sevil hakimi

Sexual assertiveness is defined as a psychosocial feeling about an individual’s interpretation of how to express her/her feelings in marital relationships. The present study aimed at investigating the effect of sexual assertiveness training on marital satisfaction and happiness of women referring to Tabriz health centers in 2021.

This semi-experimental study was conducted on 66 women of reproductive age, referring to the health centers in Tabriz, Iran. The participants who obtained a Hulbert sexual assertiveness score of less than 33 were randomly assigned to control and intervention groups. The data were collected using an eligibility checklist (inclusion/exclusion criteria), a demographic characteristics questionnaire, the Halbert Index of Sexual Assertiveness (HISA), the Larson Sexual Satisfaction (LSS) scale, and the Marital Happiness Scale (MHS). The educational intervention of HISA was held in three sessions lasting 60-90 minutes. Eventually, the participants completed HISA, LSS, and MHS questionnaires before and after the intervention.

The findings of the present study indicated a significant difference between the mean scores of HISA, LSS, and MHS in the post-intervention stage between the two groups (P=0.001).

Given the positive effect of sexual assertiveness training on women’s sexual satisfaction and marital happiness, it is recommended that these simple and low-cost educational interventions be considered to improve the mental and sexual status of women.

Sexual assertiveness education program improved sexual satisfaction and marital happiness. It is recommended to apply these simple and low-cost educational interventions to improve the mental and sexual status of women.

Quarantine and social distancing due to COVID 19 has led to anxiety, anger, stress, and anger in people and has had a negative impact on physical and mental health and the quality of marital relationships. Due to the lack of sufficient studies and also the fact that no study was found in the literature review that compared this approach over the phone and face-to-face, this study was conducted with the aim of comparing the effect of telephone and face-to-face counseling with the explicit approach on women's marital interactions.

This quasi-experimental study was conducted in 2022 in the health centers of Tabriz city on women aged 18 to 40 with a sexual performance score of less than 28. The participants were assigned to two groups of face-to-face counseling and telephone counseling with a ratio of 1:1 using a computerized random number table with blocks of four and six. Counseling based on explicit approach was done in the face-to-face counseling group during three meetings of 60-90 minutes, and for the telephone counseling group, there were three individual telephone counseling sessions of 60-90 minutes. Pre-test questionnaires including sexual performance, quality of sexual life and marital satisfaction were completed before and eight weeks after the end of the intervention.

The mean (standard deviation) score of the quality of sexual life after the intervention was significantly increased in both face-to-face and telephone counseling groups compared to before the intervention. Also the mean (standard deviation) of the total score of sexual performance and marital satisfaction after the intervention in the face-to-face counseling group was significantly higher than that of the telephone counseling group.

Using counseling based on ex-PLISSIT approach in both face-to-face and telephone counseling groups, are effective in sexual health. Therefore, during crises such as a pandemic, or other restrictions to hold face-to-face counseling sessions, telephone consultations are useful.

Practical Implications:

 Counseling based on ex-PLISSIT approach is effective for sexual health.

The purpose of this study was to determine the effect of debriefing intervention on post-traumatic stress disorder (PTSD) following traumatic childbirth.

This was a randomized clinical trial conducted on 70 postpartum women who experienced traumatic childbirth and referred to health centers of Tabriz, Iran. The participants were assigned into two groups of counselling and control (n=35 per group) using block randomization. The intervention group joined a counselling session with critical incident stress debriefing (CISD) approach 3-5 days after childbirth. Post-traumatic Stress Checklist (PCL-5) and Edinburgh Postnatal Depression Scale (EPDS) were completed by the subjects before the intervention session, and 4-6 weeks after childbirth. ANCOVA was used for data analysis.

The mean score of PTSD symptoms showed significant decrease in the intervention group compared to the control group (adjusted mean difference [AMD] =-5.72, 95% CI: -10.47 to -0.96, P=0.01).

It is recommended to compare the effectiveness of structured and unstructured debriefing in 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.

