فهرست مطالب giti ozgoli

Considering the prevalence of high-risk pregnancies in developing countries, the increase in maternal and fetal morbidity and mortality, as well as the adverse effects of these pregnancies on the mental health of couples، it is necessary to understand the experience of high-risk pregnancy in couples. Since one of the most realistic ways to achieve the challenges ahead is to use people's own experiences, this study was conducted with aim to explain the experience of couples with high-risk pregnancies.

 This qualitative study was conducted in 2018 on couples with high-risk pregnancies in the health centers and Sayad Hospital in Gorgan. The participants were selected in a purposeful way and with maximum diversity for structured in-depth interviews. Guba and Lincoln criteria were used for data accuracy. The data collection and analysis was done simultaneously based on the contract qualitative content analysis process based on Granheim's method and by MAXQDA software (version 10).

 Totally, 23 couples with high-risk pregnancies participated. The age range of women was 20-45 years and men were 22-52 years. The contents included the concern and fear of couples for maternal and fetal health, the way to deal with the problem, and need to comprehensive services and support of the relatives.

 Considering the worry about maternal and fetal health and the lack of comprehensive services, paying attention to increasing information and acquiring skills to cope with problems and a healthy lifestyle in couples, as well as providing comprehensive supportive services and support of the relatives is required in order to couples have a good experience of high-risk pregnancy by reducing high-risk pregnancy complications.

In many healthcare centers, evidence-based practice (EBP) is a vital tool for providing better and safer healthcare services. 

This study investigates the psychometric properties of the Persian version of the EBP implementation questionnaire in nurses.

This is a methodological and cross-sectional descriptive analytical study. We selected 400 nurses (200 for exploratory factor analysis and 200 for confirmatory factor analysis) via convenience sampling. The study questionnaire was translated based on the World Health Organization (WHO)’s guidelines. Construct validities of the EBP were assessed through exploratory and confirmatory factor analyses. The repeatability was also evaluated by the test re-test method. The study was conducted based on the COSMIN (consensus-based standards for the selection of health status measurement instruments) checklist.

The exploratory factor analysis revealed four factors: Evidence evaluation, development of evidence use, evidence sharing, and access to evidence. These factors could explain 58.30% of the total variance of evidence-based care in the nurses. Confirmatory factor analysis confirmed the goodness of fit of the 4-factor model of EBP implementation. The reliability of the evidence evaluation, development of evidence uses, evidence sharing, and access to evidence factors was confirmed using the Cronbach α coefficient. In addition, this questionnaire had excellenttest re-test reliability and the intra-class correlation coefficient (ICC), whose values were reported to be 0.996 with a confidence interval (CI) of 0.991 to 0.998 and P=0.001. Also, its re-test reliability was equal to 0.85.

The Persian version of the EBP implementation scale has acceptable reliability and validity. In addition, the number of items in this questionnaire is low. Therefore, it can be used to measure the implementation of EBP in Iranian nurses and identify groups of nurses needing special interventions.

Gestational diabetes is is associated with some degree of sexual dysfunction in women. Therefore, this study aimed to explore the perceptions and experiences of women with gestational diabetes regarding their sexual function.

This study was a qualitative research using the conventional content analysis approach and was conducted from April to December 2020 in Mazandaran Province, Iran. The participants included 15 women with gestational diabetes, six key individuals, and two husbands of women with gestational diabetes who were selected using a purposive sampling. The data were collected through in-depth semi-structured interviews. The content analysis approach was used based on the Graneheim and Lundman (2004) method. Guba and Lincoln's criteria including credibility, transferability, confirmability, and dependability were applied to achieve trustworthiness. MAXQDA10 software was used for data management.

Data analysis illustrated four themes: "sexual problems in women with gestational diabetes", "worries and problems caused by gestational diabetes", "non-comprehensive services", and " need to empower the individuals and significant others ". 

Worries and problems caused by gestational diabetes that develop in women who receive inappropriate and non-comprehensive services can affect their sexual function. Therefore the supportive role of health care providers and significant others are necessary to empower the patients to overcome their sexual problems.

