فهرست مطالب sara esmaelzadeh

 The emergence of the coronavirus disease of the 2019 (COVID-19) pandemic in Iran has markedly affected lives and taken a toll on Iranians’ mental health, especially in women. The current study investigated factors that contributed to both perceived stress and quality of life (Qol) among women during the COVID-19 pandemic in Karaj, Iran.   

 A cross-sectional online survey study was conducted between November 30, 2020, and January 30, 2021. A researcher-made questionnaire with 4 subscales, including information seeking, social support, primary appraisal, and secondary appraisal, was used.  Perceived Stress Scale (PSS-10), and 36-Item Short Form Survey (SF-36) questionnaires were also applied. A total of 581 participants completed the study. The convenience sampling method was used in this study. Multiple mediation analyses were applied using pathway analysis.   

 The mean age ± SD of the participants was 38.57±7.68 years, and 40.8% had a higher education than a high school diploma. Based on the final fitted model, higher perceived stress had a direct impact on mental QoL (β = 0.47). The Comparative Fit Index  (CFI), Incremental fit index (IFI), and  Goodness of Fit Index (GFI) were calculated as 1, and χ2/df was 4.87.Educational level and social support from both the direct and indirect pathway affected QoL. Social support affected both information-seeking behavior and secondary appraisal (β = 0.50: 95% CI, 0.38-0.59). Furthermore, information-seeking behavior and  secondary appraisal affected perceived stress. Perceived stress followed by educational level had the strongest and primary appraisal had the poorest indirect association with mental QoL.   

 In conclusion, primary appraisal, secondary appraisal, social support, educational level, perceived stress, and information-seeking behavior were correlated with higher levels of mental QoL among women. Social support and improving the situation appraisal can provide appreciated support to manage stress induced by the COVID-19 pandemic. Further assessment is needed to determine the vulnerable groups such as illiterate people.

 Unplanned pregnancy and its complications are a global problem that affects women, families, and the community.

 This study aimed to assess the relationship between pregnancy intention, pregnancy outcomes, postpartum depression, and maternal role adaptation in pregnant women referred to healthcare centers of Robat Karim City, Iran. 

 This cohort study was conducted on 240 pregnant women referred to the healthcare centers of Robat Karim in 2019. They were selected by the convenience sampling method. After completing the London questionnaire in the 26th week of gestation, the participants were equally divided into planned and unplanned pregnancy groups. Edinburgh postnatal depression scale and parenting sense of competency scale were completed 10 days and 30 days after delivery. The obtained data were presented by descriptive statistics and analyzed by the Chi-square and t test for comparison between two groups and structural equation model for assessing the relationship between variables.

The mean ± SD values of age, marital duration time, and gravidity number of participants were 30±7.1, 1.5±0.02, and 5, respectively. The results revealed a significant difference between the two groups concerning the mean score of postpartum depression and maternal competency, 10 and 30 days after delivery (P=0.001). The results of path analysis showed that pregnancy intention had a negative and significant effect on postpartum depression (B = -0.58, t value=-2.5), but a positive and significant impact on maternal competency (B = 0.39, t value=-2).
According to the determined amount of variance, the variable of intention to pregnancy predicts 33% of postpartum depression (R2=0.33). Also, two variables of pregnancy intention and postpartum depression predict 55% of maternal competency (R2=0.55). 

  Pregnancy intention had a significant effect on maternal depression and competency. It is recommended that pregnancy intention be screened during pregnancy, and also appropriate training and social support be provided for mothers with unplanned pregnancies.

 The COVID-19 crisis has created many problems, including a negative impact on student education.

 The study aimed to understand the resident medical students' performance experiences during the COVID-19 pandemic, which is essential for future planning.

 The present qualitative study was performed on 15 resident medical students in Alborz University of Medical Sciences, Iran, from September to November 2020. Data were analyzed using conventional content analysis.

 Analysis of the meaning units of interviews showed four categories describing the resident students' experiences of performance during COVID-19 as follows: Fear and anxiety, the need for support, the sense of responsibility, and the lack of educational facilities.

