The Effect of Midwife-led Psycho-Education on Parental Stress, Postpartum Depression and Parental Competency in High Risk Pregnancy Women: A Randomized Controlled Trial.

Introduction: Women with high-risk pregnancy are at increased risk of depression and anxiety during pregnancy, as well as a less favorable parent-infant interaction. This study aimed to investigate the effect of midwife-led psycho-education intervention on parental stress, competency, and postpartum depression in nulliparous women hospitalized with high-risk pregnancy. Methods: This randomized controlled trial was carried out on 66 nulliparous women admitted to the high-risk pregnancy ward of Kamali Hospital, Karaj, Iran. Using convenient sampling method, the mothers were randomly assigned to control and intervention groups. In addition to routine care, the intervention group received four sessions of midwife-led psycho-education intervention in two group sessions in pregnancy and two individual sessions immediately after delivery. The parental stress, parental competency, and postpartum depression questionnaires were used for data collection before, after, and one month after the intervention. Data were analyzed using SPSS software ver. 13.0. Repeated-measures ANOVA test was used for comparing the mean scores of parenting stress, parental competency, and depression between and within both study groups before, after, and one month after delivery. Results: While postpartum depression and parental stress decreased in intervention group, parental competency increased. Conclusion: Our findings indicated that midwife-led psycho-education was effective on parental stress, competency, and postpartum depression in high-risk pregnancy mothers. Accordingly, prenatal distress in high-risk pregnancies should be assessed routinely.

The predictor role of Internet addiction in high- risk behaviors and general health status among Alborz students: A structural equation model.

BACKGROUND: Internet addiction has become more prevalent in Adolescents. Some adolescents who tend to use Internet excessively have a poorer health status, and engage in more risky behaviors than others. Therefore, the aim of this study was to investigate the predictor role of Internet addiction in high- risk behaviors and the general health status among adolescences. METHODS: This was a descriptive-analytical study of structural equation modeling, conducted on 300 students of Alborz University of Medical Sciences. The multi-stage sampling method was used to identify the number of students aged 19-21 years studying in each faculty in the first stage and convenience sampling was used in the second stage. Data were collected using Iranian Adolescents Risk-taking Scale (IARS), the General Health Questionnaire (GHQ-28) and the Young's Internet Addiction Test (YIAT). The data were analyzed using LISREL version 8.8. RESULTS: The results of the measurement model using LISREL software showed a goodness of fit for the conceptual model. Internet addiction had a significant direct positive effect on the adolescents' high-risk behaviors (ß = 0.17). Also, Internet addiction had a significant positive effect on the adolescents' general health status (ß = 0.33) and general health problems increased by 0.33 per unit of Internet use. The result of structural model revealed no significant effects of general health on high-risk behaviors. Based on the value of the variance determined, Internet addiction could predict 11% of general health. Also, general health and Internet addiction together could predict 2.7% of high- risk behaviors. CONCLUSION: Given the effect of Internet addiction on the general health and high-risk behavior, it is recommended that adolescents will be screened about internet addiction and the necessary training is given to the adolescents on the appropriate use of Internet. All necessary information should be given to the parents regarding Internet risks and dangers.

Necessity for redesigning premarital counseling classes based on marriage readiness from the perspective of adolescents and specialists: a need assessment based on the Bourich model and quadrant analysis.

BACKGROUND AND AIM: The marriage readiness is a new concept that helps adolescents learn how to choose the right choices and have a better marital life. The present study aims to assess needs of the training priorities of marriage readiness using Bourich model and quadrant analysis. METHODS: The present study was a descriptive study. The research sample consisted of 400 students who participated in this study by random and convenience sampling from the three selected universities in the province of Alborz and 28 specialist and counselors in the sphere of marriage. The questionnaire of marriage readiness with 68 items has been provided in three areas including individual, interpersonal and contextual skills. RESULTS: The average age of student was 21.05 years. In the individual field, 20 training needs had priority scores more than 4 and the highest priority for youth in this area was "Lack of sexual inappropriate behaviors and habits and lack of disabling diseases." In the area of interpersonal skills, the highest priority is related to "participation in pre-marital training, the ability to regulate the cost of living and the parenting ability ". In the field of contextual skills, 10 issues of training scored the priority scores of more than 4, and the highest priority was given to "having a vehicle, having sufficient income and financial independence." CONCLUSIONS: Based on the quadrant analysis model, the views of students and marriage counselors are not aligned and experts do not have the right viewpoints about the youth needs.

Effect of education based on protection motivation theory on adolescents' reproductive health self-care: a randomized controlled trial.

BACKGROUND: Adolescents should be empowered to improve their reproductive and sexual health needs. The present study aimed to investigate effects of protection motivation theory-based education on student girls' reproductive and sexual health self-care. METHODS: This randomized controlled trial was conducted in parallel on 90 female students living in dormitories of the Alborz University of Medical Sciences in Iran. The data collection lasted from January 2017 to May 2018. Convenience sampling was performed, and samples were put into intervention and control groups by block randomization. The intervention group received six educational sessions based on the protection motivation theory(PMT). The data collection tool of this research consisted of the protection motivation theory and reproductive health self-care questionnaires. RESULTS: There was no significant difference between control and intervention groups in demographic characteristics. The results of the repeated measures test indicated that the reproductive health self-care variable had a significant change (p = 0.000), and there was a significant difference between groups (p = 0.000). The total score of the Protection Motivation Theory Questionnaire was not changed over time (p = 0.54) and there was no significant difference between groups (p = 0.51) according to results of the repeated measures test. CONCLUSION: According to effects of an educational intervention based on the protection motivation theory, it is suggested to utilize this model as an educational framework for adolescents' reproductive and sexual health by healthcare providers, schools and universities as well as holding periodic courses educating adolescents within short-term intervals in order to achieve the higher sustainability of the educational results.

