[Women's experiences about menopause and related factors]

Introduction: Women's quality of life following menopause is influenced not only by physical and psychosocial factors, but also by menopause-related concerns, their feelings and attitude and adjustment to menopause. The aim of the present study was to assess women's experiences after menopause and its related factors

Materials and Methods: This descriptive study was conducted in 2016 on 350 menopausal women referred to 12 health centers affiliated to Tabriz University of Medical Sciences. Subjects were recruited using a two-stage sampling method, and data were collected through interview using two questionnaires, including a demographic questionnaire and a valid and reliable questionnaire, the "assessment of women's experiences in after menopause". Data was analyzed using Pearson and spearman correlation coefficient, one way ANOVA and multiple linear regression statistical methods

Results: Assessment of women's experiences in after menopause revealed a total score of 34.9+/-16.9 percent [Mean+/-SD]. Scores for the domains of women's experiences in menopause were 42.8+/-19.3% for physical complications, 34.8+/-26.4% for negative attitudes, 34.1+/-27.5% negative feelings, 32.7+/-19.6% for concerns, 33.2+/-28.2% for adjustment, and 29.5+/-24.3% for psychological complications. Duration of menopause was the only predicting factor for total score of women's experiences in menopause, i.e., with addition of one year to duration of menopause, the total score decreased by 1 point

Conclusion: Duration of menopause was the only predicting factor for the total score of women's experiences. Future policies and programs for improving quality of life of women after menopause should concentrate on decreasing menopause related physical complications, negative attitudes and feelings, concerns and psychological complications

[Trans fatty acids and gestational diabetes mellitus: systematic review]

Introduction: Gestational Diabetes Mellitus [GDM] is a common metabolic disorder in pregnancy that is diagnosed for the first time in the second half pregnancy. Associations between consumption of trans fatty acids and GDM have been conflicted in many studies. The purpose of this study is to determine this relationship. Materials and Methods: This is a narrative review to assess the relationship between trans fatty acids consumption before and during pregnancy and GDM incidence. We searched Google Scholar, Cochrane, and Science Direct and Med Line for identifying relevant analytic studies [Cohort and case- control studies]. We used the key words: Trans Fatty Acids, Gestational Diabetes Mellitus, pregnancy glucose intolerance. Result: At last we identified 12 relevant studies. Studies demonstrated that high trans fatty acids and animal fat intake before and during pregnancy significantly increased blood glucose levels in late pregnancy. Conclusion: High trans fatty acids intake and animal fat consumption in daily diet before and during pregnancy disturb glucose metabolism and increase risk of GDM in the second half of pregnancy, although all of the studies recommended more widespread clinical trials to identify the exact relationship between high trans fatty acids intake and GDM

[Mimetical signs and symptoms of thyroid disorders in healthy pregnant women, a population based study]

Introduction: Although for thyroid disorders are the second most prevalent endocrine abnormalities among reproductive aged women, the signs and symptoms of thyroid disease can often be masked by the physiologic changes of pregnancy. The aim of this study was to identify physiological signs and symptoms common to both pregnancy and thyroid disorders among a community based sample of pregnant women without thyroid dysfunction

Materials and Methods: This population-based cross-sectional study was conducted on 1600 pregnant women. A comprehensive questionnaire including questions regarding the signs and symptoms of thyroid disease was completed for subjects and relevant clinical examinations were conducted. Blood samples were taken and serum thyroxine [T4], T-uptake, thyrotropin [TSH] and thyroid peroxidase antibodies [TPO-Ab] were measured

Results: Of study participants, 63.5% had normal thyroid function. The prevalence of overt hypothyroidism and hyperthyroidism were 3.8%, and 0.8%, respectively and 29.8% of patients had subclinical hypothyroidism. Of pregnant women without thyroid dysfunction, 64.8% had one or more of the signs and symptoms of thyroid disorders. Most common symptoms were fatigue [30.3%], followed by lethargy and drowsiness [20.3%]

Conclusion: Normal physiological changes of pregnancy can mimic some of the signs and symptoms of thyroid disorders. The results indicated that over half of the healthy pregnant women experienced one or more of the signs and symptoms of thyroid disorders during pregnancy. Correct interpretation of signs and symptoms of thyroid dysfunction during normal pregnancy is critical to discriminate between physiologic and pathological changes

Study on the correlation between serum androgens and sexual function in post-menopausal women

