Publications by authors named "Nasrin Abedinia"

12 Publications

  • Page 1 of 1

I am HIV-positive, but I am a human being: qualitative study on experiences of stigma in health care centres in the Islamic Republic of Iran.

East Mediterr Health J 2019 Nov 4;25(10):669-676. Epub 2019 Nov 4.

School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.

Background: People living with HIV can have many health problems and may face difficulties when seeking health care because of stigma and the inappropriate behaviour of health care staff.

Aims: This study aimed to assess the problems people living with HIV face when seeking health care in the Islamic Republic of Iran.

Methods: A qualitative study was conducted with 10 people living with HIV who were members of the positive fellowship club of the Imam Khomeini Hospital in Tehran, Islamic Republic of Iran. Participation was voluntary. Using a focus group discussion, the participants talked about the problems they faced when seeking health care in different health departments and clinics. Data were analysed using inductive content analysis.

Results: The participants faced many problems in all health departments and clinics when seeking health care. The most important problems were: 1) refusal of treatment in outpatient, medical and surgical departments; 2) inappropriate behaviour of consultants and medical staff; and 3) insufficient knowledge of medical staff about HIV and how it is transmitted.

Conclusions: Providing medical and health care staff with more information on HIV and its transmission, training them on proper treatment and management of patients with HIV, and providing free treatment packages and medical services for people living with HIV may help reduce the stigma and problems HIV patients face when seeking health care, and improve the care they receive.
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http://dx.doi.org/10.26719/emhj.19.012DOI Listing
November 2019

Investigation of the effectiveness of psychiatric interventions on the mental health of pregnant women in Kashan City - Iran: A clinical trial study.

Asian J Psychiatr 2019 Dec 1;46:79-86. Epub 2019 Oct 1.

Department of Pediatrics, Institute of Family Health, Maternal, Fetal and Neonatal Health Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Aim: Pregnancy is one of the most sensitive periods in a person's life; therefore maternal mental illness during pregnancy increases the risk for adverse developmental outcomes in children (Jha et al., 2018). The aim of this study was to determine the effectiveness of psychiatric interventions in the mental health of pregnant women in Kashan, Iran.

Methods: The purpose of this clinical trial was to evaluate an integrated model of mental health during pregnancy over the period of 2015-2018 in Kashan. Subjects consisted in 202 pregnant women (101 in the intervention group and 101 in the control group) who were referred to Kashan Health Centers in the 6th to 10th weeks of pregnancy. The General Health Questionnaire-28, Golombok Rust Inventory of Marital State, an interview on psychiatric symptoms, and a review of the history of the mental health of the mother and first-degree relatives were utilized for data collection. In the intervention group, psychiatric measures and predictive drug treatments were presented.

Results: Overall, from among 102 pregnant mothers, 39 women (37.14%) were identified as at-risk and high-risk. The highest number of mothers identified as at-risk and high-risk were in the first trimester of pregnancy and in the 6th to 10th weeks of care (64%). With the start of psychiatric interventions in the intervention group, the subscale of physical complaints and anxiety showed a significant decrease compared to the control group (P < 0.01). Mental health improvement was achieved in 95% of expectant mothers through Level I predictive measures, and only 5% of participants required the specialist level of intervention.

Conclusion: By identifying psychiatric disorders in pregnant mothers during the first level of pregnancy care services and taking suitable measures, an integrated model for mental health services in primary health care for pregnant women can help managers, policymakers, and decision-makers to improve health and reduce the costs in the health system in order to achieve the Sustainable Development Goals.
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http://dx.doi.org/10.1016/j.ajp.2019.09.036DOI Listing
December 2019

The Effect of Psycho-Social Problems on Risky Behaviors in People Living With HIV in Tehran, Iran.

J Family Reprod Health 2018 Jun;12(2):89-95

Department of Public Health, Faculty of Public Health, Flinders University, Flinders, Australia.

Over the past years, the prevalence and the progression rate of HIV infection in Iran especially through high-risk sexual relationships have regrettably been reported at very high levels. This cross-sectional study tries to analyze stigma, mental health, and coping skills on risky behaviors in HIV-positive adults in Tehran- Iran. This cross-sectional study was conducted on a sample of 450 HIV-positive adults. Participants completed a socio-demographic questionnaire, the General HealthQuestionnaire-28, the Berger HIV Stigma Scale as well as the Lazarus Ways of Coping Questionnaire (WOCQ). To analyze the data, the independent-samples t-test and Pearson Correlation were used. The findings of this study revealed that mental health, stigma, and avoidance-escape coping mechanisms were correlated with risky behaviors (p ˂ 0.05).Furthermore, the amount of stigma among female individuals compared to men was reported at higher levels and mental health status in the given group was lower than among male individuals. It seems that psychological treatment techniques could be effective in improving mental health and reducing risky behaviors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391305PMC
June 2018

Stigma and Dissatisfaction of Health Care Personnel in HIV Response in Iran: A Qualitative Study.

