mozhgan khalili

Lifestyle and social health in fertility play a decisive role on mental health, and infertility is one of the unpleasant life experiences that can affect a person's mental health. In addition, marital satisfaction is also affected by infertility and plays an important role in the mental health of couples.

In order to find the relationship between these factors mentioned in the "background" section, this study aimed to determine a predictive model of depression in infertile women based on lifestyle and social health components mediated by marital satisfaction.

The present study was a descriptive and correlational study in which 360 infertile women were selected based on the depression score obtained from the Beck questionnaire (score 8 and above). Then, social health, lifestyle, and marital satisfaction questionnaires were completed by the selected infertile women. Subsequently, the raw data obtained were analyzed using SPSS-Ver.22 and partial least squares (PLS)-Version 3 software. Finally, a predictive model was designed based on the relationship and correlation between the variables.

The findings showed that there is a significant relationship between social health and depression (r = -0.55, P < 0.01), between social health and marital satisfaction (r = 0.48, P < 0.01), between social health and lifestyle (r = 0.52, P < 0.01), lifestyle and depression (r = -0.41, P < 0.01), between lifestyle and marital satisfaction (r = 0.59, P < 0.01), and between marital satisfaction and depression (r = -0.61, P < 0.01). Negative values of the above-mentioned correlations (r) indicate an indirect relationship and positive “r” values indicate a direct correlation.

Based on the results of the present research, the main hypothesis of this research was confirmed and it can be concluded that the model designed to predict the depression of infertile women based on lifestyle and social health components with the mediation of marital satisfaction is valid.

 Depression caused by infertility for couples, especially women, causes disruption in lifestyle and social health.

 This study was conducted in order to investigate depression and its relationship with social health and healthy lifestyle components in infertile women who referred to infertility centers in Kermanshah in 2021.

 In this study, 360 infertile women referring to the infertility centers of Kermanshah were selected using available methods. Data collection tools were Beck depression questionnaires (shortened), Keys social health questionnaires, and Valkropiroki lifestyle promotion questionnaires, which were completed after obtaining consent from the research samples. The results of data extraction were analyzed using SPSS software and Pearson's correlation coefficient test.

 360 investigated samples obtained depression scores between 8 and 12, which indicated depression in them. 56.9% of them scored 8, which indicates mild depression, and only 0.3% of the sample scored 12. Between social health and depression (P < 0.01, r = -0.55 between social health and lifestyle (P < 0.01, r = 0.52), lifestyle and depression (P < 0.01, r = -0.41), there was a significant relationship.

 Based on the results of this study, depression caused by infertility and the components of social health and lifestyle are directly related to each other, and having a healthy lifestyle and social health can prevent depression in infertile women, and also improve the reduction of depression in infertile women by correcting these components.

Infertility has negative effects including sexual dysfunction in infertile women. This study investigated the effect of counseling based on the PLISSIT model on sexual function of infertile women.

This study was performed on 60 infertile women, who were randomly assigned to two intervention (direct and indirect counseling) and control groups (20 in each group). In the direct counseling group, the intervention included four face to face sexual counseling sessions, once a week, based on the PLISSIT model. In the indirect counseling group, the similar content of counselling was given through booklet and the participants received telephone counseling. Sexual function was measured using female sexual function index (FSFI) pre and four weeks after intervention. One-way ANOVA was used to compare the groups before the intervention and ANCOVA with control of the baseline score after the intervention.

There was no significant difference between the sexual function of three groups at baseline. After the intervention, by controlling the baseline score, a significant difference was observed in the overall score of sexual function in the direct counseling group (mean difference: 5.1, 95% CI: 26.3 to 29.7, P=0.001). In the indirect counseling group, after the intervention, only a significant differences was observed in the pain dimension (mean difference: 0.9, 95% CI: 2.5 to 3.9, P=0.044).

It seems that PLISSIT based direct counseling improves more the sexual function of women with infertility. So, it is recommended that such counseling program be integrated into the health care program of infertile women.

According to Cavell, on one hand relation between moral values and the reality based on the grammatical criteria of Wittgenstein is not rational; on the other hand, disability of moral criteria is not logical .From this point of view, the claim of having access to the pure reality is meaningless, because there is not a logical possibility of such success that one can or cannot do it. In other words, we don't have the natural possibility for having a logical and rational way to solve moral problems. Therefore moral issues are not rational.From the view of Cavell’s Wittgenstein, meaning is appearing during using language game inside its form of life. So, in the process of responding to an ethical request, Wittgenstein's human, responds to the reality in certain situations, depending on the conditions, with the intention and moral judgment, Thus from his view point, before using words in moral language games, we do not have meaning.