 The present study showed that the COVID-19 pandemic had posed incredible new challenges for resident students. Assessing the mental health of residents, providing adequate protective equipment, and support from authorities and community members can create empathy, reduce the feeling of fear, and increase their accompaniment with pandemic managing programs. Due to the problems created in the training of residents during the pandemic, it seems necessary to propose rehabilitation courses to improve the training program for residents in various fields.
 

During pregnancy and postpartum, women bet more concerned and dissatisfied with their bodies. Primiparous women face more physical and mental health problems in the postpartum period.

This study aimed to investigate the effect of a midwife-based counseling program on the quality of life in women with body image concerns during postpartum.

This randomized controlled trial was conducted on 64 primiparous women with body image concerns who had been referred to the health centers in Alborz Province, Iran,in January 2019. The convenience sampling method was used for recruiting the study participants. Then, the samples were assigned to the intervention and control groups by random number table allocation. Next, the intervention group received a three-session counseling program.The data gathering questionnaire in this study included a Multi-Dimensional Body Self-Relation Questionnaire (MBSRQ) and a 36-item short-form quality of life questionnaire.  Questionnaires were completed before, immediately after, and one month after the intervention.The obtained data were analyzed using descriptive statistics, the Chi-square test, Fisher exact test, and repeated measures test.

The mean ±SD age of the study participants was 26.4 ±5.4 years. Also, 94%of the samples had wanted pregnancy, 54%had a vaginal delivery,and 59.4%were overweight.There was no statistically significant difference between the control and intervention groups before the intervention regarding their demographic characteristics. The results of the analysis of variance (ANOVA) with repeated measures test indicated that the length of time affected the total scores of multi-dimensional body self-relation (P= 0.001). Also, the repeated measures ANOVA results showed that time significantly impacted the quality of life score (P= 0.001).

The study results showed that a midwife-led counseling program could affect the score of quality of life in women with body image concerns in postpartum.

Spirituality can affect the patients’ perception of health, disease, and interaction with other individuals. Human immunodeficiency virus (HIV) is more stressful in women due to their maternal role and reproductivity; therefore, coping with the disease is more difficult for women than for men.

This qualitative study tried to investigate experiences, as well as spiritual perception and its role, in the lives of women positive for HIV using conventional content analysis. Therefore, the present study was carried out on 15 women positive for HIV referring to the Behavioral Diseases Counseling Center of Imam Khomeini Hospital in Tehran, Iran. The data collection was conducted through in-depth semi-structured interviews.

In the analysis of the interviews, after being infected, two spirituality groups were categorized into three subgroups, including 1) compliance with the disease, 2) belief in divine destiny, and 3) responsible behaviors to obtain God's satisfaction. The spirituality group and disease charges group were extracted divided into two subgroups of 1) divine punishment and 2) feeling of guilt.

Regarding the role of spirituality in coping with and enduring HIV among patients, it is recommended to perform interventions on women with HIV based on spirituality and religious beliefs, as well as decrease of the disease charges in societies. It is also suggested that caregivers in risky behaviors counseling centers should be trained in the domains of spirituality and spiritual well-being. Moreover, the caregivers can use the religious beliefs of the infected patients to help them with the disease disclosure and adaptation, use of drugs, and reduction of risky behaviors, as well as the harm to the community.

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

Pregnancy and childbirth are among the most stressful experiences in women. This study was conducted to determine effects of cognitive-behavioral counseling on posttraumatic stress disorder in mothers with infants hospitalized in neonatal intensive care units. The present randomized, controlled, clinical trial was conducted during year 2016. A total of 90 eligible females, attending Kowsar Hospital (Qazvin, Iran), were recruited through convenience sampling and allocated to the intervention and control groups, using random blocks of four. A total of eight counseling sessions were held for the two groups. The post traumatic stress disorder (PTSD) symptom scale was distributed among the participants before, immediately after, and three weeks after the intervention. The collected data were analyzed using the SPSS 19.0 software. The two groups were not significantly different in terms of baseline PTSD scores. According to the generalized estimation equation model, the two groups had significant differences in terms of the mean PTSD scores immediately and three weeks after the intervention (P = 0.002) and the mean scores were significantly lower in the intervention group on both occasions. Friedman test results confirmed the reducing trend in the intervention group’s mean PTSD scores at all three occasions (P = 0.000). Counseling had a positive effect on reducing PTSD symptoms in mothers with special conditions. This method can, hence, be recommended for improving the health status of these mothers