Sexual dysfunction could be influenced by menopause and related hormonal changes. The purpose of this study is to examine the correlation between serum levels of androgens and sexual function in post-menopausal women. This is a community-based, descriptive-analytical study involving 405 post-menopausal women, aged 40 to 65 years, who had reached menopause during the three years prior to the study. A multi-stage, randomized sampling was conducted. Data was collected using the Female Sexual Function Index [FSFI] questionnaire, a researcher-made questionnaire, and blood samples were obtained to assess serum levels of androgens [testosterone, DHEAS], SHBG and estradiol. Among subjects, 61% had female sexual dysfunction [FSD]. Total testosterone levels had a negative correlation with scores in the domain of desire [r=-0.108, P=0.029], DHEAS levels were positively correlated with scores in the domain of pain [r=0.113, P=0.022] and the free estradiol index [FEI] was also positively correlated with scores in the domain of pain [r=0.115, P=0.020]. Satisfaction with marital relationship had a significant positive correlation with total testosterone levels [r=0.131, P=0.008] and the free androgen index [FAI] [r=0.100, P=0.044]. Examining the correlation between FSFI scores and hormone levels, multiple regression analysis showed that serum levels of total testosterone and FAI were predicting factors, in the domains of lubrication [P=0.042] and satisfaction [P=0.021] respectively. Androgenic hormones can affect certain aspects of sexual function in post-menopausal women, subject, which, however, requires further investigation

[Comparison of pregnancy self-care, perceived social support and perceived stress of women with gestational diabetes and healthy pregnant women]

Pregnancy complicated by diabetes requires increasing health care resources for controlling sugar levels during pregnancy and reduce the severe perinatal consequences. Now a days changing lifestyle patterns have changed susceptibility to disease. This study was conducted to determine and compare some of the lifestyle factors [pregnancy self-care, perceived social support and perceived stress] of women with gestational diabetes and healthy pregnant women. A comparative- descriptive study was conducted on 100 pregnant women with definite diagnosis of gestational diabetes [diabetic group] and 100 healthy pregnant women [controls] attending teaching health centers affiliated to the Shahid Beheshti University of Medical Sciences in 2013. Data were collected through interviews using a questionnaire related to pregnancy self-care, perceived social support and perceived stress. Data were analyzed using SPSS-18 software. Demographics and obstetrics variables were similar in the diabetes and the controls groups mean pregnancy self-care score was 71.9 and 81.87, respectively [P<0.001], mean perceived social support the was 65.75 and 73.88, respectively [P<0.001], and mean score of perceived stress was 51.57 and 60.27, respectively [P<0.001]. Study results showed that pregnant women with gestational diabetes had less self-care, social support and perceived stress. This study further reveals the importance of women's self-care and perceived social support during pregnancy. The incidence of gestational diabetes can be prevented through increased awareness and education of pregnant women regarding appropriate lifestyles during pregnancy and any interventions that could improve them

inventory for assessment of female workers' health promotion behaviour based on the integrated model of planned behaviour and self-efficacy

This study aimed to develop and assess the psychometric properties of an Inventory for Iranian Female Workers' Health Promotion Assessment [IWAHPA]. In the first phase of the study a content analysis approach was applied to explore the meaning of health promoting behaviours among female workers. A 120-item questionnaire was developed, based on the integrated model of planned behaviour and self-efficacy. In the second phase the instruments' psychometric properties were assessed. Scale level content validity index was 0.93. Confirmatory factor analysis showed confirmatory factor index 0.97, goodness of fit index 0.95 and root mean square error of approximation 0.05. Concurrent validity versus the Health-Promoting Lifestyle Profile II showed r= 0.60. Cronbach alpha ranged from 0.70 to 0.93 across the subscales. Test-retest reliability revealed no significant differences. The IWAHPA is a culturally sensitive instrument, with a satisfactory level of validity and reliability, that can be used for planning female workers' health services

[Quality of midwifery care provided to women admitted for delivery in selected hospitals of Yazd]

The World Health Organization emphasizes the evaluation of health services to improve quality of care. Because the main purpose of quality measurement is to identify the weaknesses of a program, this study aims to assess the quality of midwifery care provided to women admitted for delivery in selected hospitals of Yazd medical science university. A total number of 100 women randomly selected and were included in a cross-sectional study conducted in Yazd, Iran. Data were collected in the labor and delivery wards of Shaheed Sadoughi and Afshar hospitals, between September 2010 and February 2011. A valid and reliable observation check list was used for data collection. The validity of check list was accessed by content validity and the reliability was approved by computing spearman coefficient [0. 93]. The check list included 247 items covered the 26 dimension of care across labor process. Observation was done by a midwife who was not practicing at the study sites, and was especially trained in study method. Data were analyzed using SPSS 16. The mean age of subjects was 24 / 43 +/- 5/4 years. The Number of pregnancies of was 1 to 2, in 64 percent of participants in the study. The results showed that the overall quality of midwifery care provided in different stages of labor, was not desirable. The highest scores of quality was related to midwife- mother communication and perennial repair, and the poorest score was related to vital sign control. it is essential that the authorities plan to control the services provided by staff, Installation and implementation of treatment protocols of ministry of health, informing personnel duties and holding workshops to take steps to eliminate the existing shortcomings. The protocols should be translated into action with an enhanced collaboration among midwives, obstetrics and reproductive health programmers

