Publications by authors named "Zahra Behboodi-Moghadam"

49 Publications

Impact of endometriosis on reproductive health: an integrative review.

J Obstet Gynaecol 2021 Mar 1:1-20. Epub 2021 Mar 1.

Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Endometriosis is a debilitating chronic disease that affects 10% of the general female population, with a frequency of 38% in infertile women. This review aims to provide an overview of the impact of endometriosis on different aspects of reproductive health. A literature search was performed in four international databases, including PubMed, Science Direct, Scopus, and Google scholar, from January 1995 to December 2019 to identify the potentially relevant articles. We included all relevant articles published in English and identified 46 studies on health issues in women with endometriosis. The research suggests that women with endometriosis are at risk for physical, psychosocial, social, and sexual disturbances and obstetrical complications. More research is needed to clarify better understanding of endometriosis complications specifically obstetrical consequences.
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http://dx.doi.org/10.1080/01443615.2020.1862772DOI Listing
March 2021

A population-based study of health-promoting behaviors and their predictors in Iranian males, 2019.

Arch Public Health 2021 Feb 25;79(1):23. Epub 2021 Feb 25.

Midwifery Department, Social determinants of Health Research Center, Tabriz University of Medical Sciences, P.O. Box: 51745-347, Shariati Street, Tabriz, 513897977, Iran.

Background: Health-promoting lifestyle (HPL) is any measure taken to maintain a person's health. The most important and influential factor in maintaining and enhancing health are health-promoting behaviors (HPB). This study aimed to determine HPB and their predictors among Iranian men.

Methods: In this cross-sectional study, 783 Iranian men, living in Tehran, were selected, using multistage cluster sampling. The employed questionnaires, namely the sociodemographic questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), and the second part of the Personal Resource Questionnaire (PRQ 85-Part 2), were completed through interviews. The relationship between the dependent variables (HPLP-II and its subdomains) and independent variables (sociodemographic characteristics and social support) was investigated using the adjusted General Linear Model (GLM).

Results: The mean ± standard deviation of the total HPLP-II score was 2.72 ± 0.44 in the range of 1-4. Among the six dimensions of the HPB, the participants achieved the highest score (3.00 ± 0.52) and lowest score (1.96 ± 0.56) in spiritual growth and physical activity, respectively. The Pearson test showed that the perceived social support was significantly correlated with HPLP-II (r = 0.23; p < 0.001) and all of its subdomains (r = 0.09-0.24; p < 0.001). Based on the adjusted general linear model, social support, age, job, and income adequacy were the predictors of HPL in men and could explain 30.9% of the variance of the HPL score.

Conclusions: The research findings confirmed the importance of social support and modifying variables (social and personal) in the incidence of HPB in men.
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http://dx.doi.org/10.1186/s13690-021-00543-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905917PMC
February 2021

Perceptions and experiences of women with premature ovarian insufficiency about sexual health and reproductive health.

BMC Womens Health 2021 Feb 8;21(1):54. Epub 2021 Feb 8.

Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.

Background: Premature ovarian insufficiency (POI) is a condition with impaired ovarian function that occurred in women before the age of 40. Considering that women with POI are in reproductive age and their fertility and sexual life are afflicted by this disorder directly, the present study aimed to investigate perception and experience of women with POI of sexual and reproductive health (SRH).

Methods: This is a qualitative that was implemented based on the conventional content analysis approach. The data were collected using semi-structured in-depth interviews with 16 women having POI, based on purposeful sampling and continued until data saturation. The participants were women with POI that referred to the three infertility center in Tehran, Iran. The audio recorded data were transcribed verbatim and then analyzed using conventional content analysis based on the method proposed by Zhang and Wildmouth.

Results: After content analysis of the interviews with a focus on the perception and experience of women with POI of SRH, four main categories emerged i.e. endangerment of women's health, psychological agitation, disruption of social life and disturbance in sexual life.

Conclusion: POI affects different aspects of women SRH (women physical, psychological, social and sexual heath). Therefore, knowledge of patients' concerns by health professionals is helpful to improve service delivery and increasing the effectiveness of treatment interventions by a comprehensive health care attitude.
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http://dx.doi.org/10.1186/s12905-021-01197-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869211PMC
February 2021

Exploring the impact of endometriosis on women's lives: A qualitative study in Iran.

Nurs Open 2020 Dec 22. Epub 2020 Dec 22.

Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Aim: Considering the wide impact of endometriosis on various aspects of health, this study aimed to explore the impact of endometriosis on Iranian women's lives.

Design: The present study used a qualitative approach and conventional content analysis.

Methods: Twenty patients suffering from endometriosis referring to Imam Khomeini Hospital in Tehran took part in this study. The sampling was done purposefully until data saturation. After deep semi-structured interviews, the content analysis of the interviews was done according to the steps proposed by Zhang and Wildemuth.