Preterm infants’ mothers experience higher level of anxiety and depression, and are more prone to postpartum depression compared to the mothers of term infants. This anxiety at the beginning of and during the breastfeeding process causes serious disorders. Given the fact that psychological interventions can reduce individuals’ problems, the present study aimed to investigate the effect of acceptance and commitment therapy on mental health and breastfeeding self-efficacy of the preterm infants’ mothers.

In this randomized controlled trial, 90 mothers of preterm infants admitted to the neonatal ward and neonatal intensive care unit (NICU) of two university-affiliated hospitals in Tabriz in 2021 were examined. Participants were assigned to the intervention and control groups adopting stratified block randomization method. The intervention group received group counseling on ACT in eight 60-minute sessions, and the control group received routine care. The Depression Anxiety Stress Scale-21 (DASS-21) and the Breastfeeding Self-Efficacy Scale (BSES) were completed by the participants before and immediately after the intervention. ANCOVA test with adjustment of confounding variables was used to compare two groups regarding the outcomes.

The total mean score of BSE in the intervention group was significantly higher than that in the control group (Mean difference (MD): 5.7; 95% CI: 4.6 to 6.8, P<0.001). Furthermore, the mean score of all subscales of mental health, including anxiety, stress, and depression in the intervention group was significantly lower than that in the control group (P<0.001).

The mental health and BSE of preterm infants’ mothers may have been improved using ACT. It was recommended that counselling sessions (e.g., ACT) should be offered for preterm infants’ mothers during postpartum period.

Preterm birth was a stressful event for parents and may have aroused negative emotions in mothers. Our study results showed that counseling based on acceptance and commitment therapy may have improved the mental health and breastfeeding self-efficacy of mothers with preterm infants

Preterm infants’ mothers experience higher level of anxiety and depression, and are more prone to postpartum depression compared to the mothers of term infants. This anxiety at the beginning of and during the breastfeeding process causes serious disorders. Given the fact that psychological interventions can reduce individuals’ problems, the present study aimed to investigate the effect of acceptance and commitment therapy on mental health and breastfeeding self-efficacy of the preterm infants’ mothers.

In this randomized controlled trial, 90 mothers of preterm infants admitted to the neonatal ward and neonatal intensive care unit (NICU) of two university-affiliated hospitals in Tabriz in 2021 were examined. Participants were assigned to the intervention and control groups adopting stratified block randomization method. The intervention group received group counseling on ACT in eight 60-minute sessions, and the control group received routine care. The Depression Anxiety Stress Scale-21 (DASS-21) and the Breastfeeding Self-Efficacy Scale (BSES) were completed by the participants before and immediately after the intervention. ANCOVA test with adjustment of confounding variables was used to compare two groups regarding the outcomes.

 The total mean score of BSE in the intervention group was significantly higher than that in the control group (Mean difference (MD): 5.7; 95% CI: 4.6 to 6.8, P<0.001). Furthermore, the mean score of all subscales of mental health, including anxiety, stress, and depression in the intervention group was significantly lower than that in the control group (P<0.001).

 The mental health and BSE of preterm infants’ mothers may have been improved using ACT. It was recommended that counselling sessions (e.g., ACT) should be offered for preterm infants’ mothers during postpartum period.

Preterm birth was a stressful event for parents and may have aroused negative emotions in mothers. Our study results showed that counseling based on acceptance and commitment therapy may have improved the mental health and breastfeeding self-efficacy of mothers with preterm infants

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.

Depression is highly prevalent during pregnancy and after childbirth, and many factors, including the type of delivery, can contribute to developing this condition. Considering the increased use of remifentanil in painless labor and the need for conducting more studies on the consequences of this method this study aimed to determine the mean score of postpartum depression in women giving birth by either remifentanil-induced painless delivery or elective cesarean section.

The present study was a longitudinal investigation conducted on140 women referred to private hospitals, Tabriz, Iran, between 2020 and 2021 in two groups: women with elective cesarean delivery and women with vaginal delivery with remifentanil analgesia (n=70/each). Depression during pregnancy was assessed at 35-37th weeks’ gestation, and postpartum depression was determined four weeks after childbirth using the Edinburgh Postnatal Depression Scale (EPDS). Independent t test and paired t test were used to compare depression scores.