Effect of Group Counseling on Parents' Self-Efficacy, Knowledge, Attitude, and Communication Practice in Preventing Sexual Abuse of Children Aged 2-6 Years: A Randomized Controlled Clinical Trial.

BACKGROUND: The present study aimed to examine the effectiveness of group counseling on parents' self-efficacy, knowledge, attitude, and communication practice in preventing sexual abuse of children aged 2-6 years. METHODS: A randomized controlled clinical trial was carried out on 62 parents in Karaj (Iran) during the period of March-November 2016. Three kindergartens were randomly selected using the cluster sampling technique. Block randomization was used to assign the participants into two groups (N=31 in each group), namely the intervention group and the control group. Data collection included demographic characteristics, a "Parental Knowledge, Attitude, and Practice" questionnaire on the prevention of child sexual abuse, and the Farrell and Walsh self-efficacy pretest-posttest. The participants in the intervention group attended a counseling program of a 90-minute session per week, for 3 consecutive weeks. The participants were evaluated before, immediately after, and one month after the intervention. All statistical analyses were performed using the SPSS software (version 19.0). Data were analyzed using the Chi-square, independent t-test, Mann-Whitney, and Friedman tests. P<0.05 was considered statistically significant. RESULTS: There was no significant difference between the intervention and control groups in terms of the mean knowledge (P=0.50), attitude (P=0.48), practice (P=0.93), and self-efficacy (P=0.43) before the intervention. However, a significant difference was observed between the groups immediately after (P<0.001) and one month after (P<0.001) the intervention. CONCLUSION: Counseling is an effective tool in increasing the self-efficacy of parents on child sexual abuse. The awareness of child sexual abuse and its prevention should be raised in the society through effective training programs. Trial Registration Number: IRCT2017051227557N4.

The effect of a health literacy approach to counselling on the lifestyle of women with gestational diabetes: A clinical trial.

Background: Gestational diabetes is a common pregnancy disorder that affects the mother's and neonate's health. The present study was conducted to investigate the effect of a health literacy approach to counselling on the lifestyle of women with gestational diabetes. The present randomized controlled clinical trial was conducted in 2017 using a parallel design. The subjects included 84 eligible women presenting to Alborz and Kamali Hospitals, Karaj, Iran. Methods: Convenience sampling was first used to select the subjects. They were then assigned to an intervention or control group based on randomized blocks of four. Both groups attended counselling sessions. The mothers in the intervention group attended six sessions of counselling with a health literacy approach in addition to counselling on routine pregnancy care. The control group attended counselling sessions on safe pregnancy care and received a training package containing all the subjects discussed in the intervention group. The Lifestyle Questionnaire and the Iranian Health Literacy Questionnaire were completed by the mothers at the beginning and at the end of the sessions as well as three weeks after the sessions. The data obtained were analyzed in SPSS-19. Results: According to the study findings, the scores of lifestyle (P=0.8) and health literacy (P=0.423) showed no significant differences between the intervention and control groups before the intervention. Significant differences were, however, observed in the mean scores of lifestyle and health literacy between the two groups immediately and three weeks after the intervention. Comparing the means showed a higher increase in the mean scores in the intervention group (P<0.001). Conclusions: Providing counselling services by midwives can significantly help modify mothers' unhealthy lifestyle choices and increase their health literacy; therefore, reducing maternal and neonatal consequences, especially in high-risk pregnancies. Trial registration number: IRCT2017021427728N3 Trial registry: Iranian Registry of Clinical Trials Trial registration date: 5th April 2017.

The evaluation of a virtual education system based on the DeLone and McLean model: A path analysis.

Background: The Internet has dramatically influenced the introduction of virtual education. Virtual education is a term that involves online education and e-learning. This study was conducted to evaluate a virtual education system based on the DeLone and McLean model. Methods: This descriptive analytical study was conducted using the census method on all the students of the Nursing and Midwifery Department of Alborz University of Medical Sciences who had taken at least one online course in 2016-2017. Data were collected using a researcher-made questionnaire based on the DeLone and McLean model in six domains and then analyzed in SPSS-16 and LISREL-8.8 using the path analysis. Results: The goodness of fit indices (GFI) of the model represent the desirability and good fit of the model, and the rational nature of the adjusted relationships between the variables based on a conceptual model (GFI = 0.98; RMSEA = 0.014).The results showed that system quality has the greatest impact on the net benefits of the system through both direct and indirect paths (ß=0.52), service quality through the indirect path (ß=0.03) and user satisfaction through the direct path (ß=0.73). Conclusions: According to the results, system quality has the greatest overall impact on the net benefits of the system, both directly and indirectly by affecting user satisfaction and the intention to use. System quality should therefore be further emphasized, to use these systems more efficiently.

Bringing X, Y, Z Generations Together to Facilitate School-Based Sexual and Reproductive Health Education.

This generic qualitative study explores the perspective of Malaysian teachers regarding the constraints of the current school-based sexual and reproductive health education in secondary schools of Klang-Valley Malaysia. For this study, in-depth interviews were conducted with twenty eight science teachers of government schools. The majority of participants named the teaching strategy and capacity of teachers, the lack of co-operation from the school and parents, limited resources in teaching and students themselves as some of the challenges. We concluded that if sexual health education is to be effective, it needs to be provided by people who have some specialized training. The teachers should be trained to teach sexual reproductive health education classes at the basic level, and in-service training for teachers already in the field should be intensified. Local adaptation to culture, language, religion, and so forth is often necessary.