Results: The mean age of the participants was 34.53 (SD: 5.81) years (range: 23-43) with duration of illness of 6.30 ± 5.86 years. Their educational level varied from high school to university, and most of them were employed. Analysis of the data from participants' experiences led to the formation of 5 categories under the titles "Physical suffering, instability of marital life, mental disorder, disruption in social life and self-care" and 11 subcategories.

Conclusion: The findings of the present study showed that endometriosis can adversely affect women's lives including physical, sexual, psychological and social problems. Although in some cases patients adopt different strategies for self-care, the need for more support is felt.
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http://dx.doi.org/10.1002/nop2.744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046092PMC
December 2020

Effect of a Health-Education Program Based on the BASNEF Model of Overall Sexual Health Satisfaction and Satisfaction with Quality of Sexual Relationship among Women with Infertility.

Int J Womens Health 2020 4;12:975-982. Epub 2020 Nov 4.

Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.

Introduction: Female infertility is increasing in Iran, encompassing all dimensions of women's lives. One of the most important effects of infertility is on sexual function. All women have the right to sexual health. Using educational models, one can see a positive effect on women's sexual function. The present study aimed to investigate the effect of an education program based on the beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model on promoting overall sexual health satisfaction and satisfaction with the quality of sexual relationships among women with infertility.

Methods: This was a quasiexperimental study conducted on 80 infertile women referred to an infertility center affiliated with Tehran University of Medical Sciences, in Tehran, Iran in 2016-2017. Infertile women with primary infertility were divided into experimental and control groups based on odd and even days. The intervention was carried out based on the BASNEF model over four sessions. Data were collected using a demographic questionnaire, the BASNEF questionnaire, and items on overall sexual health satisfaction and satisfaction with their sexual relationship. The questionnaires were completed before and 4 and 8 weeks after the intervention in the two groups. Friedman, χ, and -tests were used for data analysis.

Results: After the educational intervention, BASNEF values and overall sexual function and satisfaction with the quality of sexual relationships had significantly improved in the experimental group (<0.05), while changes were not significant in the control group.

Conclusion: The results showed that the BASNEF model-based educational invention improved overall sexual health and satisfaction among intertitle women. Indeed, it seems that using theory-based educational interventions in infertility centers might be helpful.
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http://dx.doi.org/10.2147/IJWH.S248734DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7651995PMC
November 2020

Marriage, a way to achieve relaxing evolution: A grounded theory investigation.

J Educ Health Promot 2020 31;9:211. Epub 2020 Aug 31.

Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Background: Marital satisfaction is a complex of feelings, which includes pleasure, satisfaction, and pleasure experienced by the husband or wife in all aspects of marriage, and it is an important part of individual health, especially mental health. This qualitative study was conducted to understand marital satisfaction using grounded theory on couples.

Materials And Methods: This qualitative study was implemented using grounded theory based on Corbin and Strauss, 2008, to investigate the process of marital satisfaction formation among couples from 2014 to 2016. The sampling was started as purposeful and continued as theoretical. The data were obtained using semi-structured interviews. 28 interviews were taken from 25 participants; MAXQDA software was used to facilitate the organization of classes and subclasses.

Results: The central variable of this study was called "toward a relaxing evolution." On that account, the main classes included "supportive companionship" and "responsible love," and variables of "personality traits," "interactive relationships," "economic status," "passage of time," and "present resources in society" provided the basis for the formation of marital satisfaction.

Conclusion: To achieve marital satisfaction, couples should set their family's ultimate goal toward achieving a relaxing evolution for the entire family, and they should accompany each other in order to achieve that goal. This sometimes requires sacrifice and forgiveness to achieve the ultimate goal of the family.
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http://dx.doi.org/10.4103/jehp.jehp_386_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530402PMC
August 2020

Asymptomatic coronavirus infection among pregnant women: a necessity for universal screening of COVID-19 in pregnant women admitted to labor.

J Matern Fetal Neonatal Med 2020 Oct 7:1-2. Epub 2020 Oct 7.

Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1080/14767058.2020.1832073DOI Listing
October 2020

Anticipating COVID-19-related stigma in survivors and health-care workers: Lessons from previous infectious diseases outbreaks - An integrative literature review.

Psychiatry Clin Neurosci 2020 11 25;74(11):617-618. Epub 2020 Sep 25.

Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1111/pcn.13140DOI Listing
November 2020

Concerns of Infertile Women Candidates for Egg Donation: A Qualitative Study.

J Family Reprod Health 2020 Mar;14(1):21-31

Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Women with premature ovarian insufficiency, menopause, gonadal dysgenesis, and genetic disorders as well as those with a history of recurrent in vitro fertilization failure may benefit from the assisted fertility techniques. These women experience concerns that directly affect their married life especially in egg donation treatment. This study was conducted to investigate the reproductive health concerns of infertile women who were candidates for egg donation. This qualitative content analysis was conducted in 17 infertile women who were referred to Imam Khomeini Hospital Infertility Clinic from July 2018 to March 2019. The participants were selected through purposeful sampling. Data were collected through individual in-depth semi-structured interviews. A conventional qualitative content analysis approach was adopted for data analysis using the MAXQDA12 software. The results of data analysis showed five themes, including threatened married life, lack of supportive situation, religious beliefs, psychosocial damage, and damaged feminine identity. Infertility is usually accompanied by a great psychological sadness referred to as "stress of infertility". Assisted reproductive techniques (ART) are also a source of stress for patients; therefore, it has a significant impact on the marital relationship and mental health of infertile women. Hence, there is a need for psychological support from the treatment team to reduce woman reproductive health concerns.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428411PMC
March 2020

Evaluation of effectiveness of a sexuality education program for parents of male adolescents: promoting of parent-adolescent sexual communication.

