions can increase their adaptation and reduce their incompatible responses to their infant and partner.

This study aimed to examine the effect of early self-care based education program on primiparous women’s selfevaluation.

A randomized controlled clinical trial was conducted from May to October 2018 on 58 primiparous women referred to the Neonatal Screening Center in Karaj (IRAN). A random allocation method was applied to select intervention and control groups. The data were collected using a three-part questionnaire consisting of general, developmental, and health deviation postpartum evaluationmade by researchers. The intervention group received three education sessions throughout the 3 - 5, 10 - 15, and 17 - 22 days after childbirth. The control group received routine postpartum care. Data were analyzed by descriptive statistics (such as mean, standard deviation, and absolute frequency) and statistical tests (including t-test, paired t-test, and chi-square) or non-parametric statistical tests (e.g., the Wilcoxon and Mann-Whitney test) using SPSS version 19.

Before the intervention, there was no statistically significant difference in themean total self-evaluation scores between the intervention (131.269±12.742) and control (137±9.600) groups (P-value = 0.073), but six weeks after delivery, a significant difference was observed in the mean self-evaluation scores between the intervention (149.692 ± 7.625) and control (122.923 ± 11.495) groups (P-value < 0.001).

The results of this study showed that early self-care education program was effective for primiparous women’s selfevaluation and increased the postpartum adaptation of the women.

The process of becoming a mother is one of the most satisfying and fulfilling events in women’s lives. Maternity for the first time can be stressful and also can increase anxiety in women.

The present study aimed to determine the effect of an empowerment training program on the difficulty of transitioning to parenting as well as parenting stress of primiparous mothers.

The sample of this quasi-experimental study consisted of 78 primiparous women who were selected due to convenient sampling. Participants completed the demographic, difficulty in transition to parenting, and parenting stress questionnaires before and after the study. The participants received four training sessions (the first session was face to face at 3-5 days after childbirth and subsequent training sessions were conducted by telephone at 2, 4, and 6 weeks postpartum) based on the self-efficacy model.

The mean age of the participants in the study was 27.012±4.99 years. The results of the Wilcoxon test showed that training significantly reduced parenting difficulty (P value = 0.0001, z = -7.626) and parental stress (P value = 0.0001, z = -7.50). The mean score of parenting difficulty decreased from 97.02±17.34 to 81.65±15.45, and themean parental stress score decreased from 80.08±22.53 to 61.13 ± 12.20. The results also indicated that education in all four domains (responsibility and commitment, satisfaction, selfesteem, and personal commitment) significantly reduced the difficulty of the transition to parenting (P value = 0.0001). According to the results, training has also been effective in reducing the difficulty of transitioning to parenting in terms of maternal concerns, enjoyment, change in life, new challenges of mother’s postpartum feeling.

The outcomes of the present study highlight the effectiveness of empowerment training on the difficulty of the transition to parenting as well as parenting stress in primiparous mothers.

Delivery is a physiological process that may cause neurophysiological changes in the lumbosacral region.

The current study aimed to compare motor control of the lumbosacral region and pelvic floor muscle strength and performance in women with C-section and vaginal birth.

In this cross-sectional study, 120 prim parous women referring to healthcare centers in Karaj (Iran) during 2019 are studied. The participants were selected using convenience sampling. Themotor control of the lumbosacral region was examined by four clinical tests (standing bent, active straight leg raising, bent knee fall out, and knee lift abdominal test) using a pressure biofeedback unit. Muscle strength and performance were measured using the Oxford scoring system and the PFPI-20 questionnaire, respectively. Data were analyzed using independent t-test, Mann-Whitney, and Chi-square tests. Statistical significance was considered when P value < 0.05.

Based on the standing bent test, a significant difference was found between those in vaginal delivery and C-section groups (P = 0.011). Also, the mean scores of muscular strengths (P = 0.009) and pelvic floor muscular function (P = 0.01) in the vaginal delivery group were significantly higher than the C-section group.

the mean scores of pelvic floor motor control, pelvic floor muscular strength, and function in the C-section group were higher than those in the vaginal delivery group. This study demonstrated the necessity of postpartum pelvic floor muscle rehabilitation, especially in vaginal delivery

  Preterm labor is the most stressful experience for mothers. Consultation by interpersonal psychotherapy (IPT) approach is a method to support mothers with pre-term labor. This study aimed to assess the effect of IPT oriented child birth education on adaption role and stress in mothers of infants admitted to the intensive care unit. This randomized interventional study investigated 92 primiparous women with a newborn admitted to the newborn intensive care unit of Kamali Hospital. The sampling method was convenient and samples were randomly assigned to two groups of control and intervention by four blocks randomization method. In addition to routine care, the intervention group received three IPT counseling sessions. The data collection tool in this study was parental stress questionnaire and maternal role adaptation questionnaire. The results of repeated measure test indicated that the maternal stress score had a significant change over time (P < 0.001) with significant differences between the two groups (P < 0.001), and maternal role adaptation changed significantly over time (P < 0.001) with a significant difference between the two groups (P < 0.001). Considering the impact of interpersonal psychotherapy-oriented child birth education on maternal stress and maternal role adaptation, as well as the limited duration and cost of this program and the possibility of training it by nurses and midwives, it is suggested to include this training program in routine interventions for mothers with a premature baby.