Cervical cancer has been recognized as an important health problem in women. Infection with some genotypes of human papillomavirus (HPV) is the most important risk factor associated with cervical cancer. The present study was conducted with aim to estimate the prevalence of genital HPV in suburban women.

In this systematic and meta-analysis study from February 20 to March 20, 2023, databases of Web of Science, Scopus, PubMed and Embase and Google scholar search engine were searched without time restrictions using the keywords such as "papillomavirus", "genital wart" and "suburban population" and relevant synonyms. In the selection criteria, observational studies on the prevalence of genital papillomavirus in suburban women were included. Heterogeneity of the studies was evaluated with I2 and Cochran's Q test. Funnel plot and Egger & Begg tests were used to assess the publication bias of the studies.

Finally, 10 studies with a sample size of 65,813 remained in accordance with the purpose of our study. The results of the meta-analysis showed that the overall prevalence of HPV in suburban women was 17% (95% CI: 13-21%) and HPV/16 genotype with a prevalence of 18% (95% CI: 13-23%) was the most common genotype in the affected people.

In general, the prevalence of genital papilloma virus infection was relatively high in suburban women. This result can be useful for policy makers in planning preventive strategies for cervical cancer in poor and low-income environments.

  Infertility has serious implications on psychological and social well-being as well as the sexual life. Considering that sexual health is an essential element of human health, the present study was performed to explore the experiences of Iranian infertile women regarding their sexual health.

 This qualitative study was conducted using conventional content analysis (Lundman and Graneheim's approach) in Tehran, Iran from November to March 2018. Twenty infertile women (aged 25-42 years old with various reasons for infertility), who were selected purposefully, participated in this study. The data were collected through in-depth semi-structured interviews All interviews were tape-recorded and transcribed verbatim. Guba and Lincoln's criteria including credibility, transferability, confirmability, and dependability were applied to achieve trustworthiness.

 Three themes emerged from the data analysis including 1) Impact of the process of diagnosis and treatment on women’s sexuality 2) Psychological, behavioral, interpersonal and economic factors influencing sexual health, and 3) cultural and religious norms affecting sexual life.

 Infertile women's sexual health is influenced by the process of diagnosis and treatment; psychological reactions to infertility, economic, personal, and cultural-belief system.

Type 1 diabetes mellitus (T1DM) can profoundly influence different dimension of health such as sexual and reproductive health (SRH). The aim of this study is to develop and evaluate the psychometric properties of the Sexual and Reproductive Health Questionnaire for Women with Type 1 Diabetes Mellitus (SRHQ-WT1DM).

This protocol for a sequential exploratory mixed-methods study has two phases. Conducting a literature review, the first phase of the study will develop the items of SRHQ-WT1DM. Data analysis in this phase will be performed using directed content analysis and according to the framework proposed by the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) for SRH in women. The second phase will evaluate the psychometric properties of SRHQWT1DM through a methodological study. Face and content validity will be evaluated both qualitatively and quantitatively, and construct validity will be done by exploratory factor analysis and convergent validity. The questionnaire’s reliability and stability will be examined using internal consistency (by Cronbach’s alpha calculation) and test-retest method (by Intra class correlation coefficient calculation), respectively. Descriptive statistics, Pearson correlation coefficient, and independent t-test will also be used. Women with T1DM who are of childbearing age and have unknown mental disorders will be selected as participants in the study from the Iranian Diabetes Society.

Development and psychometric evaluation of a specific tool for SRH assessment in women will help identify and fulfill their SRH-related needs and improve dimensions of their SRH.

Although pregnancy is a pleasant period for most women, it is often a stressful period with physiological and psychological changes. Physical health and mental health are two general dimensions of quality of life. It seems that the quality of life has an effect on the sexual function of pregnant women. Therefore, this study was conducted with aim to compare the relationship between sexual function and the quality of life of pregnant women in different trimesters of pregnancy.