Int J Adolesc Med Health 2020 Aug 25. Epub 2020 Aug 25.

Department of Education of Karaj, Department of Education of Alborz Province, Alborz, Iran.

Objectives Parents play a significant role in promoting of healthy sexuality in adolescents. The purpose of the present study was to assess the effectiveness of a sexuality education intervention program to enhance parent-adolescent sexual communication. Methods This study was a randomized controlled field trial. Parents of male adolescent aged 13-16 years were recruited from eight public all-boys high schools in Karaj, Iran. A multi-stage stratified random sampling method was used and 102 parents were assigned into intervention and control groups. The recruitment and data collection process lasted from February to November 2019. Self-report demographic questionnaire and six general parenting and parent-adolescent sexual communication measures were used to assess the impact of intervention. Sexuality education program was presented for the parents of intervention group, in the form of four weekly 2-h sessions. Parents were assessed at the baseline, within one week post-intervention, and three-month follow-up to evaluate the outcome variables. The data were analyzed using the Chi-square test, two-sample t-test, general linear model analyses, and Bonferroni test. Results In terms of parent-adolescent general communication, parental monitoring, parent-adolescent communication about sex-related topics, parent's sexual communication skills, parent's self-efficacy, and responsiveness to sexual communication. There were no significant differences between intervention and control groups at the baseline (p>0.05). Compared to controls, intervention parents reported more improvement in general communication across the time; however, significant differences were not observed regarding general communication and parental monitoring (p=0.94, p=0.95). Parents in the intervention group significantly differed from those in the control group for the mean scores of parent-adolescent communication about sex-related topics (p=0.04), parent's sexual communication skills (p=0.04), parent's self-efficacy (p=0.002), and responsiveness (p<0.001) to sexual communication at each follow-up. Conclusions We identified the educational program as a promising tool for improving parent-adolescent communication regarding sexuality-related issues. This program provides the evidence for implementation of parent-based sexuality education programs.
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http://dx.doi.org/10.1515/ijamh-2020-0079DOI Listing
August 2020

Designing and psychometric of reproductive health related behaviors assessment tool in Iranian males: an exploratory mixed method study protocol.

Reprod Health 2020 Aug 3;17(1):118. Epub 2020 Aug 3.

Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Background: Male reproductive health is a relatively new concept, and most men are neglected in reproductive health discussions. Therefore, it appears that there is insufficient information about the male reproductive health. This study aims to design a psychometric instrument for assessing the male reproductive health-related behavior.

Methods/design: This is a sequential exploratory mixed-method study with a classical instrument development design. It will be conducted in two qualitative and quantitative phases on the studied units including the men living in Tehran. In the first phase, a qualitative study of a contractual content analysis approach will be conducted in order to perceive the concept of male reproductive health-related behavior, determine the dimensions of the questionnaire, and explore the items. In the second phase, a quantitative study will be carried out to evaluate the psychometric properties as well as (form, content, and construct) validity and reliability of the instrument designed in the first phase. Finally, the instrument will be scored and interpreted.

Discussion: Discovering men's perception of concept of reproductive health-related behavior can help design a valid and reliable questionnaire which can be used in studies evaluating the male reproductive health-related behavior.

Ethical Code: IR.TUMS.FNM.REC.1397.157.
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http://dx.doi.org/10.1186/s12978-020-00966-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398262PMC
August 2020

Endometriosis reproductive health questionnaire (ERHQ): A self-administered questionnaire to measure the reproductive health in women with endometriosis.

J Gynecol Obstet Hum Reprod 2021 Mar 8;50(3):101860. Epub 2020 Jul 8.

School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: Endometriosis is a disabling disease impacting on different aspects of reproductive health. The present study aims to develop and evaluate the psychometric properties of a questionnaire to measure the reproductive health in women with endometriosis.

Material And Methods: This study used an exploratory mixed-methods design and included three phases. In the first phase, a sample of 20 women with endometriosis participated in semi-structured interviews. In the second phase, item pools were generated. In the third phase, face validity, content validity, and construct validity were assessed. To estimate the reliability of the tool internal consistency and test-retest methods were used.

Results: sixty items were included in the psychometric evaluation stage of the scale. After the assessment of the content validity ratio (CVR), content validity index (CVI), and exploratory factor analysis, 15 items were omitted, leaving 35 items in the final scale. The exploratory factor analysis revealed four factors: physical problems, psychological problems, counteracting strategies, and instability of marital life. The reliability, according to Cronbach's alpha was 0.809, and the external reliability, as evaluated by the test-retest method and the intraclass correlation, was 0.825.