[Concerns of women with polycystic ovary syndrome: a qualitative study]

Polycystic ovary syndrome [PCOS] is one of the most common chronic endocrine disorders with a prevalence estimated to range between 4-25%, depending on the diagnostic criteria used. It has significant and diverse clinical consequences associated with reproductive, metabolic, psychological morbidity and some cancers. It is not clear how PCOS symptoms influences women's physical experiences and concerns. This qualitative study aimed to explain study the effects that life experiences and concerns women with polycystic ovary syndrome have. Twenty women, aged 18 to 39 years, diagnosed with PCOS were interviewed using semi-structured open interviews to reach data saturation. All the interviews were recorded and transcribed, and data were analysed using content analysis, with deductive and inductive methods. Four closely intertwined themes were disclosed: Physical consequences of PCOS, fear of the future, economic burden of disease and coming to terms with a chronic condition. The results of our study suggest that healthcare professionals working with PCOS patients should consider providing peer support groups as a means to alleviate patients concern and to promote self management activities like lifestyle modification. Ideally, support groups should be designed to meet the patients support needs and expectations, and should be evaluated regularly

[ simpler diagnostic method to assess Hirsutism in the Iranian population: based on modified Ferriman-Gallwey scoring system [Tehran lipid and glucose study]]

Hirsutism is a common endocrine disorder among reproductive women. There is no clear definition and criterion for the clinical evaluation and diagnosis of hirsutism. The aim of present study is to introduce a simpler diagnostic method on the basis of modified Ferriman-Gallwey [mF-G] system, which examines fewer body areas, but with the same sensitivity, specificity and positive predictive value [PPV]. A one thousand women, aged 18-45 years, participants of the Tehran Lipid and Glucose Study, were recruited by random systematic sampling. Data were collected by a questionnaire and clinical examination. The total mF-G score was calculated and ROC curve was drawn for subsets of areas. The new cut-off points were calculated for those subsets with optimal sensitivity, specificity, positive and negative predictive value and concordance percentage. The subset of 5 areas of the lips, chin, thighs, upper and lower abdomen [cut-off point 5], had sensitivity and specificity of 97/5% and 89/9% [R[2]= 0/92%, P<0.0001] respectively, and was the nearest subset to mF-G method. The subset of lip, abdomen and thighs [cut-off point 4] was 91/5% sensitive and 92% specific, with the highest PPV [72/2%] and concordance percentage [91/9%] with the golden standard [mF-G score >/= 8]. Using the 3 area subset of lip + lower abdomen + thighs serves as a simple and more accepted method for hirsutism assessment and can be used in wide epidemiologic studies

[Sexual health challenges of adolescents in Iran: a review article]

Becoming to an adult who is sexually healthy is one of the key developmental activities for adolescents. sexual health is included of sexual development and reproductive health and also the ability to create and maintain good interpersonal relationships, are valued for their body, Respectful engagement with both sexes in correct method and expressed a desire, love and intimacy based on personal and stable social values. In this study, using key words adolescence, sexual behavior, sexual risk behavior and sexual health and peers, related studies from 1370 to 1390 in IranMedex, Irandoc, Medlib, SID and Google scholar were investigated. Factors and challenges are associated with adolescent sexual health can be categorized into the following 4 themes [12 sub themes]: Religious beliefs and spirituality [abstinence]; lack of sexual education [false beliefs and knowledge about sexual function; adolescents' attitudes toward risky behavior and sexual relations; information sources of adolescents; skills for "say no"]; community and youth issues[gender differences; relationships with peers; monitoring and control by the family; communication challenges between teen and parents; socioeconomical factors; Centers for reproductive health services to adolescents]; adolescents sexual relationship outcomes [catching sexually transmitted diseases probability]. In some areas, including relationships between parents with children, gender differences, attitudes and sexual behavior and the influence of peers, Studies conducted in our country is well. But in areas such as spirituality and religious beliefs, self-control, prevalence of sexually transmitted diseases and AIDS, life skills in adolescents and intervention strategies to promote sexual health of adolescents there are a great gap