Coping strategies are one of the key elements of mental health and have a significant relationship with mental health. Cash developed the body image coping strategies inventory (BICSI) to evaluate how individuals cope with threats or challenges about their body image. The purpose of this study was to examine the factor structure of the BICSI among Iranian female adolescents. Participants were 537 high school students from Karaj, Iran, who volunteered for participating in this study. In order to achieve the aim of the study (factorial validity), the study population (n = 537 participants) was split into two subsamples randomly. The subsamples were processed by the randomization function on SPSS (V. 22). AMOS Graphic (V. 20) software was used in order to examine the factorial validity of three BICSI factors. The Persian version of BICSI met all the requirements for confirming the quality of measurement. In addition, the factorability of constructs in the scale was confirmed as the results of confirmatory factor analysis showed good model fit indices (P ≤ 0.05). Cronbach’s alpha as an internal consistency indicator was above 0.8 for all three subscales. Based on the results of this study, the Persian version of BICSI was validated among Iranian adolescents.

The present study aimed to examine the effectiveness of group counseling on parents’ self-efficacy, knowledge, attitude, and communication practice in preventing sexual abuse of children aged 2-6 years.
A randomized controlled clinical trial was carried out on 62 parents in Karaj (Iran) during the period of March-November 2016. Three kindergartens were randomly selected using the cluster sampling technique. Block randomization was used to assign the participants into two groups (N=31 in each group), namely the intervention group and the control group. Data collection included demographic characteristics, a “Parental Knowledge, Attitude, and Practice” questionnaire on the prevention of child sexual abuse, and the Farrell and Walsh self-efficacy pretest-posttest. The participants in the intervention group attended a counseling program of a 90-minute session per week, for 3 consecutive weeks. The participants were evaluated before, immediately after, and one month after the intervention. All statistical analyses were performed using the SPSS software (version 19.0). Data were analyzed using the Chi-square, independent t-test, Mann-Whitney, and Friedman tests. P There was no significant difference between the intervention and control groups in terms of the mean knowledge (P=0.50), attitude (P=0.48), practice (P=0.93), and self-efficacy (P=0.43) before the intervention. However, a significant difference was observed between the groups immediately after (P Counseling is an effective tool in increasing the self-efficacy of parents on child sexual abuse. The awareness of child sexual abuse and its prevention should be raised in the society through effective training programs.

BackgroundAdolescents, pay particular attention to their body image. Dissatisfaction with body image in people can lead to stress. Accordingly, this study aimed to investigate the effectiveness of group counselling on body image and coping strategies among adolescent girls.
Materials and MethodsThis clinical trial study was conducted on 60 adolescent girls in Karaj City, Iran. The samples were selected using a multi stage sampling technique. For the intervention group, four counseling sessions were held weekly and each session lasted 60 to 90 minutes. The control group received an educational body image package at the end. The Multidimensional Body-Self Relations questionnaire and Body Image Coping Strategy Inventory were completed by participants in both groups before and two weeks after the intervention. The collected data were analyzed using the SPSS-19.0 software.
ResultsThe mean score of the positive rational acceptance before the intervention in intervention and control groups were 43.541±2.798 and 41.875±13.146, respectively. These values after the intervention were 62.708±2.484 and 46.972±16.545 in the intervention and control groups, respectively. There was a significant difference between the intervention and control groups in the mean score of body image and the positive rational acceptance two weeks after the completion of the intervention (P = 0.0001).
ConclusionThe overall results of this study indicated the effectiveness of intervention (Group Counseling) in improving the body image score and increasing the positive strategic skills.