Postpartum depression was significantly higher in women who had undergone a cesarean section than in those giving birth by remifentanil-induced painless vaginal delivery (P = 0.009).

The prevalence of postpartum depression was higher in women who underwent elective cesarean section than women who underwent painless vaginal delivery with remifentanil. Considering the steady rise in worldwide cesarean section rate and the health burden and consequences of postpartum depression on mothers and children, health legislators should take measures to reduce women’s tendency towards the cesarean section in the long run

Breastfeeding is known as a normative means of infant feeding, and human milk is considered the optimal nutrition source for infants. Although there are several tools for assessing infants’ feeding behavior, currently, only the Preterm Infant Breastfeeding Behavior Scale (PIBBS) is specifically developed to measure the feeding behavior of preterm infants. The present study aimed to evaluate the validity and feasibility of PIBBS.
The Preterm Infant Breastfeeding Behavior Scale was translated using forward/backward methods. Cohen’s kappa coefficient was used to evaluate the inter-rater reliability of the questionnaire. To this end, the feeding behaviors of 70 neonates born at 32-35 weeks of gestation were assessed on two consecutive days, once by the researcher and again in the evening shift of the same day by one of the nurses, and then, PIBBS questionnaire was completed. The internal consistency of the instrument was measured by calculating Cronbach’s alpha coefficient.
The total Cohen’s kappa of the instrument was estimated to be 0.72 on the first day of observation and 0.79 on the second day, which was considered substantial. The Cronbach’s alpha coefficient of the instrument was 0.791, which was acceptable.
The PIBBS was a valid and reliable instrument for the evaluation of preterm newborns’ feeding behavior.

Mother–child attachment is formed from early stages of pregnancy and peaks in the second trimester and continues until after childbirth. The fetal or neonatal death as a tragic event could lead to the grief experience among parents, especially mothers. The present study aimed to determine the effect of a coping program on mothers’ grief following perinatal deaths.

This trial study was performed on 56 women with the experience of perinatal death during the last 1–3 months with a score of Perinatal Grief Scale (PGS) ≥91, who were referred to the health centers of Tabriz, Iran, from September 2020 to June 2021. Participants were randomly assigned into the intervention and control groups through stratified blocking on the basis of the stillbirth and neonatal death using Random Allocation Software with a block size of 4 and 6 with a ratio of 1:1. The intervention group received a coping program individually during three sessions, once a week for 45–60 min. Data collection tools included the demographic and obstetric characteristic questionnaire and PGS. The data were analyzed using SPSS24. The groups were compared through t‑test, and ANCOVA after adjusting the effect of baseline score.

Prior to coping program, the mean standard deviation of the grief total score was 108.32 (14.31) in the intervention group and 107.92 (6.65) in the control group (P = 0.89). After coping program, the mean of the grief total score was 82.28 (16.72) in the intervention group and 101.05 (12.78) in the control group. After adjusting the effect of baseline score and stratified factors, the mean of the grief total score in the intervention group was significantly lower than that in the control group [Adjusted mean difference (AMD): −18.77, 95% confidence interval: −26.79 to − 10.75, P ≤ 0.001].

Conducting a coping program during 1–3 months after experiencing perinatal deaths is effective in reducing the mothers’ grief reactions. It is recommended to evaluate the effectiveness of the same intervention after perinatal deaths for both parents with a longer follow‑up period in further studies.

One of the important and common problems of mothers after giving birth is insufficient milk production. To increase it, due to the side effects of chemical drugs that increase milk, medicinal plants have become more popular. In recent years, with the clarification of the need for evidence-based clinical practice, quality and appropriate information is needed. The present study aims to review the results of clinical trials on the effect of milk thistle in increasing breast milk volume.