Conclusion: ERHQ is a new, valid, and reliable patient-generated instrument to measure the reproductive health in women with endometriosis. It can be used by researchers and health providers to provide a better understanding of the impact of endometriosis on different aspects of reproductive health over time and to meet the needs of patients living with this condition.
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http://dx.doi.org/10.1016/j.jogoh.2020.101860DOI Listing
March 2021

Analysis of Maternal Coronavirus Infections and Neonates Born to Mothers with 2019-nCoV; a Systematic Review.

Arch Acad Emerg Med 2020 15;8(1):e49. Epub 2020 Apr 15.

Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: The emergence and fast spread of 2019 novel coronavirus (2019-nCoV) threatens the world as a new public health crisis. This study aimed to clarify the impact of novel coronavirus disease (COVID-19) on pregnant patients and maternal and neonatal outcomes.

Methods: A comprehensive literature search was conducted in databases including PubMed, Scopus, Embase, ProQuest, and Science Direct. All studies including original data; case reports, case series, descriptive and observational studies, and randomized controlled trials were searched from December 2019 until 19 March 2020.

Results: The search identified 1472 results and 939 abstracts were screened. 928 articles were excluded because studies did not include pregnant women. Full texts of eleven relevant studies were reviewed and finally nine studies were included in this study. The characteristics of 89 pregnant women and their neonates were studied. Results revealed that low-grade fever and cough were the principal symptoms in all patients. The main reported laboratory findings were lymphopenia, elevated C-Reactive Protein (CRP), Amino alanine transferase (ALT), and Aspartate amino transferase (AST). In all symptomatic cases, chest Computerized Tomography (CT) scans were abnormal. Fetal distress, premature rupture of membranes and preterm labor were the main prenatal complications. Two women needed intensive care unit admission and mechanical ventilation, one of whom developed multi-organ dysfunction and was on Extracorporeal Membrane Oxygenation (ECMO). No case of maternal death was reported up to the time the studies were published. 79 mothers delivered their babies by cesarean section and five women had a vaginal delivery. No fetal infection through intrauterine vertical transmission was reported.

Conclusions: Available data showed that pregnant patients in late pregnancy had clinical manifestations similar to non-pregnant adults. It appears that the risk of fetal distress, preterm delivery and prelabor rupture of membranes (PROM) rises with the onset of COVID-19 in the third trimester of pregnancy. There is also no evidence of intrauterine and transplacental transmission of COVID-19 to the fetus in the third trimester of pregnancies.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211430PMC
April 2020

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine.

ScientificWorldJournal 2020 30;2020:7484631. Epub 2020 Mar 30.

Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran 1419733171, Iran.

Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women's practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.
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http://dx.doi.org/10.1155/2020/7484631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149485PMC
November 2020

Concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents: a qualitative study.

Reprod Health 2020 Feb 14;17(1):24. Epub 2020 Feb 14.

Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran.

Background: Parents play an important role in promoting the sexual health of their adolescents. However, many parents experience several challenges. The purpose of this study was to explore the concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents.

Methods: This qualitative study was designed based on the conventional content analysis approach. Semi-structured and in-depth interviews were conducted with 16 parents of male adolescents aged 12-18 years. All interviews were audio recorded and transcribed verbatim. The data were collected through purposeful sampling and continued until data saturation. Finally, the Graneheim and Landman strategies were used to analyze data.

Results: According to the participants' comments, four main categories were extracted as follows: fear of emotional and sexual harms, quality of parent-child relationships, effect of media and cyberspace, and necessity of sexuality health education.

Conclusions: The findings highlighted the need for sexuality health education through cooperation with schools for offering appropriate education to the students, parents, and school staffs. The results showed that parents required training to enhance their knowledge and skills to improve their communication with their adolescents about sexuality issues. Therefore, it is necessary to design, implement, and evaluate culture-appropriate educational programs to address the parents' concerns regarding adolescents' sexual health.
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http://dx.doi.org/10.1186/s12978-020-0883-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023711PMC
February 2020

Reproductive health issues in female patients with beta-thalassaemia major: a narrative literature review.

J Obstet Gynaecol 2020 Oct 30;40(7):902-911. Epub 2020 Jan 30.

Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Tehran University of Medical Sciences, Tehran, Iran.