This cross-sectional study was conducted in 2019 on 360 pregnant women (120 pregnant women in each trimester) referring to the pregnancy care clinic of Rasht public Hospitals. The tools were questionnaires of demographic characteristics, FSFI sexual function, and quality of life SF-36. Data analysis was done using SPSS statistical software (version 23) and t-test, Chi-square, ANOVA and Pearson's correlation coefficient. P<0.05 was considered statistically significant.

The mean score of the total sexual function of the studied subjects was 18.64 ± 10.05. Sexual dysfunction was seen in 86.4% of the samples. The scores of sexual functions in the first to third trimester of pregnancy were 23.92 ± 7.79, 18.84 ± 8.84, and 13.17 ± 10.37, respectively. It showed a statistically significant difference between the total score and the scores of the dimensions of sexual function with trimesters of pregnancy (p<0.001). The quality of life of the groups with and without sexual dysfunction had statistically significant differences in the two main dimensions of physical health and mental health (p<0.001). The mean scores of physical health and mental health were 54.82 ± 18.73 and 60.18 ± 17.59, respectively. Also, satisfaction (r=0.162, p=0.002) and pain (r=0.108, p=0.041) had a positive correlation with physical health. The total score of sexual function (r=0.158 and p=0.003) had a positive correlation with mental health. Lubrication (r=0.126, p=0.017), orgasm (r=0.146, p=0.006), satisfaction (r=0.247, p=0.0001), pain (r=0.165, p=0.002) and the total score of sexual function (r=0.158, p=0.003) were positively correlated with mental health.

The rate of sexual dysfunction increases with increasing gestational age. Also, quality of life with the highest mean score of mental health was related to the first trimester and the highest mean score of physical health was in the third trimester of pregnancy. Sexual function had a positive correlation with the mental health dimension of quality of life.

To investigate the direct and indirect effects of demographic characteristics, relationship satisfaction, and psychological factors on female sexual distress (FSD) using path analysis.

This study was conducted in two stages. Initially, we obtained the FSD predictor factor's conceptual model through a literature review and expert panel. In the Second stage, a population-based cross-sectional study on 207 non-pregnant and married women (without any age restriction) in Zanjan, Iran was conducted. FSDs-R, FSFI-6, DASS-21, and GEMREL Standard questionnaires and the demographic researcher-made questionnaire were used in this study.

Sexual function (SF) had the strongest relationship with FSD from the direct path (β = -.49) and overall effect (β = -.58). The highest indirect effect belonged to depression-anxiety-stress level (β = .284) mediated by SF (β = -.42) and relationships satisfaction with spouse (β = -.20). Age difference (β = -.13) and relationships satisfaction with spouse (β = -.19) had only a direct effect on FSD. Marriage Duration had only indirect effect on FSD through mediating role on SF (β = -.26) and depression-anxiety-stress level (β = -.15).

Among the predictor factors investigated in this study, sexual dysfunction is the most important predictor of FSD. In addition; men older than their spouses, longer marriage duration, relationship dissatisfaction with the spouse and higher rate of depression-anxiety-stress have positive correlation with SD. Therefore, we should offer a combination of the mentioned factors in providing care for women with SD.

Educational status affects all aspects of life, including sex life. Regarding the relationship between women’s sexual satisfaction and their education level, contradictory results have been obtained so far. This systematic review aimed to summarize the existing knowledge in this area.

In this study, three electronic databases, including PubMed, Scopus, and Web of Science were searched for all the related articles published from 1 January, 2000 to 28 June, 2022. The MeSH keywords including “educational status”, “education”, and “sexual satisfaction” were combined with Boolean operators of AND and OR. There were no geographical constraints in this study. Inclusion criteria were all observational articles evaluating the relationship between the educational status of heterosexual, nonpregnant, and non-sick women with sexual satisfaction. The quality of articles was assessed by the Newcastle-Ottawa scale (NOS) and the data were analyzed qualitatively.