In this systematic review study, the search for the effects of milk thistle in increasing breast milk volume was conducted in Magiran, MedLib, SID, and IranMedex using the keywords milk thistle, silymarin, milky plants. The search for clinical trials was conducted in EMBASE, PubMed, Scopus, Ovid, and ProQuest using the keywords Milk thistle, Silybum marianum, Silymarin Silybin, breast milk production, herbal galactagogues, increase breast milk, and Clinical trial. The publication year was 2005-2020. The criteria for excluding articles were: Unavailability of full texts, irrelevant results, pilot studies, case reports, review studies, and animal studies. Data analysis was done qualitatively.

Initial search yielded 624 records. Of these, 4 eligible articles with a sample size of 294 were selected and reviewed. All studies showed that milk thistle plant had a positive effect on increasing milk volume. In these studies, no serious side effects from the consumption of this plant were reported.

Milk thistle plant increases milk production in new mothers. The number of studies in this field is low, especially in Iran, which has a long history in traditional medicine and use of herbal medicine. More studies are needed in this field.

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.

Women’s experience during childbirth can affect various aspects (psychological and physical), which has not yet been done accurately. The current study aimed to compare experiences of parturient women with remifentanil analgesia and elective cesarean section (C-section) and provide improver strategies for women living in Tabriz, Iran.

This is a mixed-method study with an explanatory sequential approach. The first stage is quantitative and longitudinal. Participants will be divided into two groups of elective C-sections and parturient women who receive remifentanil. They will be matched concerning social class, type of provider, and birth rank. In the first stage, data will be collected using a socio-demographic questionnaire, Edinburgh’s Depression during pregnancy questionnaire, Labor Agentry Scale, and midwifery-neonatal outcomes checklist within 24 hours after delivery. Participants will be followed up to 30 days after delivery to complete the Edinburgh Postpartum Depression questionnaire. The second stage is a qualitative study to explain the perceptions of parturient women who had either elective C-section or painless delivery (using remifentanil), including factors related to labor experiences. In the third stage, a mixed study will be performed to provide strategies for improving labor experiences.

Women’s experiences during cesarean section can have different effects on maternal and neonatal outcomes; Following the use of two methods of continuous analgesia with remifentanil and spinal anesthesia and analgesia caused by these methods in cesarean section, women’s experiences may be different; The protocol presented in this study is a clinical guide to present this important issue (experiences of women during cesarean section looking for an appropriate method of analgesia)

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

Genital self-image could express an individual’s attitudes towards her feelings-thoughts and changes in her behavior in a variety of conditions positively or negatively. This study aimed to determine the relationship between socio-demographic characteristics with the genital self-image in women referred to Health Care Centers.

This cross-sectional study was performed on 239 women between 18-40 years old in 5 health care centers of Qazvin, by convenience sampling method in 2015-2016. Data were gathered using the research-made questionnaire of genital self-image set by the researcher. Independent t-test, one-way ANOVA, and general linear model were used to analyze data. Data were analyzed using SPSS 16.

The mean score (SD) of the genital self-image in participants was 53.4 (12.1) from the total range of 0-100. Most women (83.7%) had moderate, 9.2% good and 7.1% poor genital self-image, respectively. There was a significant statistical relationship between the variables of occupation, woman and her husband's education levels, and body mass index with genital self-image (P<0.05).

Only a small number of women had a good genital self-image. Therefore, concerning the adverse and inappropriate consequences of genital self-image, it is recommended to study the other factors affecting genital self-image.

Postpartum anxiety may be associated with depression, postpartum blues, and maternal mood disorders. This systematic review investigated the effects of music therapy on postpartum anxiety and pain levels.

English databases including Cochrane, Medline, Embase, Web of Science, Scopus, and PubMed and Persian databases including Scientific Information Database (SID) and the Iranian Registry of Clinical Trials (IRCT) were searched. The data were analyzed in RevMan 5.3 and reported as forest plots. The present study was conducted on postpartum women (i.e., the participants). All randomized controlled trials comparing the effects of music (i.e., the intervention) and placebo or routine care (i.e., the control) on postpartum anxiety and pain (i.e., the outcome) were included in the study.

