esmat mehrabi

Women’s satisfaction with their childbirth experience is crucial in determining their likelihood of undergoing a cesarean section (CS) in future pregnancies. However, there is a significant gap in investigating the effectiveness of maternity care methods during childbirth on women’s satisfaction. This systematic review and meta-analysis aimed to fill this gap by assessing the impact of care methods on women’s satisfaction with the childbirth experience.

We conducted an extensive literature search using electronic databases such as Medline, Embase, Scopus, CINAHL, ProQuest, Cochrane library, Web of Science, Google Scholar, PubMed, SID and Magiran from 1990 to June 2023. Studies were included if they were published in English, examined the effect of childbirth care interventions on women’s satisfaction, and reported sufficient data to calculate the mean difference or standardized mean difference. The quality of the studies was assessed using the Cochran’s risk of bias tool.

Our search yielded 9 relevant studies with moderate quality. These interventions were categorized into three types as follows: continuous care, respectful care, and care based on effective communication. The meta-analysis revealed that communication-based care methods significantly improved women’s satisfaction with the childbirth experience (mean difference [MD]: 4.73; 95% CI: 1.35 to 8.11; P = 0.001) and overall childbirth experience (MD: 11.04; 95% CI: -4.34 to 26.42; P = 0.001). The heterogeneity among the studies was high (I2 = 98%).

Our findings suggested that the methods of childbirth care play a substantial role in creating a pleasant experience and improving women’s satisfaction. However, more studies with robust methodology and standardized instruments are required to determine the efficacy of such care in diverse cultural contexts, particularly in countries with high CS rates. Moreover, healthcare providers and policymakers must prioritize communicative dignity-based care during childbirth to enhance women’s experiences and reduce the likelihood of CS.

The present study aimed at investigating the influence of home counseling on breastfeeding self-efficacy (BSE) and breastfeeding performance following cesarean section (CS) among primiparous women.

This randomized controlled clinical trial was conducted on 60 primiparous women following CS in Ardabil, Iran. The subjects were assigned to the intervention and control groups using the block randomization method, ensuring a fair and unbiased selection process. The intervention group participated in three home counseling sessions on 3 and 7 days and a month after childbirth, and the control group received only routine postpartum care. The demographic and obstetric characteristics, BSE scaleshort form, and breastfeeding practice questionnaires were filled out by groups 10 to 15 days and two to four months after childbirth for data collection. After birth and adjusting the birth weight impact, the infant’s weight was measured at two and four months. Chisquare and repeated measures ANOVA (RMANOVA) tests were employed for data analysis, providing a comprehensive and rigorous approach to our research.

In the intervention group, the total mean (SD) score of BSE increased significantly from 50.56 (2.35) during 10-15 days to 62.86 (1.77) two months after birth and 64.2 (1.37) four months after birth. This positive trend was not observed in the control group, where the score changed from 44.26 (5.89) during 10-15 days after birth to 43 (6.93) two months and 39.13 (6.98) four months after birth. Additionally, a significant difference was found in comparing breastfeeding performance in terms of the frequency of breastfeeding during 24 hours, duration of each breastfeeding, exclusive breastfeeding, and frequency of breastfeeding problems between two groups during 10-15 days and two and four months after childbirth (P<0.05). These results highlight the potential of home counseling to improve BSE and performance, offering hope for better postpartum care.

The results revealed that home counseling effectively influences the improvement of BSE and breastfeeding performance after CS. Therefore, it is suggested that in-home supportive interventions be employed among mothers who underwent CS to promote breastfeeding and exclusive breastfeeding.

In the case of abnormal Pap smear, colposcopy is recommended. Women referred for colposcopy experience high levels of stress. The present study aimed to evaluate the effect of supportive counseling on stress reduction in women undergoing colposcopy.

This quasi-experimental study was performed on 72 women undergoing colposcopy in Ardabil, Iran. Participants were randomly assigned into two groups. The intervention group received supportive counseling during three sessions ‎every three days. The control group only received a pamphlet containing information on colposcopy. The data were collected using perceived stress scale. Independent t-test, and ANCOVA were used to analyze the data.