Out of a total of 4984 retrieved articles, nine studies with a sample size of 10488 women were included in this systematic review (2003-2021). In subjects with sexual dysfunction and mental health problems, as well as those affected by economic pressure, sexual satisfaction was predicted by the mentioned factors and not by the education level. Generally, in the studies where it was possible to compare the participants with all levels of education (illiterate to academic) and there was no sexual dysfunction, mental health problems, and economic pressure, women’s level of education was the predictor of their sexual satisfaction.

According to our results, education was the most effective predictor of women’s sexual satisfaction in stable conditions without sexual dysfunction. Education can improve women’s educability, knowledge, and attitudes towards sexual issues, thereby increasing their sexual satisfaction. However, for a more definite conclusion, high-quality and larger studies are needed to measure the relationship between sexual satisfaction and women’s education.

There is a possibility of more accumulation of environmental pollutants due to lower levels of iron in the body of women. Different results have been reported on the association of lead with breast cancer, therefore, this systematic review study was performed with aim to determine the relationship between lead and breast cancer.

In this review study, to find the related articles, international databases (Web of Science, Embase, Scopus, Google Scholar and PubMed) and national (Irandoc, Magiran, SID and IranMedex) were searched with different keyword combinations related to "Lead" And "Breast Cancer" obtained from MESH in 2000 to 2022. Selection of articles was based on inclusion and exclusion criteria and articles' quality was assessed using the Newcastle Ottawa scale.

Out of 4057 articles reviewed, 13 articles had good quality. All studies were in English and were observational. According to most studies, serum lead levels were not associated with breast cancer, but lead levels in bone and breast tissue were also associated with exposure to lead as an environmental contaminant with breast cancer.

Different ways of exposure to lead have led to different results and it cannot be certainty said that exposure to lead causes breast cancer, while this relationship also depends on the method of measuring lead. In this regard, long-term studies with accurate measurement of environmental lead and body tissues, especially for women at higher risk are recommended.

This study aimed to develop and psychometrically validate the Sexual Health Scale for Middle-Aged sexually active women (SHIMA).

This study was a sequential exploratory study consisting of two phases. In phase one, we interviewed 19 middle-aged women and reviewed the existing instruments to generate an item pool. Then, a panel of experts (n = 16) examined the items. In the second phase, the psychometric properties of the scale were assessed. For content and face validity, a panel of experts (n = 8) and a group of middle-aged women (n = 10) reviewed the items. For construct validity, a cross-sectional study was carried out on a sample of 427 married women. Finally, SHIMA’s reliability was assessed.

In the first phase, the sexual health concept was explored, and a provisional scale including 60 items was generated. Next, 21 items were removed based on content and face validity. Accordingly, the results obtained from the exploratory factor analysis (EFA) indicated acceptable loading for 34 items tapping into six factors that jointly explained 48.67% of the total variance observed. The internal consistency evaluation revealed that Cronbach’s alpha and McDonald’s omega were greater than 0.7, and the average inter-item correlation was greater than 0.4, except for one factor that showed borderline results. Test-retest reliability over a 2-weeks interval was 0.90, indi-cating its high stability.

The SHIMA is a reliable and valid scale for measuring sexual health in middle-aged married women. It can be used as a sexual health screening scale by healthcare professionals and for research purposes.

Quality of sexual life can be influenced by cultural and social contexts. This study aimed to investigate the relationship between structural determinants of health (such as education, income level, job, culture, and ethnicity) and quality of sexual life in women.

In this systematic review, we searched six databases, including Web of Science, Scopus, ProQuest, PubMed/Medline (NLM), Cochrane, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to obtain all the related observational studies (cross-sectional, cohort, and case-control).

Nine studies met the inclusion criteria. Based on the Newcastle-Ottawa Scale (NOS), the risk of bias in most of the included studies was fair. According to the results, the relationship between education level and quality of sexual life among women was significant in four studies. Also, in one study, job and income level were significantly correlated with women’s quality of sexual life.