Out of a total of 60 retrieved articles, four eligible articles were selected and entered the meta-analysis process. According to the results, anxiety (MD = -0.68, 95% CI = -1.90 to -0.54, P < 0.001) and pain (MD = -1.85, 95% CI = -3.96 to 0.26, P < 0.001) levels of patients in the music therapy group were reduced more significantly than those in the control group.

The results showed that music therapy can significantly reduce both postpartum anxiety and pain scores. However, due to the high heterogeneity of the studies, more randomized trials using a standard tool such as the Consolidated Standards of Reporting Trials (CONSORT) statement are needed.

Kangaroo mother care (KMC), as a complement to incubator care, is one of the ten recommendations of the World Health Organization (WHO) for the care of preterm infants. The KMC stabilizes the heart rate, improves oxygen saturation, makes weight gain better, and reduces crying in the infant. In order to launch KMC unit, the barriers for implementing this type of care should be recognized.

This qualitative research was conducted using a focus group discussion and individual semi-structured interview with nurses, doctors, executive and management staff of a neonatal unit of a third level teaching hospital in Tabriz, northwest Iran. The participants were selected using purposeful sampling. Content analysis was used for analyzing data. Data were analyzed by MAXQDA 10 software.

After analyzing data, four main themes were extracted including mother-related barriers, father-related barriers, physician- related barriers, and system-related barriers.

Based on the findings of the research, it seems that in order to facilitate practicing continuous KMC, much emphasis should be placed on training the parents and health care providers. Furthermore, in some cases, reforming the payment system for physicians, providing an instruction for performing continuous KMC, and continuous assessment of hospitals annually are necessary.

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.

Internet dependency has become one of the 21st century dilemmas affecting different aspects of married life such as sexual relationships. Considering the importance of family in the Iranian society, this study aimed to determine how internet dependency is related to sexual desires and satisfaction among married clients of healthcare centers. 

This cross‑sectional study was conducted on 326 married clients referred to healthcare centers in Tabriz City, Iran, between February and August 2019. Proportionate stratified random sampling was used based on the health complexes and the healthcare centers covered by them. One of the healthcare centers covered by each complex was selected randomly. The data collection tools included a demographic characteristics checklist, the Internet Addiction Test (IAT), the Index of Sexual Satisfaction (ISS), and the Hurlbert Index of Sexual Desire (HISD). The collected data were analyzed using the Pearson correlation coefficient test and multiple linear regression model.

The mean (SD) was 37.33 (15.37) for of internet dependency, 59.20 (17.27) for sexual desire, and 104.45 (22.81) for sexual satisfaction. There was a negative correlation between internet dependency and sexual satisfaction (r = ‑0.47, p </em>< 0.001). This correlation remained significant (B = ‑0.41, df = 9, p </em>< 0.001,) even when occupation (B = 3.66, p </em>= 0.01), satisfaction with married life (B = 15.34, p </em>< 0.001), and sexual desire (B = 0.60, p </em>< 0.001) were adjusted as potential confounding factors.

Internet dependency can cause a reduction in sexual desire and sexual satisfaction. Designing educational interventions in healthcare centers is recommended to manage the use of internet and to inform clients about the effects that internet dependency may have.

Hot flash is a prevalent health problem among breast cancer survivors. Due to the prohibition of estrogen use in patients affected by breast cancer, the treatment of hot flashes is a major challenge in these patients. In this regard, the objective of this study was to compare the effect of exercise and acupressure on decreasing hot flashes in patients with breast cancer.

This randomized controlled clinical trial was carried out on 99 women with breast cancer referring to two divisions of the Oncology Clinic of Tabriz Medical Sciences University in Iran. Participants were assigned to exercise, acupressure, and control through random selection. For the members of the acupressure group, acupressure was applied to the HE7, SP6, and HE GU points by an acupuncturist for 15 minutes three days a week during an 8-week period. Regarding the exercise group, a moderate 60-minute aerobic exercise program was designed and implemented 3 days a week for 8 weeks. Finally, the control group was awarded general education on lifestyle changes in order to reduce hot flashes.

Data analysis results showed a reduction in the mean of hot flash scores in both acupressure and exercise groups in the 4th and 8th weeks compared to the control group (P<0.001). However, acupressure and exercise did not significantly reduce the hot flash scores in either group.