Self- medication is defined as consuming nonprescription medicines to treat self-diagnosed disorders or symptoms. This study was carried out to examine prevalence of self-medication during three months ago and its correlates among the elderly population in Karaj-Iran by using the HBM model.
This cross sectional study was conducted on 189 elderlies who were covered by health care centers. The inclusion criteria were absent of cognitive disorders and being over the age of 60. The multistage sampling was used in this study. The data collection tools included: demographic characteristics and a questionnaire based on the HBM model, including knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers. Statistical analysis of the data was performed using chi-square tests, Student t-tests, ANOVAs and multiple logistic regressions. Analyses were done by SPSS 19.0.
The prevalence of self-medication was 26.5%. The most common medicine used for self-medication was Supplements (87.30%), cold drugs (40.2%), and pain killers (39.6). There was significant correlation between self-medication and health insurance coverage (P=0.01) and chronic diseases (P=0.001).There were two predictors of self -medication behavior in our study, which were having chronic disease and perceived susceptibility with OR were 1.46(95% CI:0.71-2.40) and 0.93(95%CI:0.76-1.13), respectively.
Due to the study results, it is suggested that an interventional program should be considered the promoting of the perceived susceptibility of the elderly population regarding self-medication and policy makers should be noted to elderly health insurance coverage.

Promoting the reproductive health of women with HIV is very important..
The aim of this study was to design a reproductive health assessment scale for this vulnerable group and determine its psychometric properties..
Patients and This study adopted an exploratory mixed-methods design and included three phases. In the first qualitative phase, a sample of 25 HIV-positive women participated in semi-structured interviews and a focus group discussion. In the second part, item pools were generated. In the last phase, face validity, content validity, and construct validity were assessed using exploratory factor analysis. Internal consistency and test-retest methods were used to estimate the reliability of the scale..
Forty-eight items were included in the psychometric evaluation stage of the scale. Based on the assessment of the content validity ratio (CVR), content validity index (CVI), and exploratory factor analysis, 12 items were omitted, leaving 36 items in the final scale. The exploratory factor analysis revealed six factors: disease-related concerns, life instability, coping with the illness, disclosure status, responsible sexual behaviors, and the need for self-management support. The reliability according to Cronbach’s alpha was 0.713, and the external reliability, as evaluated by the test-retest method and the intraclass correlation, was 0.952..
The proposed tool, which consists of six factors and 36 items, is a reliable and valid scale for assessing the reproductive health of HIV-positive women. The findings of these measurements will be helpful when identifying and planning for improved health outcomes of this group of patients..

Childbearing is a cause of concern for women living with HIV. To improve reproductive right of wom-en with HIV and prevent the spread of HIV; it is needed to understand fertility experiences of infected women with HIV. The aim of this study was to explore fertility intentions and experiences of HIV-infected women in Iran. Totally, 15 in–depth interviews were conducted with HIV- infected women who were at reproductive age and had referred to Imam Khomeini Hospital Consultation Center for Clients with Risky Behaviors in Tehran, Iran. Data were analyzed using the conventional content analysis method in MAXQDA 10. Analysis of the meaning units of interviews showed themes in describing of fertility desires of HIV women as follows: 1) Motherhood as a way for stability of life; 2) Uncertainties about the future; and 3) Unpleasant experience of pregnancy and delivery. This theme has three sub-themes as stigma, discrimination and weakness in health care system. Health care provider and community should respect the right of infected women and inform them on sexual and reproductive health.