Based on the results, structural determinants of health, including education, job, and income level were significantly related with women’s quality of sexual life.

Sexual activity changes during pregnancy due to hormonal and physical changes in pregnant women. This leads to a higher prevalence of sexual dysfunction in pregnancy. Evaluation of sexual function with special tools is necessary to determine sexual dysfunction during pregnancy. Pregnancy Sexual Response Inventory is one of these tools. The present study was performed aimed to translate and determine the psychometric properties, and validate the Pregnancy Sexual Response Inventory (PSRI).

This correlation type descriptive-analytical study was translated from English to Persian "Forward / Backward" to translate, psychometrics, and validate the Pregnancy Sexual Response Inventory (PSRI) in 2021. After consulting the experts and pregnant mothers, the content and face validity of the scale were determined qualitatively. The final version of the questionnaire was completed by 260 pregnant women in Rasht, chosen via convenience sampling. The reliability of the questionnaire was assessed by Cronbach's alpha coefficient and Inter class correlation coefficient (ICC). The reliability and validity of the questionnaire structure was done by confirmatory factor analysis using AMOS software and other statistical analyzes using SPSS statistical software. P< 0.05 was considered statistically significant.

Intra-class correlation was shown for each scale between 0.602 and 0.902. There was also a moderate to high correlation between each subscale and the total score of the PSRI questionnaire. All indices of goodness indicated that all subscales of this questionnaire are suitable to measure pregnancy sexual response and activity.

The psychometric properties of the PSRI Scale showed the high reliability and validity of this scale and the possibility of using this tool in Iran.

Postponed childbearing is a social phenomenon in Iranian families. There is a controversy about its effect on mental health. Therefore, this study was conducted aimed to determine the role of childbearing in the rate of depression, stress, and anxiety in Iranian women of childbearing age.

This cross-sectional study was performed in 2021 on 581 eligible non-pregnant married women from 31 provinces of Iran. Non-random available sampling was performed as electronic form in virtual space. Data were analyzed by Demographic and Medical History Questionnaire, Sleep Quality (adapted from LSQ), Marital Satisfaction (EMS), Perceived Social Support (MSMPSS), Socioeconomic Status (Ghodratnama Questionnaire), and Stress-Anxiety-Depression (DASS-21). Data were analyzed by SPSS software (version 22) and Independent t-test, Chi-square, and binary logistic regression. P<0.05 was considered statistically significant.

Female and spouse education (P <0.001), female employment (P = 0.004), and higher socioeconomic status (P = 0.04) were significantly higher in women without children. The marital satisfaction (P = 0.061), social support (P = 0.13), sleep quality (P = 0.58), history of chronic disease (P = 0.64), and place of residence (P = 0.058) were not significantly different between the two groups. After adjusting the data, the rate of depression in childless women is twice that of women with children (AOR=2.06 95% CI: 1.11-3.82). Stress (P = 0.38) and anxiety (P = 0.9) were not significantly different between the two groups.

Having children not only does not increase the rate of stress and anxiety, but also protects women against depression. Therefore, encouraging childbearing seems to promote the mental health of women in Iranian society.

Research has demonstrated the negative effects of type-1 diabetes mellitus (T1DM) on the female sexual health and reproductive function. The present study was conducted to develop the concept of sexual and reproductive health (SRH) in women with T1DM.

This concept development was conducted by directed content analysis of relevant literature. A search was carried out for articles published from 2000 to 2019 in English databases including PubMed, Web of Science, Scopus, Embase and Persian databases including Magiran, SID, and IranDoc and search engine such as Google Scholar based on a search strategy developed for each database using Boolean operators. The initial matrix was designed based on the framework proposed by the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) and information resources related to them for the concept of women's sexual and reproductive health (SRH). The selected articles were analyzed using directed content analysis with deductive approach proposed by Hsieh and Shannon. 

The final codes were extracted from the review of 151 articles based on their conceptual differences and similarities, and categories were then defined and a matrix was developed. Four categories were extracted in this study for the concept of SRH in women with T1DM, including reproductive system, safe motherhood, sexual and gender-based violence, and sexual function, along with 20 subcategories.