Achievements of the Iranian family planning programmes 1956-2006

Family planning programmes initiated in the Islamic Republic of Iran from 1966 met with limited success. Following the 1986 census family planning was considered a priority and was supported by the country's leaders. Appropriate strategies based on the principles of health promotion led to an increase in the contraceptive prevalence rate among married women from 49.0% in 1989 to 73.8% in 2006. This paper reviews the family planning programmes in the Islamic Republic of Iran and their achievements during the last 4 decades and discusses the principles of health promotion and theories of behaviour change which may explain these achievements. Successful strategies included: creation of a supportive environment, reorientation of family planning services, expanding of coverage of family planning services, training skilled personnel, providing free contraceptives as well as vasectomy and tubectomy services, involvement of volunteers and nongovernmental organizations and promotion of male participation

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

[Comparing the health status of women with wanted and unwanted pregnancy]

Unwanted pregnancy can have negative impacts on maternal health. The aim of this study was to compare the health status of women with wanted and unwanted pregnancies in Kerman, Iran. This case-control was performed on women with wanted [100 cases] and unwanted pregnancies [100 cases] whom refered to health centers in Kerman, Iran during 2010. The tool for data collection included a demographic questionnaire, short form 36 health survey [SF36] and a researcher-made pregnancy's physical health. Validity and reliability of the questionnaires were assessed initially prior to study procedure. Data was analyzed by using SPSS-16, Chi-Square, T Student and Mann-Whitney tests. Women with unwanted pregnancies had lower scores for physical and mental health, vaccination and supplement consumption, prenatal care and personal health than women with wanted pregnancies [P<0.05]. Women with unwanted pregnancies had more complications and high risk behavior compared to unwanted pregnancies [P<0.05]. This study indicated that unwanted pregnancies are accompanied with physical and mental health. Thus, special counseling and extra care measures is recommended during unwanted pregnancies. Pregnancy

[Exploring women's empowerment experiences in family planning in socio-cultural context of Isfahan city: a qualitative study]

Women's empowerment in family planning is essential key of reproductive health. In this area women should be gaining authority and power for decision-making for child bearing. Fertility decisions were influenced by power relations between the couples in family and social-cultural context. This study aimed at exploring women's empowerment experiences in family planning in socio-cultural context of Isfahan city. With a qualitative approach, data were gathered from 37 married women who eligible for contraception at childbearing age. Seven focus group discussion sessions and seven individual interviews were recorded and analyzed with using conventional content analysis. Analysis of data showed that six subcategory for two main socio- cultural factors category that contributing in women empowerment in family planning. In view of participants social factors including: The Impact of Media on Shaping the Status of Women in Decision-Making, The role of School Curriculum to Form Empowerment Infrastructures and Women Employment. Cultural factors includes: Positive Attitude to have Child, Women Responsibility for Family Planning and Men Dominant in Reproductive Decision-Making. According to the participants view, social factors such as media could play a crucial role towards strengthening women's decision-making and schools could develop the empowerment's infrastructures and women employment could improve women social status but impressive performance by them did not enough. Also cultural factors deems women to be responsible for contraception and decrease women's control over their fertility. Therefore we require profound socio-cultural changes for empowering women in family planning

[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

Educational needs assessment for men's participation in perinatal care

To assess men's educational needs to improve their involvement in perinatal care we carried out a descriptive, cross-sectional study on 400 women seeking perinatal care in Shahid Beheshti University of Medical Sciences hospitals and 400 men who were accompanying them. Participants were recruited using a quota sampling method. A questionnaire was used to collect information on demography, men's educational needs and attitude assessment. The mean attitude score was 79.13% [SD 10.5%]. More than 95% of participants agreed with perinatal care education for men and the content most required was "Signs of risks during the perinatal period" and "Mothers' nutrition". The majority of participants preferred the face-to-face couples' counselling method, at home as the best place, evening and weekends as the best time and marriage classes as the best time for initiation. Men's education is necessary to promote male involvement in perinatal care

[Domestic violence against women: review of theories, prevalence and its effective factors]