The speed and magnitude of physical, mental, social, and emotional changes during adolescence result in stress. Improper coping strategies toward stress have a negative impact on the mental health of adolescents that may continue to their adulthood.
The present study aimed at investigating puberty coping strategies, puberty knowledge, and attitude of early and late adolescent females living in Karaj, Iran.
This was an analytical cross-sectional study conducted on 513 female high school students using the multi-stage random sampling method. The Persian form of Endler and Parker coping inventory for stressful situations, the scale for the assessment of knowledge and attitudes of adolescent females towards puberty, and socio-demographic questionnaire were used to gather data. The SPSS v21 and Chi-square, Kruskal Wallis, and Spearman were used to analyze data at a significance level of 0.05.
The average age of participants was 15.40 (± 1.52). Results showed that avoidance was the dominant puberty coping strategy and the least frequent was related to the problem-focused strategy. A significant difference was observed between the frequency of coping strategies (P = 0.001), knowledge status (P ≤ 0.001) and attitude (P = 0.005) towards puberty, and source of information for puberty (P ≤ 0.001) was shown between two age groups of 15 years and under and above 15.
The findings of this study showed the significance of educating teen females about physical and psychological changes during puberty. It seems that health educators and health practitioners could help young females cope with puberty through training proper coping strategies. Parents should also be educated to be supportive and should be able to consider puberty as a stressful situation and help adolescents with proper coping.

Aim: This study aimed to evaluate the impact of self-care consultation on the nutrition and physical activity of women who are planning for pregnancy in Karaj, 2016.
In the present study, 40 women who were planning for pregnancy constituted the research sample who were selected by convenience sampling. Data collection tools included demographic questionnaire and self-care check list based on “CDC preconception health indicators, 2009”. Consultation was done based on 5A (asses, advise, agree, assist and follow-up) model. Self-care score scope was measured before, one month and three months after consulting in the area of nutrition and physical activity (with 19 questions). This study was approved by the Ethics Committee of Alborz University of Medical Sciences. Also a clinical trial registry (IRCT2016042827557N2) was performed. Sampling was performed from April to December 2016. One and three months after counselling sessions, the follow-up was done. SPSS v22 and Friedman and Wilcoxon tests were used to analyze the data at the significance level of 0.05
Findings: The results showed that the self-care level of women planning for pregnancy in the area of nutrition has changed significantly one month (p=0/001) and three months (p=0/0001) after consultation. Also their physical activity increased significantly one month (p=0/001) and three months (p=0/0001) months after consultation.
Counselling based on self-care plays an important role in improving the nutrition and physical activity of women planning for pregnancy. Based on individual capabilities, focusing on self-care can promote their performance in the area of nutrition and physical activity before pregnancy.

Communication has a fundamental role in marital life and lack of effective communication is a common compliant of married couples attending counseling and treatment centers.
This study was conducted to examine the effect of communication skills on marital satisfaction of couples attending premarriage counseling centers.
This parallel interventional study was conducted on 60 couples who attended a premarriage counseling center (Shahid Rast Ravesh) affiliated to Alborz University of Medical Sciences. A simple sampling method was used and samples were allocated into the intervention and control groups using blocks randomization. The intervention group, in addition to the routine trainings, received training on communication skills and sexual relation. The Enrich’s marital satisfaction questionnaire was completed by the participants in both groups before, after and two months after the intervention.
The mean age of the couples was 24.9 ± 4.7 years in the intervention group and 25.8 ± 4.1 in the control group. Twenty participants (66.7%) in the intervention group and 19 participants (63.3%) in the control group had diploma. Also, 13 persons (43.3%) in the intervention group and 12 persons (40%) in the control group were self-employed. There was no statistically significant difference between the two groups in socio-economic traits of the couples. The results of repeated measures showed that marital satisfaction has changed over time (P Considering the effect of communication skills on marital satisfaction of the couples, it would be suggested to include the content of communication skills in the premarriage education class.

Adolescents’ perception of their weight is a strong factor in shaping dietary habits and weight control and management. Among non-overweight and overweight adolescents, both overestimation and underestimation of weight status are associated with harmful effects. This study aimed to examine the relationship between perceived weight and attitude toward eating disorders among adolescent girls living in Karaj, Iran.
Involving a two-stage random sampling, this cross-sectional study was conducted on a total of 537 high school girls 14-18 years of age living in Karaj. The Eating Attitudes Test (EAT-26) was employed to screen for attitude toward eating disorders. Also, anthropometric measurements (weight and height), perceived and the ideal weights of the participants were assessed.
The average age of girls participating in the study was 16.12±1.20. According to the results, 70% of girls had normal body mass index. It was found that the ideal weight of 55% of the girls in the normal body mass index group fell under the lower than normal boundary. Moreover, the prevalence of eating disorders was estimated to be 23.6%. The attitude toward eating disorder was significantly correlated with body mass index of participants and their self-concept (P The results showed that girl’s adolescent with normal BMI have tendency to the lower weight. Their opinion about ideal weight fall them to the underweight group. Concerns about lean and bony body require desirable planning and weight management for adolescent girls.