β-thalassaemia major (BTM) has a high prevalence worldwide and is associated with considerable morbidity and mortality. The aim of this review is to provide an illustrative overview of the reproductive health and pregnancy related issues in females with β-thalassaemia. A literature search was performed in four international databases (1980-2018) to identify the potentially relevant articles. Common reproductive health disorders are hypo-gonadotrophic hypogonadism, infertility, delayed or absent sexual development, diabetes, hypothyroidism, hypoparathyroidism, osteopenia, preeclampsia, gestational hypertension, polyhydramnios, oligohydramnios, thrombosis, renal failure, peripheral vascular resistance, placenta previa, pleural effusion and pulmonary hypertension. Many of those aspects are related to iron overload and to ineffective erythropoiesis. Foetal complications include neural tube defects, abnormalities in different organs, spontaneous abortion, foetal loss, preterm birth, foetal growth restriction and low birth weight. Antenatal screening and accurate genetic prenatal examinations are effective measures to early diagnosis of thalassaemia and a detailed plan for management of pregnancies in BTM is important for favourable maternal and foetal outcome.
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http://dx.doi.org/10.1080/01443615.2019.1692802DOI Listing
October 2020

Social Determinants of Health in Menopause: An Integrative Review.

Int J Womens Health 2019 9;11:637-647. Epub 2019 Dec 9.

School of Nursing & Midwifery, Tehranct University of Medical Sciences, Tehran, Iran.

Menopause is one of the most important reproductive health issues of women. Because of rising life expectancy, by the year 2030, the global population of menopausal women is expected to include 1.2 billion people. The purpose of the present study is to provide a comprehensive assessment of existing studies on the relationship between social determinants of health and menopause to attract the attention of researchers and health providers to this critical issue. In present integrative review, articles for menopause published from Jan 1990 to Jan 2019 in databases including MEDLINE, ISI Web of Knowledge, Scopus, Google Scholar, IranDoc, IranMedex, MagIran and SID in English and Persian languages were extracted. After the assessment of the inclusion and exclusion criteria, 40 articles were selected and reviewed. Some social determinants of health are related to the health of women in menopause. Cultural factors, lifestyles (nutrition, exercise, tobacco use, etc.), family support, educational level, employment, economic status, marital status, and the number of pregnancies and childbirth are among the social determinants of health that present research assessed them. The need for education, improving emotional and social support, planning for lifestyle enhancement, and improving socio-economic status is felt, which results in promoting women's health during menopause.
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http://dx.doi.org/10.2147/IJWH.S228594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910086PMC
December 2019

The effect of educational program based on theory of planned behavior on health promotion and childbearing of minor thalassemia couples.

J Educ Health Promot 2019 24;8:200. Epub 2019 Oct 24.

Nursing and Midwifery School, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: It is essential to provide key information and support to every woman regarding pregnancy and childbirth to enable all women to make a fully informed decision regarding their choice of reproduction. The study aimed to find the impact of an educational program based on the Theory of Planned Behavior (TPB) on health promotion and childbearing of minor thalassemia couples.

Subjects And Methods: This study was quasi-experimental. A total of 70 women with minor thalassemia held in Minudasht health center were classified into two groups: study and control. The study group received the educational program based on TPB, and the control group only received the routine program. The data were collected using the TPB-based questionnaire at baseline and 3 months after the intervention. They were analyzed by Chi-square, Student's t-test, Wilcoxon test, and regression analysis through SPSS version 16.

Results: The mean (standard deviation) ages of the participants in the control and study group were 30.69 (6.20) and 31.08 (6.66), respectively. There were significant differences between the two groups (study vs. control) in terms of perceived behavioral control, intention, attitude, or childbearing behavior ( < 0.001). The change in fertility behaviors had a significant increase in the study group (62.8%) compared to the control group (2.9%) ( < 0.001).

Conclusion: Based on the results, the TPB is an effective model to explain fertility intentions and behaviors in Iranian women with minor thalassemia; however, further researches are needed to generalize our findings to other people including healthy women.
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http://dx.doi.org/10.4103/jehp.jehp_109_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852303PMC
October 2019

An empowerment model of Iranian women for the management of menopause: a grounded theory study.

Int J Qual Stud Health Well-being 2019 Dec;14(1):1665958

Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences , Tehran , Iran.

: There is still no clear portrayal of women's empowerment in managing menopause. The present study was conducted to design a model for the empowerment of Iranian women in managing menopause. : This qualitative study was conducted using the grounded theory on  40-60-year-old women who were first selected through purposive sampling and then by theoretical sampling from November 2013 to July 2016. Data were collected using 33 in-depth, semi-structured, individual interviews with 30 participants. Data were analyzed using the Strauss and Corbin(2008) approach and organized in MAXQDA-10. : The analysis of the data led to the emergence of "active coping with menopause" as the core variable with four themes. The two themes "threat to feminine identity" and "latent opportunity" explained the context of the study, and "redefining the feminine identity" and "self-retrieval" explained its process. : In our social context, the phenomenon of menopause is a coin with two sides and its experience leans more on the threat to feminine identity and less on latent opportunity. The model of postmenopausal women's empowerment for managing menopause might offer health policy-makers a realistic and divergent understanding of the challenges of empowering women by explaining key concepts.
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http://dx.doi.org/10.1080/17482631.2019.1665958DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6792047PMC
December 2019

The presence of the child, the opportunity or a threat to marital satisfaction: A qualitative study.

J Educ Health Promot 2019 14;8:67. Epub 2019 Mar 14.

Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.