There was no significant difference in demographic and obstetrics characteristics of the participants (P> 0.05). Before counseling, the mean score (SD) of stress in the intervention group was 35 (4.24) and it was 33.54 (5.13) in the control group (P= 0.217). After counseling, the mean score of stress was not significantly different between the two groups [AMD: 0.93, 95% CI: -1.40 to 3.27, p =0.428].

Supportive counseling could not reduce the stress. Using other stress management strategies such as cognitive restructuring and mindfulness in women undergoing colposcopy might worth for suggeting the future studies.

Maternal anxiety has been accompanied by many unfavorable effects on breastfeeding in the postpartum period. We aimed to provide scientific evidence in identifying effective interventions for anxiety and breastfeeding self-efficacy (BSE) in a systematic review and meta-analysis.

All published studies with inclusion criteria by 2022 were searched in Embase, Cochrane library, Web of Sciences, Google Scholar, PubMed, Scopus, SID and Magiran. The literature search was performed using PRISMA instructions. Further, 20 eligible interventional studies (RCT and pre-posttest) and one case study were included in this systematic review and meta-analysis. Publication bias was checked with Eggers test and funnel plot methods. The collected data were analyzed using stata version16.

It is not possible to provide an explicit and accurate conclusion about the effective intervention method in reducing anxiety and increasing BSE among lactating women during the covid19 pandemic. The results indicated a significant increase in BSE among lactating women after educational and psychological inter-ventions (4.20, 95% CI: 3.61 to 4.80, I2 = 26.38%).

It is recommended to conduct further studies with a strong methodology and based on interven-tion methods during the postpartum period, especially in the first month of birth to reduce the symptoms of stress and anxiety in the mother, establish better mother-child attachment, and improve BSE and maternal per-formance during the Covid-19 pandemic.

Reproductive and sexual health and its dimensions are important aspects of health in human life and the World Health Organization emphasizes to promote these section health indexes. Since a review study has not been conducted to identify an appropriate approach for intervention in this field. Therefore, this study was conducted with the aim of systematically reviewing the impact of educational and counseling interventions on sexual function of women.

A comprehensive electronic search was carried out with no time limit until 6 August 2022. All published studies with inclusion criteria by 2021 were searched in Embase, Cochrane library, Web of Sciences, Google Scholar, Pubmed, Scopus, SID, and Magiran. The literature search was performed using PRISMA instructions. Cochrane Quality Assessment Scale [adapted for evaluating RCT, interventional studies] was used to evaluate the quality of the articles.

From a total of 93 articles obtained from the search in databases, by removing duplicate titles and checking the titles and summaries of the articles, 40 articles were obtained, and finally, after the final review of the full text of the articles, 21 articles were included in the present review. Due to the variety of interventional types in the studies, it was not possible to categorize counseling approaches. Studies showed that interventions based on sexual education and counseling were effective on the outcomes including marital satisfaction, sexual knowledge, sexual satisfaction, marital relationship quality and sexual performance.

Designing a comprehensive educational program with an appropriate approach focusing on various aspects of reproductive and sexual health can be an important role in promoting sexual and reproductive health. Therefore, interventional studies are necessary to identify an appropriate intervention approach to enhance reproductive and sexual literacy of couples.

During the COVID- 19 pandemic, the quality of prenatal care was affected considerably and online prenatal care emerged as a safe and effective method. This study aims to assess the quality of prenatal care during the pandemic in the south of Iran.

 This is a descriptive analytical study that was carried out in Bandar Abbas city in August 2021 for four months. Participants were 400 pregnant women referred to health centers who received prenatal care services by telephone or in person at least three times and had health records. Data collection tools were the quality of prenatal care questionnaire and a researcher-made prenatal care delivery checklist. 

The mean age of participants was 28.1±5.9 years. Less than 10% of them received full routine prenatal care. Weight measurement was the most frequent service provided to mothers (96.8%) while oral and dental health education (33.3%) was the least frequent service. Pregnant women had the highest and lowest prenatal care quality perception score in dimensions of information sharing (3.8±0.47) and approachability (2.0±0.69), respectively. Low level of education (β=0.83, 95% CI: 0.5-0.9, P= 0001) and history of infertility (β=-0.32, 95% CI: -0.29-0.64, P= 0.008) were the two variables predicting the perceived prenatal care quality.