The findings can be utilized to develop specific tools for assessing SRH in women with T1DM as well as designing programs targeting SRH promotion in this vulnerable group.

Adipokines play essential roles in the human body, including regulating the inflammatory process, the immune system's activity, the vascular system, and reproductive function, and performing glucose homeostasis. Adipokine levels change during pregnancy and postpartum, and these hormones play an important role in fetal growth and development. This study aimed to compare maternal leptin and omentin-1 serum levels in vaginal and cesarean deliveries and their relationship with anthropometric indices.

This descriptive-analytical study was performed in 2020 on 90 women (45 patients with vaginal delivery and 45 patients with elective cesarean delivery) admitted to the Mahdieh Hospital in Tehran, who were selected conveniently. Intravenous blood samples were taken in the first 24 hours after delivery to measure maternal leptin and omentin-1 serum levels.

The mean age was 25.8±4.6 and 29.5±4.5 in women with vaginal delivery and elective cesarean delivery, respectively. The results showed that maternal leptin and omentin-1 serum levels were higher in vaginal delivery than in cesarean delivery, although the difference was significant only in leptin serum levels (p<0.001). Also, no significant relationship was observed between fetal sex and anthropometric indices with maternal leptin and omentin-1 serum levels (p>0.5).

Leptin serum levels were significantly higher in the first 24 hours after vaginal delivery than after cesarean delivery Vaginal delivery can be recommended as the preferred method due to its critical role in metabolic and anti-inflammatory activities and reproductive function regulation.

One of the goals of the third millennium development is maternal and neonatal health. One of the harmful factors of health is natural disasters. This study was performed aimed to determine maternal complications in Kermanshah earthquake in 2017.

This cross-sectional study was conducted on 850 women who had delivery in Imam Khomeini hospital of Eslam Abad Gharb. The earthquake group included the women who had delivered in the earthquake of 2017 and the non-earthquake group included the women who were delivered in the same hospital in 2016. All data obtained from patients' records. Data were analyzed by SPSS software (version 21) and Independent t-test, and Mann-Whitney test, Chi-square and Fisher exact test. P<0.05 was considered statistically significant.

In women who had delivered in an earthquake, prevalence of maternal complications included preterm labour in 99 (22.3%), premature rupture of membrane in 30 (7.05%), caesarean section in 179 (42.1%), postpartum hemorrhage in 42 (9.9%), gestational hypertension in 24 (5.6%) and abortion in 11 (2.58%). In women who had delivered in 2016, there were preterm labor in 51 (11%), premature rupture of membrane in 12 (2.8 %), caesarean section in 153 (36%), postpartum hemorrhage in 20 (5%), gestational hypertension in 9 (2.1%) and abortion in 2 (0.5%). There were significant differences between the two groups in all cases (P<0.05).

Natural disasters such as earthquakes can increase maternal complications. Therefore, necessary precautions and health care should be increased in the event of a natural disaster.

Menopause is a physiological period in a woman's life that is accompanied by symptoms or complications which may need treatment. This study was conducted with aim to consolidate the existing knowledge to evaluate the effect of fennel on sexual health of postmenopausal women.

In this review study, to find the clinical trial studies which evaluated the effect of fennel (oral, inhaled or vaginal) on sexual health of postmenopausal women, the databases of PubMed/Medline(NLM), SCOPUS, Web of Sciences, ProQuest, The Cochrane library, and Google scholar were searched from 2000 to 2021 with no language restrictions with the keywords of "Sexual Satisfaction", "Sexual function", "Sexual life", "fennel", "Menopause" and related terms. The primary outcome was evaluation of sexual health in postmenopausal women. Studies which their full text was in Persian or English entered the study. The Cochran checklist was used to assess the quality of studies.