Background: The aim of this qualitative study was to explore if the presence of a child in the family was an opportunity or threat to the marital life.

Methods: In this common qualitative content analysis, semi-structured interviews with 20 participants were conducted. All of the interviews were recorded and then transcribed. The data were categorized, and the main themes and sub-themes were extracted.

Results: Twenty transcription were analysed. The data analysis led to the development of the first theme of "feeling evolution" with the category of "flourishing the motherhood sense," and the second theme of "strengthening the marital life" with the two categories of "the marital life stabilization" and "efforts for a common goal."

Conclusions: The presence of the child can lead to the feeling of development and stabilizing the marital life. Furthermore, the presence of the child can facilitate or hinder marital satisfaction. Given the challenges due to a lack of preparation of parents for childbirth, consultation and support by family members or the society can help with adaptation with this life period and increasing the positive effects of the presence of the child on parents' relationships and marital satisfaction.
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http://dx.doi.org/10.4103/jehp.jehp_250_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442331PMC
March 2019

Prevalence of sexual dysfunction in women with systemic lupus erythematosus and its related factors.

Reumatologia 2019 28;57(1):19-26. Epub 2019 Feb 28.

Candidate of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Iran.

Objectives: Systemic lupus erythematosus (SLE) affects all body organs. This disease has marked physiological, mental, and cognitive effects on the patient and results in sexual dysfunction, depression, and decreased self-confidence. This study was conducted to compare sexual function, depression, anxiety, stress, and the related factors in women suffering from SLE.

Material And Methods: In this cross-sectional study, 340 women (170 with SLE and 170 healthy) aged 18-49 years were investigated. Convenience sampling was used to select the participants. In this study, a demographic questionnaire, the Depression, Anxiety, and Stress Scales - 21 Items (DASS-21), and the Female Sexual Function Index (FSFI) were applied. Data were analyzed with SPSS 16 using Spearman's correlation, χ, Mann-Whitney, covariance, and multiple regression statistics; -values less than 0.05 were considered significant.

Results: The results showed a significant difference in sexual function between the SLE and healthy groups. According to covariance analysis, the difference remained significant after controlling for confounding factors (stress, depression, anxiety). Moreover, the effect of SLE on the sexual function had a significant correlation with age, life status, number and age of children, economic status, menstruation, duration of marriage, age at diagnosis, disease duration and activity, stress, anxiety, and depression. The results of multiple regression analysis showed that age, disease activity, depression, and life status had the highest correlation with sexual dysfunction in women with SLE.

Conclusions: The results of this study indicated that more attention should be paid to the sexual health of women suffering from SLE as a neglected aspect of their treatment, which requires an interdisciplinary approach to shift the care of these patients from a biomedical model to a biopsychosocial model.
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http://dx.doi.org/10.5114/reum.2019.83235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409822PMC
February 2019

Social Challenges of Mothers with Blindness in Iranian Setting.

Arch Iran Med 2018 10 1;21(10):486-487. Epub 2018 Oct 1.

Associate professor, Zahra Behboodi Moghadam, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery.

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October 2018

Polycystic ovary syndrome and its impact on Iranian women's quality of life: a population-based study.

BMC Womens Health 2018 10 11;18(1):164. Epub 2018 Oct 11.

Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.

Background: Polycystic ovary syndrome (PCOS) is a major public health concern worldwide affecting up to one in five women at reproductive age. It is associated with biochemical and hormonal disturbances as well as adverse cosmetic, reproductive, metabolic, and psychological consequences, resulting in worsened quality of life. The aim of the present study is evaluating the quality of life and determining its degrading factors among Iranian women suffering from this syndrome.

Methods: This cross-sectional study was conducted on 200 PCOS women in Hamadan, Iran. In order to measure quality of life we used the Persian version of Health-related Quality of Life Questionnaire for PCOS (PCOSQ). Descriptive statistics was used to explore the data. In addition linear regression analysis was performed to assess factors affecting health-related quality of life in this population.

Results: The mean score for quality of life domains (from the greatest to the least serious concern) were: infertility (3.43 ± 1.63), emotions (3.55 ± 1.17), menstrual problems (3.77 ± 1.36), body hair (3.80 ± 2.05) and weight (4.32 ± 1.80), respectively. The higher score represents better function. However, multivariate analysis revealed that hirsutism had the strongest impact on the patients' quality of life (p < 0.001) followed by infertility (p = 0.038) and menstrual irregularity (p = 0.003).

Conclusion: The findings showed that impairment of quality of life was associated with PCOS related conditions such as hirsutism, infertility and menstrual problems.
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http://dx.doi.org/10.1186/s12905-018-0658-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180458PMC
October 2018

Measures of health-related quality of life in PCOS women: a systematic review.

Int J Womens Health 2018 1;10:397-408. Epub 2018 Aug 1.

Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran,

Introduction: Polycystic ovary syndrome (PCOS) is associated with biochemical and hormonal disturbance and adverse cosmetic, reproductive, metabolic, and psychological consequences, resulting in reduced health-related quality of life (HRQoL). Various generic and specific questionnaires have been used for assessing different dimensions of HRQoL in PCOS women. The purpose of this systematic review was to identify those general and specific instruments and to determine the factors that affect HRQoL in PCOS women.

Materials And Methods: The research strategy involved general and specific terms in relation to PCOS women and their QoL. A review was performed on studies that were published between 1945 to 2017 and that were indexed in MEDLINE, ISI Web of Science, and Scopus. A narrative synthesis of the data was provided.

Results: In total, 52 studies (9 qualitative and 43 quantitative) were included in the review. The analysis indicated that 3 specific and 5 general instruments were used to measure the QoL in PCOS women. Of these, the 36-Item Short Form Health Survey (SF-36) and the Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ) were used most frequently. All studies assessed different aspects of QoL in PCOS women and found that PCOS had negative effects on QoL in this population.

Conclusion: The PCOSQ and the SF-36 were used most frequently for the assessment of QoL in PCOS women. Perhaps using either a specific questionnaire solely or a specific questionnaire in conjunction with a generic measure would be more appropriate when measuring QoL in PCOS women. However, both questionnaires showed that they are able to capture different aspects of QoL in PCOS women and to identify areas that can help to improve QoL in these women.
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http://dx.doi.org/10.2147/IJWH.S165794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078086PMC
August 2018

The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review.

Avicenna J Phytomed 2018 Mar-Apr;8(2):96-113

Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Mashhad University of Medical Sciences, Mashhad, Iran.

Objective: Premenstrual syndrome (PMS) is one of the most common problems among women of reproductive age. The popularity of complementary/alternative therapies has grown in recent years, and these treatments have been more commonly used by women (48.9%) than men (37.8%). The aim of this systematic review was to assess effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome.

Methods: PubMed, Scopus, Cochrane, and Google Scholar were searched along with SID, Magiran and Irandoc up to Dec 2017.Inclusion criteria consist of Iranian, published, randomized controlled trials (RCTs) using Iranian herbal medicine for treatment of reproductive age women with PMS. Eventually Eighteen RCTs met the inclusion criteria.

Results: Overall, studies have shown that , , and might alleviate symptoms of PMS.

Conclusion: This research demonstrated efficacy and safety of Iranian herbal medicines in alleviating PMS. Therefore, herbal medicine can be regarded as an alternative treatment for women suffering from PMS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885324PMC
April 2018

Perceptions of teenage women about marriage in adolescence in an Iranian setting: A qualitative study.

Electron Physician 2018 Feb 25;10(2):6292-6298. Epub 2018 Feb 25.

Ph.D. in Reproductive Health, Assistant Professor, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran.

Background And Aim: Early marriage threatens the health and human rights of millions of girls all around the world. The aim of this study was to explore the perceptions of Iranian teenage women about marriage in adolescence.

Methods: A qualitative study was conducted based on the conventional content analysis approach on 14 teenage married women (aged13-19 years) who attended all urban-rural healthcare centers (4 centers) in Ardabil, Iran between May 2016 and Jan 2017. Data were collected through in-depth semi-structured interviews. Purposeful sampling was continued until data saturation. The data were analyzed using the Graneheim and Landman strategies.

Results: The mean age at marriage was 13.2 (SD=1.25) years and the duration of marital life ranged from 45 days to 3 years. During the data analysis, three main categories were extracted that each of them consisted of three sub-categories. The main categories, included "a false sense of sexual development", "death of dreams", and "threatened independence".

Conclusion: Results of this study revealed that teenage women could not comprehend opportunities in life. These findings could help health care providers and policy makers to provide teenage women with special care and better support to prevent negative consequences of early marriage.
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http://dx.doi.org/10.19082/6292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878021PMC
February 2018

The Effect of Empowerment and Educational Programs on the Quality of Life in Iranian Women with HIV.

J Int Assoc Provid AIDS Care 2018 Jan-Dec;17:2325958218759681

6 Assistant Professor of Reproductive Health, Department of Midwifery, Tabriz branch, Islamic Azad University, Tabriz, Iran.

AIDS affects physical, mental, social, and psychological health status. One of the goals of Health for All in the 21st century is to improve the quality of life. This study is a randomized clinical trial conducted on 120 HIV-positive women. Women were administered assessment questionnaires to be completed during the structured interview. After sample collection, participants were divided randomly into 3 groups by using the table of random numbers, then, respectively, received educational intervention, empowerment program, and routine procedures offered by the center and were followed by refilling the questionnaires 12 weeks after intervention. Depending on the type of data, chi-square, analysis of variance, and paired t test were used, and SPSS version 16 was used for data analysis. The finding showed that knowledge increased after intervention in educational ( P = .02) and empowerment groups ( P = .006); also empowerment group indicated significant difference in psychological ( P = .006) and spiritual ( P = .001) domains and their total quality of life ( P = .004). According to this study, exposing HIV-positive women to empowerment education is effective in improving their quality of life.
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http://dx.doi.org/10.1177/2325958218759681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748527PMC
September 2019

Factors influencing the use of contraceptives through the lens of teenage women: a qualitative study in Iran.