The quality of prenatal care provided to pregnant mothers in southern Iran during the pandemic is not favorable. The use of community-based midwifery system, gaining mothers’ trust in online services and telephone follow-up, and improving online prenatal care infrastructure should among the priorities of decision makers in the health sector.

Sexual and marital satisfaction play an important role in the stability of couples' relationships, so it is necessary to take a proper approach to promote them. This study aimed to identify and categorize psychological interventions affecting sexual satisfaction and marital satisfaction of women in Iran.

An electronic systematic review search was conducted using the Persian and English databases of SID, Embase, PubMed, Scopus, Web of Science, Medline, Cochran library, and Google Scholar motor engine until 2021 to identify all relevant clinical trials and experimental and quasi-experimental studies assessing the effect of psychological interventions on sexual and marital satisfaction.

Totally, we retrieved 528 studies from the previously mentioned databases, of which, 38 met the eligibility criteria. The subgroup meta-analysis of 4 studies conducted showed that interventions based on individual consultations increase sexual satisfaction (MD: 2.94, 95% CI: −0.36 to 6.24, P= .23), (I2 =30.83%). The subgroup meta-analysis of 10 studies conducted revealed that couple-based consultations increase marital satisfaction (MD: 5.93, 95% CI: -2.59 to 9.27, P=.95), (I2 = 0%).

The results of meta-analysis demonstrated the effect of counseling-based psychological interventions on increasing sexual and marital satisfaction of couples. However, further clinical trials are required before making a definitive conclusion.

This study was conducted to determine factors related to childbirth satisfaction in women who experienced psychological traumatic childbirth.

This cross-sectional study was conducted to examine 375 postpartum women who had experienced psychological traumatic childbirth according to criterion A of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5 [A]). Data-gathering tools were the demographic and obstetric characteristics questionnaire and Mackey childbirth satisfaction questionnaire. The data were analyzed using SPSS (version 24.0), and independent t test, ANOVA, Pearson correlation coefficient, as well as multivariate linear regression test were used to perform data analysis.

The mean (standard deviation) of the delivery satisfaction score was 120.09 (27.11) out of 170. The predictors of satisfaction with delivery in women who had experienced psychological traumatic childbirth included type of delivery (P < 0.001), accordance of the delivery with the desired delivery (P = 0.013), and analgesia (P = 0.02).

It seems that with continuous training and counseling about the type of delivery, the mother’s participation in delivery decisions, and also providing a variety of analgesia methods during delivery can increase childbirth satisfaction and reduce psychological traumatic childbirth.

Performing appropriate and regular screening can effectively reduce cervical cancer and mortality rate, however, the available evidence suggests that women’s participation in cervical cancer screening remains low in middle‑ and low‑income countries, and that it is necessary to identify appropriate intervention methods to change behavior. The present study was designed to determine the effect of decision‑aid‑based counseling on cervical cancer screening behavior among women.

This trial study was conducted on 154 women with no history of Pap smear during the past 3 years and refers to Tabriz health care centers. The participants were assigned to the intervention (decision aid based counseling) and control (routine health education) groups through randomized block design with block sizes of 4 and 6 and a 1:1 allocation ratio. The data were collected using the sociodemographic and fertility characteristics, stages of change checklist, and shared decision‑making (SDM) and decisional conflict (DC) questionnaire before and 6 months after the intervention by interview and then, analyzed by SPSS24 software. The independent t‑test, ANCOVA tests were used.

A significant difference was observed between the two groups in terms of changing the stages of cervical cancer screening behavior 6 months after the intervention. As after the intervention, the frequency of individuals entered the preparation or action stage was more than the control group (P = 0.001). The mean score of SDM in the intervention group was significantly higher than the control group after intervention ([45.49 ± 1.18] vs. [27.56 ± 1.18] [Mean Difference (MD): 17.92; 95% confidence interval [CI]: 14.59–21.25; P < 0.001]). The mean score of DC in the intervention group was significantly lower than the control group after intervention ([29.16 ± 1.09] vs. [34.14 ± 1.09] [MD: −4.97; 95% CI: 1.09–8.04; P < 0.002]).