J Int Assoc Provid AIDS Care 2019 Jan-Dec;18:2325958219829606

5 Washington, USA.

Background And Aims: With regard to the disease pandemics of HIV/AIDS, it is clear that there is need for prevention, treatment, care, and support of HIV positive patients in the health care system. In order to achieve these goals, job satisfaction should be a priority for health care staff. This study examined the problems of health care personnel and the behavior of patients undergoing HIV/AIDS counseling at Imam Khomeini Hospital in Tehran, Iran.

Methods: Interviews were conducted individually with 5 health care personnel who participated in this study. Participants had 30 to 45 minutes each per session at the clinic, during which they were able to discuss the problems they faced in their careers. All conversations were officially recorded.

Results: The most common problems mentioned by these health care workers included the lack of safety and standardization of work conditions, the lack of appropriate equipment, limited space, high numbers of patients, low staffing levels and financial and morale problems compounded by the lack of support by hospital authorities.

Conclusion: The authorities need to allocate more funds to provide facilities and appropriate working conditions for health care staff in order to increase job satisfaction and enable staff to provide the best services and care to HIV positive patients.
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http://dx.doi.org/10.1177/2325958219829606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748510PMC
April 2020

Relationship Among HIV-Related Stigma, Mental Health and Quality of life for HIV-Positive Patients in Tehran.

AIDS Behav 2018 Dec;22(12):3773-3782

Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran.

People living with HIV/AIDS (PLHA) face several challenges in terms of the medical management of their disease. Alongside this are stigma, discrimination and psychosocial issues associated with HIV infection. In this study, the relationships associated with HIV-related stigma, mental health and quality of life for HIV-positive patients were investigated. This cross-sectional study examined a sample of 450 HIV positive patients from the Infectious Diseases and Behavioral Health Clinic of Imam Khomeini Hospital in the city of Tehran, Iran. PLWHA completed Socio-Demographic Characteristics, Berger Scale Stigma (BSS), General Health Questionnaire (GHQ-28), WHO Quality of life-BREF (WHOQOL-BREF) and Philips Social Support Appraisals (SSA). Stigma was significantly correlated with psychological variables, social support, and quality of life. A prevalence of psychiatric disorders was reported by 78.8%. Findings suggested that psychosocial interventions reduce HIV related stigma, address psychological disorders and build social support to improve quality of life for people living with HIV.
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http://dx.doi.org/10.1007/s10461-017-2023-zDOI Listing
December 2018

Increase Concentration of Transforming Growth Factor Beta (TGF-β) in Breast Milk of Mothers With Psychological Disorders.

Acta Med Iran 2017 Jul;55(7):429-436

Department of Pediatrics, Institute of Family Health, Maternal, Fetal and Neonatal Health Research Center, Valiasr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Several studies have shown an imbalance between proinflammatory and anti-inflammatory cytokines in depression and anxiety disorders. However, less attention has been paid to the role of cytokines in psychological disorder in mothers who breastfeed. This study looks at whether concentration levels of TGF-β2 are altered in anxious and depressive breastfeeding mothers. This study checked the concentration level of TGF-B2 in relation with psychological symptoms on 110 breastfeeding mothers; based on random sampling method with using of Beck Depression Inventory (BDI), General Health Questionnaire (GHQ) and Spielberger Stress Scale (STAI) in 2015 also TGF-β2 was measured in breast milk using ELISA. We used of Pearson Correlation Method, independent t-test and one-way analysis of variance (ANOVA) to analyze the data. Psychological symptoms (Anxiety and depression) showed positive correlation with TGF-Beta level in which relationships were significant (P=0.01). Psychological problems may be uniquely associated with the level of TGF-β in breast milk. More attention should be paid to the mental health of mothers during breastfeeding, and more research needs to be done in this subject to clarify the relationship between psychological variables with the level of TGF-β in breast milk.
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July 2017

Effect of Ramadan Fasting on Stress Neurohormones in Women with Polycystic Ovary Syndrome.