BMC Public Health 2018 01 30;18(1):202. Epub 2018 Jan 30.

School of Nursing and Midwifery, Tehran University of Medical Science, Tohid Square, Eastern-Nosrat Street, Tehran, 1419733171, Iran.

Background: One out of seven teenage girls in developing countries marries before the age of 15. While the fertility rate of teenage girls is high, the rate of contraceptive use remains low; therefore, this group of teenagers needs reproductive healthcare. This study was undertaken to explore factors influencing the use of contraceptives from the perspective of teenage women living in the city of Ardabil in Iran.

Methods: This qualitative study was conducted with 14 married women aged 13-19 years who attended in urban-rural healthcare centers in Ardabil. Eligible women were recruited using purposive sampling and were invited to take part in individual in-depth semi-structured interviews. The duration of the interviews varied from 45 to 90 min with an average of 55 min. Sampling continued until data saturation was reached and no new data was collected. Each interview was tape-recorded after obtaining the participant's permission, transcribed verbatim and analyzed for identifying categories and themes using conventional content analysis.

Results: Three themes and eight subthemes were developed. The themes were as follows: "insufficient familiarity with contraceptive methods", "pressure to become pregnant" and "misconceptions".

Conclusion: Despite the high prevalence of early marriage in Iranian society, teenage women are not empowered or prepared for marriage and birth control. Sexual and reproductive healthcare services to teenage women should be improved to meet their needs.
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http://dx.doi.org/10.1186/s12889-018-5116-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791335PMC
January 2018

Helicobacter pylori infection and risk of preeclampsia: a systematic review and meta-analysis.

J Matern Fetal Neonatal Med 2019 Jan 19;32(2):324-331. Epub 2017 Sep 19.

i Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences , Babol , Iran.

Objective: Helicobacter pylori is associated with many pregnancy adverse effects such as preeclampsia (PE). We performed this systematic review and meta-analysis study to assess the possible association between H. pylori infection and PE and this is the first meta-analysis to clarify this issue.

Methods: PubMed, ISI (Web of Science), SCOPUS, and Google Scholar databases were searched (up to April 2017) to identify the relevant studies. The Meta-analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines were used to do this study. Pooled odds ratio (OR) and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model. Heterogeneity was assessed with the χ-based Q-test and I statistic.

Results: A total of eight studies including 889 participants (460 preeclamptic women and 429 controls) met the eligibility criteria. A positive association was found between H. pylori infection and PE (OR: 3.35; 95% CI: 2.21-5.10). Heterogeneity was acceptable (χ = 13.39; I = 47.7, 95% CI: 0-77). In subgroup analysis, cytotoxin-associated antigen A seropositivity was a substantial risk factor for PE when immunoblotting methods (OR: 11.12; 95% CI: 5.34-23.16; χ = 6.42; I = 53.3, 95% CI: 0-85) were used, whereas it was not potential risk factor for PE when ELISA was used as a detecting method (OR: 1.11; 95% CI: 0.6-2.06; χ = 1.83; I = 0, 95% CI: 0-90).

Conclusions: This study indicated that women with H. pylori infection, especially those infected with Cag A positive strains are more likely to have PE compared with the uninfected women.
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http://dx.doi.org/10.1080/14767058.2017.1378331DOI Listing
January 2019

The Experience of Litigation From the Perspective of Midwives in Iran.

J Forensic Nurs 2017 Jul/Sep;13(3):135-142

Author Affiliations: 1School of Nursing and Midwifery, Tehran University of Medical Sciences; 2Guilan University of Medical Sciences; and 3Department of Midwifery, Tehran Medical Sciences Branch, Islamic Azad University.

Introduction: Errors and notices to appear in court are a reality of life for many midwives and exert significant effects on both their professional and personal lives. Given the increasing population policies in place, this study was conducted to examine midwives' experiences of litigation in Iran.

Methods: A qualitative study was conducted in 2014 using an interpretive phenomenological approach. The interviews were recorded and transcribed and were then analyzed using the Diekelmann method.

Findings: Midwives who participated had professional experience ranging from 3 to 22 years at the time of the complaints. Five participants had received more than one complaint, and 10 participants were judged as guilty creating/leaving significant effects on various dimensions of their lives.

Conclusion: The present research disclosed four main themes from the interviews including feeling ruined by the complaints, being conflicted between denial and belief, having shattered hopes of release, and experiencing the slowed-down rhythm of midwifery. From these, a basic pattern of "living in despair" was extracted. Litigation is a painful experience for midwives. Anxiety regarding compensation for the patients' losses, public judgment, prolonged litigations, and undermined professional dignity create physical and psychological ramifications for these midwives. Negative feelings about litigation, compounded by the lack of legal support from the authorities, cause a sense of hopelessness regarding the future of the midwifery profession.
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http://dx.doi.org/10.1097/JFN.0000000000000164DOI Listing
October 2017