This study revealed that evidence‑based information communicated between clients and clinicians has very important role in clients’ health‑related behavior. It is recommended, health care providers apply decision‑aid‑based counseling for promoting the cervical cancer screening behavior among women.

The present study systematically reviewed the literature on the effects of menopausal symptom management aids on knowledge, decision conflict, and satisfaction about menopause-related symptom management.

All clinical trial and quasi-experimental studies published in English-language from 1990 to 2021 were searched in CINAHL, PROQUEST, Web of Sciences, Google Scholar, PubMed, and Scopus databases. In addition, we used the Ovid search interface for MEDLINE, Embase, CENTRAL, and Cochrane Library. The effect of interventions on continuous outcomes, including knowledge, decisional conflict, and decisional satisfaction, with a standardized mean difference (SMD), was reported in the present study. The included studies were assessed for statistical heterogeneity by using the I2 test and examining the P value.

The results indicated the limited effect of the decision aid-based intervention on the decisional conflict, satisfaction with the decision, and knowledge. However, it is worth mentioning that the findings indicated high heterogeneity among the studies reviewed in the present study.

In the previous studies, the decision aid booklets used mostly provided limited and incomplete information on the available strategies to alleviate the symptoms perceived in menopause, so design and conduct a study with a strong, robust methodology and a comprehensive decision

Phobia of natural childbirth is one of the most important and influencing factors leading women to request cesarean sections. The present study aimed to prepare a systematic review and meta-analysis to investigate the type of interventions related to fear of childbirth (FOC).

The data collection was based on an extensive search of articles related to clinical trials (1990-2019) posted on Google Scholar, Cochran, SID, Magiran, Web of Science, Scopus, and PubMed electronic databases. In general, 109 abstracts were selected after eliminating similar publications. As a result of the qualitative evaluations of these articles, 11 studies were kept for investigation.

The studies were categorized into three groups including prenatal education with childbirth counseling, yoga courses, and psychoeducational-based interventions. Based on the meta-analysis, psychoeducational interventions have a significant effect on childbirth fears and anxiety in comparison with the control group (mean difference: 0.85, 95% CI: -1.20–0.45, P < 0.0001, I2 = 82%).

Psychologically-based interventions, can creatively play an essential role in reducing the FOC during pregnancy and even childbirth. It can also create a pleasant and traumatic-free experience which is essential for encouraging women to have a natural childbirth

Breast cancer (BC) is identified as the most common type of cancer among women in the world. The illness perception is considered as an important and influential issue in cancer control. The present study aimed to determine the predictors of illness perception among women with BC undergoing chemotherapy and radiotherapy.

This cross-sectional study was conducted on 166 women with BC referring to private and public oncology centers in Tabriz using the convenience sampling method. Patients were assessed by demographic and disease characteristics questionnaire, brief illness perception questionnaire, social support questionnaire, cancer worry scale, international physical activity questionnaire-short form, and the EORTC-in-patsat32. The data were analyzed using SPSS 25, and ANOVA, independent t test, Pearson and Spearman correlation coefficient, and multivariate linear regression were applied for data analysis.

In the present study, the mean score (SD) of the illness perception was 48.86 (17.61) out of the achievable range of 0-80. The results indicated that concerns about the recurrence, cancer stage, and place of treatment were the most important predictors of illness perception.

It seems that the early detection of BC through screening can be effective in the perceptions of BC. It is recommended that similar studies be conducted in other countries and cultures and after completing chemotherapy and radiotherapy courses.

Cervical cancer is preventable through cervical cancer screening. People may be unwilling to take screening tests when they are healthy, and performing regular screening tests largely depends on motivational factors. Accordingly, the present study aimed to investigate the effectiveness of motivationally tailored interventions on women’s cervical cancer screening.