J Family Reprod Health 2015 Jun;9(2):51-7

Maternal, Fetal- Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Objective: To determine the effects of Ramadan fasting on serum levels of stress neurohormones in Iranian women with polycystic ovary syndrome (PCOS).

Materials And Methods: This study was a clinical trial and was performed during July 2011 (month of Ramadan) in Royan institute, Tehran. A total of 40 women who were aged 20-40 years and known cases of PCOS and had no other medical diseases were included in the study. They were divided into two groups as follows: (i) study group (n = 20) who participated in Ramadan fasting and (ii) control group (n = 20) who did not participate in fasting. For evaluating Ramadan's effect on the level of neurohormones serum level of the following variables were evaluated before and after Ramadan: cortisol, adrenaline (A), noradrenalin (NA), beta-endorphin (β-End), insulin, as well as sex hormones including follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone.

Results: In the study group after Ramadan serum cortisol and nor-adrenaline levels were significantly lower than the initial levels obtained at beginning of Ramadan (p < 0.05) as compared to control group.

Conclusion: This study indicates that Ramadan fasting decreases stress neurohormones in women with PCOS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500815PMC
June 2015

Psychiatric intervention improved pregnancy rates in infertile couples.

Malays J Med Sci 2011 Jan;18(1):16-24

Infertility Clinic, Vali-Asr Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran.

Background: Infertility has mental, social, and reproductive consequences. The aim of this study is to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.

Methods: In an experimental and intervention-control study, 638 infertile patients who were referred to a university infertility clinic were evaluated; 140 couples (280 patients) with depression (from mild to severe) in at least one of the spouses were followed. All couples provided informed consent and were randomly numbered from 1 to 140. Those with even numbers were assigned to the psychological intervention before infertility treatment, and those with odd numbers were assigned to the psychological intervention during infertility treatment. Patients in the experimental group received 6-8 sessions of psychotherapy (individually) before beginning infertility treatment and were given Fluoxetine (antidepressant) at 20-60 mg per day during the psychotherapy period. The control group did not receive any intervention. Three questionnaires, the Beck Depression Inventory (BDI), the Stress Scale (Holmes-Rahe), and a sociodemographic questionnaire, were administered to all patients before and after treatment. The clinical pregnancy rate was compared between the two groups based on sonographic detection of gestational sac 6 weeks after the last menstrual period. The data were analysed by t test, X(2) and logistic regression methods.

Results: Pregnancy occurred in 33 (47.1%) couples in the treatment group and in only 5 (7.1%) couples in the control group. There was a significant difference in pregnancy rate between the treatment and control groups (X(2)= 28.318, P < 0.001). To determine the effectiveness of psychiatric interventions on pregnancy, a logistic regression analysis was used. In this analysis, all demographic and infertility variables were entered in a stepwise manner. The results showed that in the treatment group, Pregnancy in the treatment group was 14 times higher than the control group (95% CI 4.8 to 41.7). Furthermore, cause of infertility was an effective factor of pregnancy. The adjusted odds ratio in male factor infertility was 0.115 (95% CI 0.02 to 0.55) and in both factors (male and female) infertility was 0.142 (95% CI 0.03 to 0.76) compared with the unexplained group. In this study, no other variables had any significant effect on pregnancy.

Conclusion: Based on the effectiveness of psychiatric interventions in increasing pregnancy rate, it is crucial to mandate psychiatric counselling in all fertility centres in order to diagnose and treat infertile patients with psychiatric disorders.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216204PMC
January 2011

Psychiatric disorders among infertile and fertile women.

Soc Psychiatry Psychiatr Epidemiol 2009 Jul 20;44(7):587-91. Epub 2008 Nov 20.

Psychiatric and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.

This study was performed in order to determine the prevalence and predisposing factors of psychiatric disorders among infertile and fertile women attending Vali-e-Asr Hospital. A total of 150 fertile women from Vali-e-Asr Reproduction Health Research Center and fertile women from the Gynecology Clinic of Imam Khomeini Hospital were chosen by consecutive sampling. Data included demographic information, SCL-90-R, and a semi-structured questionnaire about stress factors. Results showed that 44% of infertile and 28.7% of fertile women had a psychiatric disorder (P < 0.001). Using the SCL-90-R test, the highest mean scores in infertile women were found to be on the paranoid ideation, depression and interpersonal sensitivity scales, and lowest scores were found on the psychoticism and phobic anxiety scales. The interpersonal sensitivity, depression, phobic anxiety, paranoid ideas and psychoticism scales were significantly different between infertile and fertile women (P < 0.05). Infertile women were at higher risk of developing psychiatric disorders if they were housewives rather than working women (P = 0.001). Considering the high prevalence of psychiatric disorders among infertile women, it seems that gynecologists, psychiatrists and psychologists should be more attentive to identify and treat these disorders. The use of psychotherapy, especially supportive methods, should be considered as part of the general therapeutic framework of infertility.
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http://dx.doi.org/10.1007/s00127-008-0467-1DOI Listing
July 2009

Health-related quality of life in infertile couples receiving IVF or ICSI treatment.

