effat merghati

Parents are the first line mediators in sexuality development of children. However, the majority of parents tend to have close supervision on children sexual behaviors, particularly in the conservative cultures. This article describes the development and psychometric evaluation of an instrument to measure Iranian parents’ competence in caring and nurturing their children sexually. The questionnaire was designed based on the principles in measurement, Waltz’stheory. The Iranian version of Children’s Sexual Behavior Questionnaire (CSBQ-IR) was developed and completed by 386 mothers and 101 fathers who participated in a community based sexuality education program in Tehran, capital of Iran. Reliability was assessed by Kuder-Richardson reliability coefficient and Split half. CSBQ-IR was evaluated for its construct, inclusiveness and content validity by principal component analysis. The Kuder-Richardson reliability coefficient and Split half reliability were found 0.425and 0.457 that was on acceptable range. Meaning, grammar, wording and item allocation of the questionnaire were found to be appropriate with (content validity ratio [CVR]=0.99) and(content validity index [CVI]=0.8) respectively. CSBQ-IR provides a valid assessment of the parents’ competency or incompetency in nurturing, communication, and managing their children’s sexual behaviors.

Parental education in sexuality plays a vital role in children's lives. The purpose of this study was to explore Iranian parents' perspectives about the needs of children sexuality education. This qualitative study was done in 2016. In this qualitative inquiry, seven sessions of community group interview and focus group discussions were conducted with the parents of Ghaemshahr, Iran, using purposive sampling (n = 39, 27 mothers and 12 fathers). Statistical Analysis Used: We employed thematic analysis method to extract our findings. The findings were categorized into three essential needs: (1) parents' preparedness, (2) efficacious parental management, and (3) supportive environments. The sub-theme describing the theme 1 includes “the need for adequate knowledge to answer the sexual questions and the child's sexual curiosity” and “the need for awareness about the time of beginning an appropriate sexuality education for children.” Moreover, the sub-theme describing theme 2 includes “the need for sufficient skills to begin proper and intimate communication,” “the need for effective monitoring and care,” and “the need for capability in managing the child sexual behavior.” Moreover, the sub-theme describing theme 3 includes “the need to receive training from sexual health professionals,” “the need for authorized sexuality education programs,” “the need for national-wide policy-making and strategy planning in sexuality education,” and “the need for a comprehensive and complete educational resource.” Our findings suggest that to address the goals in sexuality education for children, parents' need to be prepared in knowledge, and gaining positive attitude and practical skills. To achieve these goals, supportive environments must be provided by policy-makers and health providers with culturally appropriate strategy planning.

Drug abuse is one of the important variables influencing protective sexual behavior. The objective of this study was to explore how risky sexual behaviors develop in drug abusing women using human ecological theory.
In this study, we used a descriptive exploratory approach. The participants were 32 drug abusing women from two of the selected drop-in centers (DICs) in south Tehran, Iran, where we could have access to a vast number of female drug users. Data was collected using semi-structured face-to-face interviews. Qualitative content analysis was used to analyze the data using Graneheim and Lundman procedure.
Findings: Risky sexual behavior in drug use disorders in women was found in four themes with thirteen emerged; sexual untaught at micro-system with two subthemes “unsafe home” and “drop out of school”, Perception of differences at meso-system with three subthemes “lack of link between family and school”, “doing manly behavior” and “low awareness of health puberty than peers”, inappropriate marriages at exosystem with three subthemes “stigma”, “fear of losing love relationship” and “self-devotion”, marginalization at macro-system with four subthemes “barrier access to rights”, “selling sex as a tool of security”, “lack of belief as a sex worker” and “mistrust and doubt partner” using implication of human ecological theory.
Findings suggest that strategies supporting the discovery of risky sexual behaviors in drug use disorders in women are important in order to provide counseling and education to form their decisions toward safety sex.