In this systematic review, the electronic databases of the Cochrane Library, Web of Science, PubMed, Scopus, Embase, and Google Scholar were searched for all interventional studies (i.e., trials, pre- and post-test, or quasi-experimental ones) published before 2019. Then, the Cochrane tool was implemented to evaluate the quality of trial studies (7 articles).

This systematic review study included 7 articles with 1337 female participants. The result of our study showed that different motivational interventions (MIs) (i.e., face-to-face interviews, consultation sessions or calls, and educational programs) can effectively improve cervical cancer screening behavior in women.

Overall, motivational interventions (MIs) seem to be effective in cervical cancer screening.

The present study aimed to assess the effect of the decision-aid-based intervention on breast cancer screening behaviors in women based on the theory of change.

This interventional study was conducted among 40-69-year-old women who were randomly selected from the healthcare centers of Tabriz. The intervention group received a decision-aid booklet and an individual counseling session. In addition, the data were gathered before and eight weeks after the intervention using demographic and obstetric questionnaires and a checklist of behavior change stages. Finally, data were analyzed using SPSS24.

According to the sequential logistic regression test, women who received the decision-aid-based consultation underwent breast control, breast clinical examination, and mammography significantly more than the control group (P < 0.001).

In general, intervention programs with presenting decision-aid-based counseling could change women"s screening behaviors because such programs increase their knowledge about the benefit and harms of a decision in relation to a choice such as doing mammography

The present study was conducted to investigate the effect of motivational interviewing (MI) on dietary intake and weight changes among preconception women with obesity and overweight.

This randomized controlled trial was conducted on 70 overweight and obese women (body mass index ≥25) within the age range of 18-35 years in the preconception period referred to health centers in Tabriz, Iran. Twenty-four-hour food records were completed by women for 3 days and participants’ weights were measured before and 8 weeks after the intervention. Using a random block design and the allocation ratio of 1:1, the participants were divided into MI (6 sessions of training and MI) and control (routine preconception care) groups. The criterion for the primary outcome was the mean macronutrient intake 8 weeks after the intervention. All analyses were done according to intention to treat method.

At the baseline, there was no statistically significant difference in terms of the mean of daily energy intake, carbohydrates, fat, protein, and weight (P>0.05). After the intervention, the mean (standard deviation) of daily energy intake was 1841.3 (567.8 kcal) and 2131.0 (568.7 kcal) in intervention and control group, indicating a significant difference between the 2 groups with an adjusted mean difference (AMD) of -334.3 and a 95% confidence interval (CI) of -667.2 to -21.5 (P=0.03). However, there was no difference between the 2 groups in terms of macronutrients (P>0.05). After the intervention, the mean (SD) of participants’ weight was 74.4 (6.94 kg) and 75.7 (7.82 kg) in intervention and control groups, which demonstrated a significant difference between the 2 groups (AMD = -1.30 kg, 95% CI = -2.09 to -0.51, P=0.002).

MI is an efficient method of weight loss and the energy intake change can help preconception women with obesity or overweight to safeguard themselves against the adverse consequences of their pregnancy.

Cancer is one of the leading causes of death in the world. The characteristics of resistance to treatment and its rapid progress are the high mortality rate reasons. Patients who have been diagnosed with the disease are losing their self-awareness, which itself has a negative effect on the treatment process. However, it seems that such patients need to be considered on depressive disorders even after complete treatment of cancer. After receiving the bad news of cancer; patient, his/her family, be anxious. They initiate the patient's support until the end of the treatment period, without attention to such sudden support's adverse effects. The aim of the present study is to survey of cancer treatment and care's phenomenological and descriptive situations of the philosophy of medicine and psychology point of view. Post- disease disorder has a fundamental relationship with this fundamental situation.