In general, the results revealed that exercise and acupressure are two effective methods with negligible side effects for diminishing hot flashes in women suffering from breast cancer. Considering the prevalence of hot flashes in breast cancer patients, the use of these two methods can be a good alternative to medical treatments for controlling and reducing hot flashes

Postpartum post-traumatic stress disorder (PTSD) is regarded as a life-threatening childbirth experience for mother or infant and may be accompanied with the risk of death or serious injury to the mother or her infant. Given the changes to diagnostic criteria of traumatic childbirth brought in with DSM-5 and considering the unfavorable outcomes of postpartum PTSD, this study was carried out to identify the determinants of postpartum PTSD.

This cross-sectional study was conducted in 2018 on 310 postpartum women who had experienced a traumatic childbirth, based on the DSM-5 criteria, and referred to Tabriz health centers for routine care 42-60 days after the delivery. Subjects were selected through convenience sampling. Research instruments were demographic, obstetric, and neonatal information questionnaire, Post-Traumatic Stress Checklist for DSM-5 Criteria (PCL-5), Mackey Childbirth Satisfaction Rating Scale, and Winefield and Tiggemann Social Support Questionnaire. The data were analyzed using SPSS version 25.0, and ANOVA, independent t-test, Pearson correlation coefficient test, Spearman correlation coefficient test, and multivariate linear regression were applied.

The mean score (±standard deviation) of postpartum PTSD was 42.13 (±11.72). The determinants of postpartum PTSD also included complications during pregnancy, type of delivery, concordance between desired and actual type of delivery, method of placenta removal, analgesia, sleeping and neonatal states, satisfaction with childbirth, and perceived support during and after childbirth.

Designing interventions to make childbirth more pleasant through provision of methods for a pain-free or painreduced childbirth, promotion of satisfaction with childbirth, and support during and after the childbirth seem to be essential for reducing postpartum PTSD

Breastfeeding is an important public health strategy due to its benefits in reducing the morbidity and mortality of infants and helping to control health care costs.
Breastfeeding with various macronutrients and micronutrients plays its nutritional and biological roles in optimal growth and development of the infant. Based on the importance of breastfeeding, this study aimed to determine the levels of macronutrients in mature human milk, and the affecting factors.

This case-control study was performed in Tabriz during September-February in 2018. A total of 102 women who were delivered by cesarean section or vaginal delivery were selected using convenience sampling. Breast milk samples were collected at 15 ± 1 day postpartum, and using the Lactoscan, milk macronutrients (lactose, fat, protein) and milk energy were measured.

Mean lactose, protein, lipid, and energy mature human milk’s in both groups were (7.30) g/ml, (2.78) g/ml, (3.65) g/ml, and (68.81) kcal/ml, respectively.
Factors affecting breast milk lactose and fat levels included mother's current weight, infant's birth weight, and delivery mode.

The results of this study showed that variables such as delivery mode predict the levels of macronutrients in breast milk. Due to the importance of macronutrients for infant growth and health, paying attention to these factors, especially promoting vaginal delivery, is important.

As men age, they experience changes due to reduced androgen level that is called andropause. Several factors contribute to reduced androgen levels in men. This study aimed at determining predictive factors for andropause. This study was conducted in 2015 on 264 andropausal men living in Tabriz who were selected using cluster sampling. Data was collected from April 2015 to September 2015 using demographic questionnaires and the male andropause symptoms self-assessment questionnaire. The mean age of the participants was 58.8±6.3, and the mean male andropause symptoms self-assessment questionnaire score was 53.7±9.9. In addition, linear regression analysis showed that the variables of education, employment, satisfaction with the spouse"s behavior, housing status were among the predictors of andropause symptoms. According to the results, the prevalence of andropause symptoms was moderate. Some social determinants of health such as employment, education, and marital satisfaction played a role in andropause symptoms. It seems that conducting further studies on the main causes of this problem and finding practical solutions to reduce andropause symptoms is necessary for providing health care for andropausal men.