inventory for assessment of the health needs of Iranian female adolescents

Health needs assessment is a first step to planning adolescent health programmes but it needs to be socioculturally relevant to the target population. This study aimed to develop an instrument to assess the health needs of Iranian female adolescents and evaluate its psychometric properties. Content analysis was applied to explore the health needs of female adolescents through focus group discussions with adolescents and in-depth interviews with key informants. Five themes were identified: educational needs, and emotional, social, physical and spiritual health needs. A scale-level content validity index of 0.92 was obtained. The factor structure was identified by principal component analysis; 5 factors were extracted which accounted for 44.89% of the variance. Reliability of the instrument was demonstrated with a Cronbach alpha of 0.90 for the entire scale. Consistency was established with test-retest reliability with an interval of 2 weeks [intracluster correlation coefficient = 0.984, P< 0.001]. There was a negative correlation with the Pediatric Quality of Life Inventory [r = -0.66, P < 0.001]. The instrument is culturally sensitive with satisfactory validity and reliability and could be used for planning of adolescent health services

[Designing and psychometric properties of a questionnaire for assessing female adolescents' health needs]

Considering the social and cultural characteristics of Iranian adolescents, none of the quantitative instruments designed so far to assess their health needs is quite appropriate. The purpose of this study was to design a valid and reliable questionnaire to assess the health needs of Iranian adolescent females. Both qualitative and quantitative approaches to instrument development were adopted in this study conducted in the District of Sari in the north of Iran. Sampling was objective-based, with an attempt to have female adolescent sample as varied as possible. In the qualitative phase, a content analysis approach was used to explore the concept of health needs as seen by female adolescents. Data were collected using 8 focus group discussions [FGDs] with the presence 6-10 adolescents 12-18 years old in each FGD, as well as 11 semi-structured interviews, each one involving 11 well-informed individuals. In the quantitative phase, the psychometric properties, including content validity, face validity, construct validity, concurrent validity, internal consistency, and test-retest reliability, were determined. Five themes were identified in the qualitative phase of study, including psycho-emotional health, social health, physical health, and educational needs, as well as spiritual beliefs. The mean scale-level content validity index [S-CVI] was found to be 0.92. The factor structure of the instrument was identified by doing a Principal Component Analysis. Five factors were extracted with a total variance account of 45.37%. The reliability and consistency of the instrument were established with the Cronbach's alpha coefficient [0.90] for the entire scale and test-retest reliability with a 2 week-interval Intraclass Correlation Coefficient [ICC=0.984, p<0.001].There was a concurrent correlation between the instrument and Pediatric Quality of Life Inventory [PedsQL TM 4.0] [r=0.66, p<0.001]. The instrument developed in this study is a valid, reliable and culturally appropriate instrument for assessment of health needs of Iranian adolescent females

Role of Anxiety during pregnancy in pretem delivery

Preterm delivery has considerable social, economical and mental effects on neonate and related family. Factors predisposing to, and preventing preterm delivery are still not clearly recognized. However some studies have shown psychological factors to play some role. This study was conducted to evaluate the effect of anxiety in inducing preterm delivery. In this cohort study conducted in sari [1384-85] a consecutive series of 282 pregnant women with singleton pregnancies reffered for routine prenatal care were included. Anxiety was assessed using self-administered Spielberger's state-trait anxiety questionnaire. The 75th percentile was used for anxiety scores. Mean score of state and trait anxiety of cases was 38.5 9.9 [20-74] and 41.2 9.2 [20-77] respectively. There was a meaningful statistical relationship between state anxiety and preterm delivery [P=0.02, RR=2.71] and trait anxiety and preterm delivery [P=0.009, RR= 1.59]. Further studies incorporating multiple psychosocial domains, gaining information about women's social environment, life circumstances and possible biologic pathways through which anxiety and stress operates may reinforce our understanding of the role of stress in pregnancy

[Assessment of starch dietary regimen regarding pre-manstrual syndrome among high school students in Sari during 2007]

Pre-menstrual syndrome [PMS] is one of the abnormalities associated with pre-menstrual cycles. Approximately 85% to 97% of women are suffering from psycho-somatic of physiological and behavioral symptoms from PMS, prior to menstruation. The most common PMS symptoms include: flatulence, stress anxiety, breast tenderness, depression, fatigue, unknown irritability, anger, poor concentration, and some degree in extremities edema. There are several therapeutic methods for PMS such as: oral contraceptive pills, GnRH antagonisms, diazole, use of Calcium and vitamin supplements, and dietary modification in which there is a controversy regarding type of diet. We assessed the effect of third- hour starch dietary regimen on pre-menstrual syndrome among high school students. This randomized quasi- experimental study was performed on students in grade 2 and 3 in Private and Governmental high schools in Sari. The sample size was calculated using randomize numbers table [478 participants]. A questionnaire composed of two parts was prepared. The first part included demographic characteristics, while the second part consisted of data related to history of menstrual cycle, pervious diseases and use of drugs. The symptoms of PMS were assessed at the beginning of the study and also at the end of the first, second and third month after beginning of the third-hours starch regimen. Data was gathered by self-reporting technique, analyzed by descriptive and comprehensive statistical techniques. The age range of participants was 14 to 19 years of age [16.89 +/- 1.12]. The mean of menstrual cycle was 28.87 +/- 2.1 days, and the mean of menstrual duration was 6.32 +/- 1.8. PMS symptoms score was 12.85 +/- 8.01 prior to dietary regimen, and at the end of one, two and three months, following dietary regimen in-take were 11.03 +/- 7.59, 12.47 +/- 7.79 and 11.13 +/- 6.71 respectively. This study indicated that there were significant differences among the groups. The results of this study revealed that carbohydrate-rich diet in-take can improve PMS symptoms. Therefore, it appears that codified teaching programs via medical health service and instruction to the students, is beneficial about the effects of diet on relieving PMS symptoms, and can reduce the usage of drugs during menstrual cycle

[MR vaccination in pregnancy and its subsequent complications]

MR vaccination is prohibited among pregnant women, therefore pregnancy is recommended three months after vaccination. On the other hand, pregnant women acquiring these diseases face unwanted complications. We tried to determine the frequency of congenital disorders in the newborns of the vaccinated pregnant women under 25 years in Mazandaran province. This historical cohort study was done by consent method on 1031 cases throughout Mazandaran province. 406 cases out of the population were vaccinated without prior information about their pregnancy. The data were collected by questionnaires through referring to their healthcare files and telephone contacts just to make sure about their vaccination conditions. The data obtained from these cases along with the data from 493 pregnant women who were not vaccinated during the years 2002-2003 were statistically analyzed. Pregnancy complications were observed in 58 [6.5%] subjects; 24 [41.38%] in the control group and 34 [58.62%] in the case group. The rate of complications in the subjects under the study was as follows: premature delivery in 27 [46.57%] subjects; 8 [29.62%] in the control group and 19 [70.38%] in the case group; weight under 2500 gram at birth in 19 [32.75%] subjects; 12 [63.16%] in the control group and 7 [36.84%] in the case group; still birth in 6 [10.34%] subjects 1 [16.67%] in the control group and 5 [83.33%] in the case group; abortion in 6 subjects [10.34%]; 2 [23.33%] in the control group and 4 in [66.67%] in the case group. Only one person in the control group had intra uterine growth retardation. No significant pregnancy complication difference was observed between the case and the control groups in this study [P>0.05] Results of this study and the related researches indicate that though MR vaccination during pregnancy is safe, the randomly performed vaccination of pregnant women, should be advised and the followed up for the probable unwanted complications