The pregnancy-related anxiety questionnaire is one of the specialized scales designed for pregnancy-related anxiety measurement including fear of delivery, fear of birth of a handicapped child, and concern about pregnancy- and delivery-related body changes. The present study aimed to assess psychometric properties of Pregnancy Related Anxiety Questionnaire- Revised2 (PRAQ-R2) among Iranian women. In this methodological, cross-sectional study, 109 pregnant women in the second trimester of pregnancy were studied through proportional randomized sampling. Content validity was evaluated in two qualitative (by experts) and quantitative (content validity ratio [CVR] and content validity index [CVI]) stages. In the next step, a confirmatory factor analysis was used to determine the validity of the structure. For reliability, the internal consistency (Cronbach α) was calculated and the stability of the questionnaire was analyzed using intragroup correlation coefficient with 20 samples.
b> Based on the results, the evaluation of content validity in quantitative step showed that CVI and CVR were 0.97 and 0.98 for PRAQ-R2, respectively. The reliability of the questionnaire calculated by intraclass correlation coefficient (ICC = 0.73) and internal correlation (α = 0.74) verified the high reliability of the instrument. Moreover, the construct validity was confirmed by confirmatory factor analysis. In general, the findings support the validity and reliability of the questionnaire. Therefore, it is recommended that a short form of anxiety questionnaire be used to assess the anxiety and concerns of Iranian women during pregnancy in clinical trials.

Objectives: Focusing on the associated factors of sexual dysfunction is essential for promoting the quality of life in multiple sclerosis (MS) patients. Therefore, the present study aimed to assess sexual dysfunction, along with its levels and correlates in women with MS. Materials and Methods: A total of 150 women aged 18-45 who referred to the MS society of Tabriz (Iran) were recruited in this cross-sectional study using a convenience sampling method during March-June 2018. The data were collected employing demographic characteristics questionnaire, Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), Fatigue Severity Scale (FSS), and Beck Depression Inventory-Short Form (BDI-13) Items. Then, a neurologist rated the level of disability by the Expanded Disability Status Scale (EDSS). Finally, multivariate linear regression was applied to analyze the data. Results: The mean (standard deviation) age of MS patients was 36.64 (5.93) and the mean score of MSIS was 47.30 (14.92), ranging from 19 to 95. In addition, among the MS patients, 133 (88.6%) women reported sexual dysfunction (SD) including 125 (83.3%) women with primary SD, 85 (56.6%) women with secondary SD, and 55 (36.6%) women with tertiary SD. The results of multivariate regression analyses showed that predictive variables for SD in women with MS included education, depression, and spouse cooperation in home affairs. Conclusions: In general, SD is a common manifestation of MS. Women with MS should be screened and treated for depression. Further, the findings demonstrated that implementing support strategies by the husband could reduce SD in women with MS.

Many women experience unplanned pregnancies in their life and have to make a critical decision whether to abort or continue with the pregnancy. The present study aimed to assess the factors affecting the decision about unplanned pregnancies. The present prospective study was conducted on 230 women with unplanned pregnancy who were selected through sequential sampling, including 80 women who had decided to abort and 150 who had decided to continue with their unplanned pregnancy, and referred to health complexes and centers, and obstetrics and midwifery offices in Tabriz, Iran, in 2017. Data were collected through perceived threats, support, and beliefs and values questionnaires and analyzed using the t-test and the logistic regression with a hierarchical modeling strategy. According to the results, the mean scores of perceived threats (40.02±5.5), perceived support (23.09±2.8), and beliefs and values (18.12±3.2) were significantly higher in the abortion group compared to the continuation group (19±3.3, 21.04±3.05 and 11.2±4.3; P < 0.001). The results of the hierarchical modeling strategy showed that the perceived threats of the continuation of pregnancy had the greatest predictive power over the decision to abort (β=1.12; 95% CI: 1.08-1.17; P < 0.001). The results of this study showed that women’s decision about the outcome of unplanned pregnancy is potentially affected by three groups of reasons, including perceived threats, support, and beliefs and values. Indeed, understanding these factors provides a broad picture of the situations affecting women’s decision-making. The findings of this study suggest the need for planning and implementing counseling interventions based on the abovementioned factors, especially identifying perceived threats and providing appropriate strategies to remove these threats in women who have to make such critical decision in their life.