Seven studies with 570 postmenopausal women included in this review according to inclusion criteria. Based on the results, the positive effect of fennel in various forms of inhaled, oral and vaginal alone or in combination with other herbal medicines on the sexual health of postmenopausal women has been reported in six studies. Only one study comparing it with citalopram found no effect of fennel.

It seems that fennel is a drug which affects sexual health in postmenopausal women. In future studies on fennel, it is suggested that the evaluation of side effects and cost-effectiveness be considered.

Female sexual dysfunction is one of the major health problems of women after childbirth. So, the present study was conducted with the aim of localizing the postpartum sexual function and dyspareunia (The Carol Scale).

This methodological study conducted in 2019-2020 on 200 woman during three months after vaginal delivery. The original version of the Carol scale is in Spanish, which after obtaining permission from the tool developer, was translated into Persian using protocol of forward-backward translation. First, the face and content validity and then the construct validity were determined by confirmatory factor analysis. The reliability was determined by the test-retest method as well as the Intra class correlation coefficient (ICC).

Structural factor analysis was performed using confirmatory factor analysis and four factors of original tool were confirmed. The fit of the four-factor model was confirmed ideal fit based on goodness of fit indices. All reliability indices reported good internal consistency and the overall ICC was 0.793 which indicates the stability or repeatability of the scale over time.

The Persian version of the Carol scale has evidence supporting reliability, validity, and responsiveness and can be used for assessment of postpartum sexual function and dyspareunia among Iranian women after vaginal delivery.

The World Health Organization recommendation requires the development and use of effective, brief, clear, and evidence‑based education packages to improve health‑care outcomes. No comprehensive sexual health improvement package exists for the pregnancy period in the Iranian health system. This study aimed to develop a package to promote sexual health in pregnancy.

The present study is a qualitative study, which was conducted in 2019 in Tehran, Iran. Sexual health package during pregnancy was developed based on the National Institute for Health and Clinical Excellence (NICE) steps. The first step included reviewing of international guidelines, strategies, handbooks, education packages, and articles in this regard. The package was developed in the second step. In the third step, quality assessment was performed using expert opinion with the Appraisal of Guidelines for Research and Evaluation Instrument II (AGREE II) tool, and validation was performed using Delphi method.

Package content was designed in two sections: for midwives and health‑care providers and for pregnant mothers in three sessions (in each trimester of pregnancy). The quality assessment using the AGREE II guidelines revealed excellent quality (>89%). The package was validated based on expert opinion (>95%).

The sexual health promotion package during pregnancy was designed with high quality and validity based on NICE steps. It is recommended, midwives be performed this designed and validated package in routine pregnancy care to promote the couple’s sexual health.

There is sufficient information about female sexual function, but few studies have investigated postpartum female sexual function. Postpartum women’s sexual function may be dramatically affected by childbirth. This study aimed to explore women's perceptions and experiences of the concept of postpartum sexual function.

This qualitative study was conducted using a directed content analysis approach based on Female Sexual Function Index (FSFI) between 2018 and 2019. Data were collected through semi-structured interviews with 13 women referred to the health centers of Babol University of Medical Sciences, Babol, Iran and were selected, purposively. The data were analyzed manually using directed content analysis adopted by Hsieh and Shannon (2005).

Overall, eleven categories emerged from the analysis. The six emerged categories were related to the predetermined components, namely sexual desire, arousal, lubrication, pain, orgasm, and satisfaction. The remaining five newly emerging categories included changes in the frequency of sexual intercourse, disturbed situation, changes in intimacy and relationship, physical (anatomical) changes, and psychological consequences.

The results showed some new categories, in addition to the components of FSFI, which could be added to the concept of sexual function in postpartum period. Therefore, health service providers should consider these new additional concepts in the assessment, care, and treatment of female sexual dysfunction in postpartum women.