Violence against women is a human rights issue, but it is also a health issue and its physical, mental and social consequences can put women, family and society's health in danger. This article aims to review domestic violence phenomenon with a psychological and social approach and estimates its prevalence. This study is based on literature review and used of databases: Pub med, Google Scholar, Proquest, Elsevier and Spring for Lating articles and Iran Medex, Magiran databases and Scientific Information Database [SID] for Persian articles, accompanied by a library study on violence against women. The results show different levels of domestic violence in different parts of the world. But in various studies showed the prevalence is 10-60 percent and 1-37 percent in pregnancy period. In 28 provinces of Iran, as the National Study on Violence against Women shows, the prevalence is 66 percent and various researches have shown that it is high in some cities of Iran, even in the pregnancy period. The effective factors on the domestic violence are such as: personal and familial characteristics, social environment and social class, men's economical power, supporting institutions, media's role and supportive laws. In general, women cannot reach their proper statues and overcome violence unless fundamental changes in cultural, social, economical and political structures of all parts of the world are considered

[Relationship between migraine and hypertensive disorders of pregnancy]

Pregnancy induced hypertension [PIH], is a highly prevalent disorder. This study was done to define the relationship between pregnancy induced hypertension and migraine in women attending Kashan hospitals, Iran, in 2007. This was a case-control study. The subjects were recruited using a consecutive sampling method, based on documented practitioner diagnosis of PIH. Subjects were assigned to two groups of case and control. Ninety women were allocated to each group. Data collection was done through a questionnaire that included demographic details, medical and obstetrics history, and details of migraine attacks. Validity and reliability of the questionnaire were assessed using content validity and test-retest methods. The two groups were matched to eliminate confounding factors. SPSS software was used for data analysis. 180 women in two groups of 90 cases and 90 controls, with average age of 27.3 +/- 5.9 and 27.66 +/- 5.2 respectively, participated in the study. Majority were housewives with primary to middle school education, with a BMI >26, and no history of hypertension in their family or in previous pregnancies. Ten percent of subjects were affected by migraine and there were no cases of migraine with aura. Results demonstrated that history of migraine was positive in 14.4% of the case group and 5.6% of controls [Odds Ratio= 2.87]. History of migraine could be considered as a risk factor for Pregnancy Induced Hypertension

[Association between migraine and preeclampsia: a review study]

Preeclampsia is a syndrome specific to pregnancy, resulting in decreased organ perfusion due to vasoconstriction endothelium activation. Migraine is also a benign and recurrent syndrome with headache, nausea and vomiting or other neurological dysfunctions. Some studies suggest that women with migraine are more likely experience preeclampsia. This study was performed to review literature regarding possible associations between migraine and preeclampsia and to provide an analysis concerning similar mechanisms underlying both of these unknown conditions. Various sources were reviewed in order to collect data on the two conditions and underlying mechanisms involved. Although primary mechanisms of both conditions are not clearly known, abnormal platelet activity and altered vascular function have been suggested. Peripheral dysfunction in preeclampsia also occurs in cerebral vessels during migraine attacks. Patients with migraine or with altered gestational blood pressure are similarly influenced by the same drugs and interventions. Identifying the risk factors of preeclampsia and predicting them on time can prevent its occurrence. Meanwhile, the association between migraine and preeclampsia may be a key to discover the unknown etiologies of them

[Knowledge, attitude and practice of midwives about HIV/AIDS prevention in selected hospitals in Isfahan City, 2006]

HIV /AIDS infection is one of the most important causes of illness and death worldwide. Since, blood and body secretion are sources of HIV/AIDS transmission, health personnel, especially midwives are considered as high risk target groups. Knowledge and attitude of midwifery personnel about HIV/AID prevention can affect on their health behavior. This study aimed to assess knowledge, attitude and practice of midwives about HIV/AIDS prevention in the selected hospitals of Isfahan in 2006. In this descriptive analytical study, using a consensus, all of 58 midwives of selected hospitals of Isfahan including: Dr. Shareeati, Amiralmomenin, Askarieh, Eisabne-maryamand beheshti participated in the study. Our data consisted of a checklist of the practice observation and a questionnaire including 3 parts of demographic, knowledge, and attitude questions. Data were analyzed using SPSS 10 an applying ANOVA, t-test, Fisher's Exact test, Pearson and Spearmen's Correlation tests. 58 midwives aged 35.4 +/- 7.8 took part in the study. Majority had a good knowledge [96.6%], positive attitude, [93.1%], but moderate practice [70.8%] about HIV/AIDS prevention. Only 29.3% had a good practice. There was a significant difference between permanent and temporary employed midwives [P<0.05] and also a weak but significant correlation between practice score and the years of their clinical work [Pearson correlation, r= -0.3, P<0.05]. This study demonstrated a moderate practice of midwives in spite of their high knowledge and positive attitude about HIV/AIDS. It seems that further studies are needed to find effective factors on their behavior and further interventional projects to improve their health