Unwanted pregnancies and sexual health problems, and consequently illicit abortions and sexually transmitted diseases, may also occur among adolescents. Therefore, in the present study, we investigated various interventions that were used in studies to prevent unwanted pregnancy among adolescents through a systematic review.
An extensive literature search was conducted using the Google Scholar, Cochran Library, SID, Magiran, Web of Science, Scopus, Pubmed, e-learning databases on clinical trials conducted during 1990 and 2018. To evaluate the quality of the studies, the Cochran tools for RCT were used. Finally, 15 studies were selected for systematic review.
Overall, based on findings from the review of related articles, interventions to reduce unplanned pregnancies in adolescents were categorized as follows: (i) interventions focusing on contraceptive methods, (ii) interventions focusing on the impact of preventive training including health education, individual and group counseling and parent education, (iii) multiple interventions that included a combination of interventions focusing on promoting contraceptive methods and preventive training.
Evidence provided by this ystematic reiew supports the use of educational and preventive interventions focusing on multiple interventions to reduce adolescent pregnancies, but there is a need for a proper framework, infrastructure, and resources for the success of these interventions.

Cancer diagnosis for everybody may be perceived as crisis and breast cancer, as the most common malignancy in women, can influence their well-being and multiple aspects of their health. So understanding that how women in various contexts and communities adjust to the illness is necessary to facilitate this adjustment and improve their quality of life.
The aim of this study was to: 1) identify the core components of coping strategies to adjust to the illness in Iranian women with breast cancer perspective, 2) to develop and determine psychometric properties of a native self-report instrument to assess coping behaviors and measure the degree of adjustment with the breast cancer.
The present exploratory mixed method study was conducted in two consecutive stages: 1) the hermeneutic phenomenological study was done to explore the life experiences of coping styles to adjust with the breast cancer using in-depth interviews with patients that lead to item generation; 2) psychometric properties (validity and reliability) of the instrument were evaluated recruiting 340 eligible women. The item pool was reduced systematically and resulted in a 49-item instrument.
From the qualitative stage, item pool containing 78 items related to coping strategies to adjust with the breast cancer. After eliminating unwanted statements from the results, qualitative and quantitative face and content validity, the 10 factors extracted employing construct validity were: feeling of guilt, abstention-diversion, role preservation and seeking support, efforts for threat control, confronting, fear and anxiety, role wasting, maturation and growth, isolation, and fatalism. These factors accounted for the 59.1% of variance observed. The Cronbach reliability test was carried out and alpha value of 10 factors was calculated from 0.78 to 0.87 confirming all factors were internally consistent. The scale’s stability was tested using the test-retest method.
The 49-item AIMI-IBC revealed acceptable psychometric properties. This instrument provides healthcare professionals to systematically assess the coping strategies of Iranian women with breast cancer and measure the degree of adjustment with illness.

Breast cancer is the most common cancer among women worldwide and in addition to the physical complications¡ caused multiple mental and emotional challenges for patients. Present study was performed through phenomenological qualitative approach in a sample of Iranian women to deep exploration and better understanding of coping ways that patients use when face with cancer¡ with a focus on methods based on religion and spirituality based.
Data were collected through in-depth semi-structured interviews with 27 eligible patients. Interviews were transcribed and analyzed using Van Manen thematic approach. Data collection and analysis were carried out simultaneously. In addition¡ Maxqda (Ver10) software was used for data management.
The mean age of participants was 50±8.77years¡ ranging from 32 to 68 years. About 22% of these patients had Lumpectomy (remove part of breast tissue) and others (78%)¡ mastectomy (remove of all breast)¡ respectively. By analyzing and extracting the primary codes from the interviews¡ the final codes were extracted and divided into 6 sub and 2 conceptual categories¡ and relation between the conceptual categories led to emerge of the study main theme “Transcendence-oriented effort to adjustment”.
Breast cancer patients in this study predominantly employed dynamic processes and coping strategies to deal with the reality of disease that had been formed from their religious and spiritual beliefs. Therefore¡ it is necessary to health care providers¡ while maintaining respect for patients and considering their spiritual and religious beliefs¡ make available religious counseling in order to providing spiritual health promotion for patients.