Recognizing the predictors of fathers' worry about maternal health, maternity pregnancy, and infant health and personal- familial issues is the first step in counseling them. The present study aimed to determine the predictors of fathers' worry about high-risk pregnancy of their wife. This cross sectional study was conducted on 294 eligible fathers from four health centers and a hospital of Gorgan, Iran. Data collection tools were checklist of demographic and midwifery characteristics, psychological symptoms checklist (SCL-25), mothers' and fathers' worry questionnaire, and a social-familial support scale. Data were analyzed by SPSS and LISREL software 8.8 full version.  According to results of the path analysis, mothers' worry (B= 0.31, p=4.78) among the variables, which were related to fathers' worry from both paths, had the highest positive relationship. The maternal mental health indirectly had the most positive association (B = 0.12, p=3/48) and duration of marriage indirectly had the most negative association with fathers' worry (B = -0.22, p=-3.14). In a direct path, the fathers' mental health was positively related to the fathers' worry (B= 0.3, p=0.000). Mothers' worry, fathers' mental health, duration of marriage, and maternal mental health had the highest association with fathers' worry. The factor was both directly and indirectly related to the mother's worry through association with the maternal mental health. According to findings, on this basis, it is important to pay attention to supportive and counseling programs for fathers.

Episiotomy is one of the causes that can affect mothers' postpartum quality of life. Aloe Vera plant has been suggested as one of the ways to heal wounds and reduce pain. Regarding to these properties, several clinical trial studies have been conducted to determine the effect of aloe vera on episiotomy pain relief and wound healing, and different findings have been reported. This study was performed with aim to determine the effect of Aloe Vera on episiotomy pain relief and wound healing.

In this systematic review study, the databases of Scopus, PubMed (MEDLINE), Embase, Proquest, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Library and Web of Science were searched using the keywords of "pain", "Wound", "Healing", "Episiotomy", " Perineum" and "Aleo Vera" by OR and AND without time, language and geographical limitation until 23 April 2021. The quality of the articles was evaluated using the Cochran Group tool and data were analyzed by Stata software (version 14). Cochran test and I2 index were used to assess the heterogeneity of the articles.

Finally, 9 articles with sample size of 611 people were included in this systematic review study. Preliminary studies showed the effectiveness of Aloe Vera in wound healing and pain relief. Four studies with sample size of 258 patients had the potential to perform the meta-analysis for pain outcome. Results of the meta-analysis showed that Aloe vera can reduce pain intensity compared to the control group (P<0.05).

Aloe Vera seems to be effective in repairing episiotomy wounds and reducing pain; however, high quality studies with sufficient sample size are recommended for definitive results.

Postpartum pain contributes to increased irritability and excessive stress in the mother and consequently may inhibit successful breastfeeding, reduce a mother’s ability to take care of her baby, and cause an imperfect mother‑baby interaction. Evidence suggests the positive effect of ginger on reduction in uterus‑associated pain. The objective of this study is to investigate the effect of ginger capsules on postpartum pain.

The present double‑blinded, randomized, placebo‑controlled trial was conducted in Mahdiyeh Educational Hospital, Tehran. One hundred and twenty‑eight mothers having moderate‑to‑severe pain following vaginal delivery were included. The participants were divided into two groups (A and B). Interventions were performed every 8 h in 24 h. In the first intervention (2 h after the delivery), Group A received 500 mg of placebo capsules (containing chickpea flour) and Group B received 500 mg of Zintoma (ginger rhizome) capsules. In the second and third interventions, Group A received 250 mg placebo capsules and Group B received 250 mg Zintoma capsules. All participants received 250 mg capsules of mefenamic acid in each intervention in addition to ginger or placebo capsules. The pain severity was measured before and half an hour, an hour, and 2 h after each intervention. Statistical analysis was performed using the SPSS software version. 22. The Chi‑square, Fisher’s, and t tests and the GEE model were applied to assess the pain severity.

The average pain severity was not statistically significant between the groups in the beginning of the intervention ( P = 0.623). The mean score of pain significantly decreased within the duration of intervention in both groups (P < 0.001); however, the pain severity was significantly lower in the intervention group as compared to the control group at any point after the intervention (P = 0.006).

Ginger can be used as an effective remedy for postpartum pain relief.