Premarital sexual relationships could harm youth’s health in terms of sexually transmitted infections or increased risk of unprotected sexual behaviors. Sexual abstinence has been recommended to prevent young adolescents from adverse outcomes of premarital sexual relationships.. The aim of this study was to explore the viewpoints of sexually active single women about premarital sexual relationships in the Iranian context..Patients and In this qualitative study, we recruited 41 young women aged 18 to 35 years. Data were collected using focus group discussions and individual interviews. We employed conventional content analysis to analyze the data. Multiple data collection methods, maximum variation sampling, and peer checks were applied to enhance the reliability of the findings.. Eight themes emerged from the data analysis: ‘acceptance of sexual contact in the context of opposite-sex relationships, ‘sexual activity as a guarantee for keeping the boyfriend in the relationship’, ‘premarital sexual relationship as an undeniable personal right’, ‘having successful marriage in spite of premarital sexual relationships’, ‘virginity as an old fashioned phenomenon’, ‘love as a license for premarital sexual behaviors’, ‘goal-oriented relationship as a license for premarital sexual behaviors’, and ‘experiencing premarital sexual relationships in order to gain perfection’.. Results of this study could be applied to designing interventions, such as promotion of preventive beliefs or educational programs regarding premarital sexual relationships in conservative societies. These interventions could start within families and continue at schools and universities..

Although many people around the world are dealing with addiction, still no method that can detect and permanently treat it has been found. Premarital addiction test is one of the factors of great importance in this field. An erroneous detection in this test affects the psychosocial aspects and marital decisions of the individual. The purpose of this study was to determine the effectiveness of the health system in premarital addiction tests and its psychosocial effects. This interpretive qualitative study was performed using content analysis. Data were collected from 6 focus group discussions and 2 semi-structured individual interviews with couples and health care personnel. All interviews were tape-recorded and transcribed verbatim, and themes were extracted using content analysis method. Qualitative content analysis determined the 2 themes of lack of professional adequacy and consequence of marriage. Premarital addiction test is one of the health services provided by the health care system. An incorrect diagnosis not only has a considerable impact on different aspects of individuals’ life, but is also closely related to the psychosocial concept of dignity. Therefore, the professional competence of the staff in providing these services is very important and necessary.

Intimate partner violence (IPV) and risky sexual behaviors are serious and overlapping public health problems that disproportionately affect drug-involved women. Despite the fact that drug-using women experience extensive IPV, to date, no studies have investigated the association of IPV and risky sexual behaviors among drug-using women in Iran. Drug-using women (N =120) were recruited from a rehabilitation center in Tehran from March to October, 2009. The Revised Conflict Tactics Scale (CTS2), a standardized questionnaire, was used to collect data regarding violence. We used t-test and logistic regression models to explore the relationship between IPV domains and specific sexual risk behavior outcomes using SPSS 21. The means (sd) for CTS2 domains were as follows: negotiation 4.29 (1.55), psychological violence 2.55 (1.51), sexual violence 0.37 (1.00), physical abuse 1.17 (1.49), injury 2.18 (1.97), and the mean total score was 1.69 (0.96). We found significantly higher injury scores, but lower sexual abuse scores among women with sexually-transmitted infection (STI) compared to women without STI (p-values 0.030 and <0.0001, respectively). In addition, we found that psychological abuse was positively associated with STI (p-value 0.03) and increased condom use (p = 0.010), possibly mediated through an increased likelihood of having multiple partners. The findings revealed that in Iran drug-involved women experience high rates of IPV and that IPV is associated with increased risky sexual behavior. Implication: Preventive interventions for violence that are integrated within drug treatment programs, as well as harm reduction programs are highly recommended.

The purpose of this study was to describe the moral distress among Iranian registered nurses. This was a descriptive –analytic study, in which 264 out of 1000 nurses were randomly selected as a sample group and completed the questionnaire. The nurse's moral distress was assessed using Corley’s 30-item Moral Distress Scale adapted for use in an Iranian population. The collected data were analyzed by SPSS version 19. In this study, no correlation was found between the level of moral distress and any of the demographic data. The mean moral distress score ranged from 3.56 to 5.83, indicating moderate to high levels of moral distress. The item with the highest mean score was “working with unsafe levels of nurse staffing”. The item with the lowest mean score was “giving medication intravenously to a patient who has refused to take it”. Nurses working in EMS and NICU units had the highest levels of moral distress. A higher degree of moral distress is observed among nurses who work in health care systems. The results of this study highly recommend practical and research-oriented evaluation of moral distress in the medical society in Iran. Our findings suggest that Iranian version of MDS is a reliable instrument to measure moral distress in nurses.