The populations who survive from breast cancer are growing; nevertheless, they mostly encounter with many cancer related problems in their life, especially after early diagnosis and have to deal with these problems. Except for the disease entity, several socio-cultural factors may affect confronting this challenge among patients and the way they deal with. Present study was carried out to prepare clear understanding of Iranian women's lived experiences confronting breast cancer diagnosis and coping ways they applied to deal with it.
This study was carried out by using qualitative phenomenological design. Data gathering was done through purposive sampling using semi-structured, in-depth interviews with 18 women who survived from breast cancer. The transcribed interviews were analyzed using Van Manen’s thematic analysis approach.
Two main themes were emerged from the interviews including "emotional turbulence" and "threat control". The first, comprised three sub themes including uncertainty, perceived worries, and living with fears. The second included risk control, recurrence control, immediate seeking help, seeking support and resource to spirituality.
Emotional response was the immediate reflection to cancer diagnosis. However, during post-treatment period a variety of emotions were not uncommon findings, patient's perceptions have been changing along the time and problem-focused coping strategies have replaced. Although women may experience a degree of improvement and adjustment with illness, the emotional problems are not necessarily resolved, they may continue and gradually engender positive outcomes.

Fear, anxiety and pain of delivery have the important role in the passing way of the delivery process. Some clear-sighted people believ that threshold of pain differs among ethnic groups. Therefore, this study was conducted to compare primipara’s women perception of pain, fear and anxiety of vaginal delivery among Persian, Kurdish and Turkish women. In this descriptive-analytical study, 450 primipara’s women selected from general hospitals of Shiraz, Tabriz and Kermanshah city using multistep random-sampling method were assessed. Data collection was done using questionnaire and visual analogue scale of pain (VAS). Data were analyzed using descriptive and analytic statistics (mann-withneyu, Kruskal-wallis) and SPSS.16 software. In this study statistically P<0.05 was significant. The mean of pain severity in primipara’s Persian, Kurdish and Turkish women were (8.24±1.21), (7.01 ±1.98) and (7.82 ±0.79) respectively. Kruskal-wallis test showed that severity of pain was significant amonge three groups. The mean of fear and anxiety in primipara’s Persian, Kurdish and Turkish women were (55.64±14.66), (42.11 ±8.81) and (40.11 ±14.56) respectively and was significantly different amonge three groups. Significant relationship was found between maternal education with childbirth pain perception among Turkish women (P<0.001).Significant relationship was found between maternal jobs with childbirth pain perception among three groups of women. perception of pain severity, fear and anxiety of vaginal delivery was significantly different amonge Persian, Kurdish and Turkish women. It seems that different issues such as cultural, social, mental, environmental and psychological factors affect woman’s perception of labor pain.

The prevalence of obesity is increasing throughout the world. Obesity assessed by body mass index (BMI) has shown to be associated with gestational complications while the relationship using waist circumference (WC) is not clear yet. The present study was aimed to determine the relationship between WC and adverse pregnancy complications. In this prospective cohort study, 1140 nulliparous pregnant women at 1st trimester of pregnancy referred to health care centers in Ta-briz, Iran were enrolled in 2009-2010. Anthropometric indexes including (weight, height and WC) were measured using standardized measures and methods. BMI was classified into normal, overweight and obesity based on WHO classification. Abdominal obesity was defined as WC ≥ 88 cm. Pregnancy complication including gestational diabetes, hypertension and preeclamsia. Data were analyzed using SPSS, version 16. Mean of BMI and WC were 24.32±4.08 kg/m2, 81.84±9.25cm at 1st trimester of pregnancy, respectively. Prevalence of overweight (BMI=25-29.9 kg/m2) and obesity (BMI>29.9 kg/m2) was 27.6%, 8.8%, respectively. Abdominal obesity based on WC was 34.8%. Significant correlations were found between BMI and WC (r=0.73, P =0.0001). Women with BMI>29.9 kg/m2 and WC>88 cm were more likely to suffer from gestational pregnancy and hypertension, as well as preeclampsia and preterm delivery. Early maternal WC similar to BMI is related with pregnancy complications.