BMC Health Serv Res 2008 Sep 19;8:186. Epub 2008 Sep 19.

Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Infertile couples might experience psychological distress and suffer from impaired health-related quality of life. This study aimed to examine health-related quality of life in infertile couples receiving either in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment.

Methods: This was a cross-sectional study of quality of life in infertile couples attending to Vali-e-Asr Reproductive Health Research Center or Royan Institute for either IVF or ICSI treatment in Tehran, Iran. Health-related quality of life was assessed using the Short Form Health Survey (SF-36). Patients' demographic and clinical characteristics were also recorded. Data were analyzed to compare quality of life in infertile women and men and to indicate what variables predict quality of life in infertile couples.

Results: In all 514 women and 514 men (n = 1028) were studied. There were significant differences between women and men indicating that male patients had a better health-related quality of life. Also health-related quality of life was found to be better in infertility due to male factor. Performing logistic regression analysis it was found that female gender, and lower educational level were significant predictors of poorer physical health-related quality of life. For mental health-related quality of life in addition to female gender and lower educational level, younger age also was found to be a significant predictor of poorer condition. No significant results were observed for infertility duration or causes of infertility either for physical or mental health-related quality of life.

Conclusion: The findings suggest that infertility duration or causes of infertility do not have significant effects on health-related quality of life in infertile couples. However, infertile couples, especially less educated younger women, are at risk of a sub-optimal health-related quality of life and they should be provided help and support in order to improve their health-related quality of life.
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http://dx.doi.org/10.1186/1472-6963-8-186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553790PMC
September 2008

Effects of a psychological intervention on depression in infertile couples.

Int J Gynaecol Obstet 2008 Jun 5;101(3):248-52. Epub 2008 Mar 5.

Psychiatric and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objective: To determine factors affecting depression in infertile couples and the impact of a psychological intervention before or during infertility treatment.

Methods: In a cross-sectional study with 638 infertile couples assessed for depression, 140 couples with a member who had a Beck Depression Inventory (BDI) score of 17 or higher were randomized to receive psychological treatment either before or during infertility treatment. Logistic regression was performed to eliminate confounding factors.

Results: Depression was initially found in 48% of women and 23.8% of men. The mean+/-SD Beck scores fell from 18.7+/-9.7 to 10.7+/-5.8 (P<0.001) in the group psychologically treated before they received infertility treatment.

Conclusion: The psychological intervention was found useful in alleviating depression in infertile couples before they received infertility treatment.
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http://dx.doi.org/10.1016/j.ijgo.2007.12.010DOI Listing
June 2008

A survey of relationship between anxiety, depression and duration of infertility.

BMC Womens Health 2004 Nov 6;4(1). Epub 2004 Nov 6.

Vali-e-Asr Reproductive Health Research Center,Gynecology and Obstetrics department, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Keshavarz BLVD, Tehran 14194, Iran.

BACKGROUND: A cross sectional study was designed to survey the relationship between anxiety/depression and duration/cause of infertility, in Vali-e-Asr Reproductive Health Research Center, Tehran, Iran. METHODS: After obtaining their consents, 370 female patients with different infertility causes participated in, and data gathered by Beck Depression Inventory(BDI) and Cattle questionnaires for surveying anxiety and depression due to the duration of infertility. This was studied in relation to patients' age, educational level, socio-economic status and job (patients and their husbands). RESULTS: Age range was 17-45 years and duration and cause of infertility was 1-20 years. This survey showed that 151 women (40.8%) had depression and 321 women (86.8%) had anxiety. Depression had a significant relation with cause of infertility, duration of infertility, educational level, and job of women. Anxiety had a significant relationship with duration of infertility and educational level, but not with cause of infertility, or job. Findings showed that anxiety and depression were most common after 4-6 years of infertility and especially severe depression could be found in those who had infertility for 7-9 years. CONCLUSIONS: Adequate attention to these patients psychologically and treating them properly, is of great importance for their mental health and will improve quality of their lives.
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http://dx.doi.org/10.1186/1472-6874-4-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC534113PMC
November 2004