Data was reported in Iran in 2013 has shown that almost 42 percent of deliveries in public hospitals and 90 percent in private hospitals were carried out with cesarean section. This high rate of cesarean requires careful consideration. It seems that making decision for cesarean is done under the influence of cultural perceptions and beliefs. So, this study was conducted to explore pregnant women’s preferences and perceptions regarding cesarean delivery. A focused ethnographic study was used. 12 pregnant women and 10 delivered women, seven midwives, seven gynecologist and nine non-pregnant women referred to the health clinics of Tonekabon, who selected purposively, were included in the study. To collect data semi-structured in-depth interviews and participant observation were used. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using thematic analysis and MAXQDA software. Four themes emerged from the data including personal beliefs, fear of vaginal delivery, cultural norms and values and also social network. These concepts played main roles in how women develop meanings toward caesarean, which affected their perceptions and preferences in relation to caesarean delivery. Most of pregnant women believed that fear of vaginal delivery is a major factor to choose caesarean delivery. Hence, midwives and physicians could help them through improving the quality of prenatal care and giving them positive perception towards vaginal delivery through presenting useful information about the nature of different modes of delivery, and their advantages and disadvantages, as well as the alternative ways to control labor pain.

Quality-of-life (QOL) among human immunodeficiency virus (HIV)-infected people has been the center of focus worldwide. The World Health Organization QOL Group (WHOQOL Group) has developed a 31-item QOL questionnaire, which has been translated and used in many countries. This paper aimed at examining the reliability and validity of Persian version of HIV specific WHOQOL scaleBREF questionnaire (WHOQOL-HIV BREF) in Iranian patients suffering from HIV/acquired immunodeficiency syndrome (AIDS).Methods & Materials: For the purpose of this cross-sectional study, a standard “forward- backward” translation and cognitive debriefing were initially applied. Subsequently, 150 people living with HIV/AIDS visitingTertiary Referral Consultation Center for clients with risky behaviors in Tehran completed the Persian version of the questionnaire. Validity was assessed using “Known Group Comparison” through ANOVA test. Internal reliability was measured by Cronbach’s alpha and Split-Half coefficients. WHOQOL-HIV BREF was capable to discriminate between two groups who were different in their QOL (P< 0.05). Internal consistency analysis was satisfactory for domains (Cronbach’s alpha =0.64–0.85), and whole the instrument (Cronbach’s alpha=0.93). The Persian version of WHOQOL-HIV BREF is a reliable and valid instrument to assess the QOL among Iranian HIV-infected population.

Health-risk behaviors are socially constructed and influenced by the given culture. Therefore, the health-risk behaviors are prioritized differently in diverse cultures. In this study, we aimed to explore the priority of health risk behaviors among high school students in Tehran. In this qualitative study using rapid assessment approach, we interviewed 130 individuals who voluntarily participated in the focus group discussions (FGDs, n=17). They were students (n=9 FGDs), the parents (n=5 FGDs), and the teachers (n=3 FGDs). Four of the principals were individually interviewed. Interviews focused on (1) perceptions about and description of healthy or unhealthy behaviors; (2); priority of health risk behaviors in adolescents (3) perceptions and beliefs about the formation of the risk behaviors among adolescents. All sessions were embarked on the public schools located in the area five in West Tehran. After obtaining a written consent form from the participants, primary investigators and three of the trained facilitators (male and female) conducted the sessions. We employed content analysis to extract the major themes and sub-themes. The rigor of the data was obtained. Addiction, risky sexual behavior, and social misconduct ion (aggression) were identified as the main concerns for the boys. Risky sexual behavior, early marriage, eating unhealthy habits, physical motionless, and fear of the future (job, education, marriage) were identified as the main health-risk behaviors for the girls. According to our findings, health risk behaviors are classified differently for boys and girls. However, sexual risk behaviors are common findings for both groups. The adolescent's risky behaviors are formed throughout their socialization and seriously influenced by the given culture. Understanding of gender schema was identified as an important factor in the way participants do priority health-risk behaviors of young people. Comprehensive and holistic health education and promotion programs targeting adolescents as well as training programs for parents are suggested.