Coping with identity threat and health literacy on the quality of life and mental health in students: Structural equation modeling.

AIM: Adolescents face many challenges when entering university. The aim of this study was determined predictor role of coping with identity threat and health literacy on the quality of life and mental health of students. METHODS: This is a descriptive-analytical study of the structural equation study. Random sampling was performed on 300 students of Alborz University of medical science who were eligible to enter the study. The link of the questionnaires was provided to the students through social networks. The questionnaires were used to study identity threat, mental health, health literacy, and quality of life. RESULTS: The results of structural equations showed that health literacy has a negative and significant effect (ß = -0.22) and identity threat strategy has a negative and significant effect on students' mental health disorder (ß = -0.53). Mental health disorders have a negative and significant effect on the quality of life in students (ß = -0.49), and health literacy has a positive and significant effect on the quality of life (ß = 0.35). Based on Sobel criterion, mental health disorder was a partial mediator for the indirect effect of coping threat strategy on quality of life. CONCLUSIONS: Considering the effect of mental health and health literacy on the quality of life and the effectiveness of coping strategies, it is recommended to evaluate the mental health and health literacy of students in universities and provide educational programs for identity coping in the early years after entering the university.

Predictor role of marital conflict on maternal competency with mediating role of perceived stress and concerns during pregnancy: A structural equation model.

AIM: Pregnancy prepares the mother for the transition to motherhood. Maternal concerns during pregnancy cause reduced time spent with the spouse and lack of social support; additional stresses such as marital conflicts could impact maternal competency. This study aimed to assess the predictive effect of marital conflicts with the mediating role of perceived stress and pregnancy concern on maternal competency. METHODS: This was a longitudinal study. It was done on 250 mothers referred to selected health centers in Alborz province. The sampling method was convenient. Marital conflicts, perceived stress, and pregnancy concerns questionnaires were completed in the third trimester of pregnancy, and the maternal competency questionnaire was completed 6 weeks after delivery. Data were analyzed by SPSS software and smart partial least squares. RESULTS: The results of structural equations showed that marital conflicts have a negative and significant effect on maternal competency (ß = -0.14), marital conflicts have a positive and significant effect on perceived stress (ß = 0.42), and marital conflicts have a positive and significant effect on pregnancy concern (ß = 0.31). Also, perceived stress negatively and significantly affected maternal competency (ß = -0.36). DISCUSSION: Results of the study showed the necessities for screening and identifying mothers with conflicts and assessing the perceived stress of mothers will improve the mental health of pregnant mothers and consequently increase maternal competency.

Prophylactic effect of rectal and sublingual misoprostol on postpartum hemorrhage in mothers with preeclampsia following cesarean section surgery; a double-blind randomized controlled trial.

Background: Postpartum hemorrhage is one of the three major causes of maternal morbidity and mortality, so delay in the diagnosis and proper management of postpartum hemorrhage is of great importance. The present study aimed to determine the prophylactic effect of misoprostol on postpartum hemorrhage in patients with preeclampsia. Methods: This was a double-blind randomized controlled clinical trial performed on 128 pregnant women with preeclampsia undergoing cesarean section in Kamali hospital in Karaj. After cesarean delivery, immediately after clamping the umbilicus, the first group was administered 400 µg of rectal misoprostol and the second group was given 400 µg of sublingual misoprostol. The third group (control) was given 30 units of oxytocin during surgery and within 12 h after surgery, respectively. Hemoglobin and hematocrit were measured 24 h later. The estimated bleeding rate by the physician, the need for additional medication to control bleeding, and the amounts of hemoglobin and hematocrit in the first 24 h were compared in the three groups. Finally, the obtained information was entered into SPSS version 21 and analyzed using statistical tests. Results: The mean hemoglobin and hematocrit levels 6 and 12 h after cesarean section were significantly lower in the oxytocin group than in the sublingual and rectal misoprostol groups (Hemoglobin level (mg/dl) for oxytocin group 10.39 ± 0.73 and 9.53 ± 1.09 vs. sublingual misoprostol 11.05 ± 0.71 and 10.39 ± 0.84 vs. rectal misoprostol 10.92 ± 0.85 and 10 ± 1.01; hematocrit level for Hemoglobin level (%) for oxytocin group 31.27 ± 2.29 and 28.64 ± 2.93 vs. sublingual misoprostol 33.09 ± 2.20 and 31.05 ± 2.37 vs. rectal misoprostol 32.54 ± 2.7 and 29.92 ± 2.86) (p < 0.005). The mean estimation of visual bleeding in the oxytocin group was higher than the other three groups, followed by the rectal and the sublingual groups, respectively. However, there was no significant difference between the three groups regarding visual bleeding. There was no significant difference in hemoglobin and hematocrit between the two groups of sublingual and rectal misoprostol before and 6 and 12 h after the surgery (P > 0.05). Conclusion: It seems that sublingual or rectal misoprostol administration along with oxytocin is associated with a reduction in postpartum cesarean section bleeding compared to oxytocin administration alone.

Predictor role of COVID-19 anxiety on maternal competency with mediating role of mother-infant attachment: A study of structural equation modeling.

Introduction: COVID-19 pandemic is one of the factors that can increase anxiety and stress levels in pregnant women. Anxiety reduces the maternal-infant attachment. Mother-infant attachment can play an important role in maternal competency. The aim of this study was to predict effect of COVID-19 anxiety during pregnancy and the postpartum period on the maternal competency with mediating role of maternal-infant attachment. Method: A prospective longitudinal study was conducted on 253 pregnant women in the third trimester of pregnancy that referred to the health centers of Iran University of Medical Sciences and met the study inclusion criteria. Demographic questionnaire and the COVID-19 anxiety scale completed during the third trimester of pregnancy and after the delivery and Müller's mother-infant attachment and maternal competency questionnaire completed at 48 h and 6 weeks after delivery by self-report method. Smart partial lease square version 3 was used to assess the validity and reliability of the model and the relationship between the variables. Results: The findings of this study demonstrated that the COVID-19 anxiety during postpartum had a significant negative effect on the maternal-infant attachment (ß = -0.183). Also, the maternal-infant attachment had a significant positive effect on the maternal competency (ß = 0.48). Moreover, the conceptual model had good validity, reliability, quality and fit. And also the two variables of anxiety and mother-infant attachment together explained 25% of maternal competency. Discussion: Mothers experience higher levels of the COVID-19 anxiety during pregnancy and postpartum; therefore, it is recommended that particular attention should be given to the psychological support of pregnant women during the COVID-19 pandemic and quarantine. Also, the COVID-19 anxiety during the postpartum period had a negative effect on the maternal-infant attachment and competency, which necessitates the need for the support of mother-infant relationship and providing the online training to promote the maternal-infant attachment patterns and maternal competency during the COVID-19 pandemic.

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.

Effectiveness of Group Counseling with a Client-Centered Approach Based on the GATHER Principles on Sexual Satisfaction in Women with Multiple Sclerosis: A Randomized Clinical Trial.

Background: Multiple sclerosis (MS) is the most prevalent progressive sensory/neurological disability in young adults, with important psychological consequences. The present study was designed to assess the effectiveness of group counseling with a client-centered approach based on the GATHER principles on sexual satisfaction in women with MS. Methods: In this clinical trial, conducted from January 2018 to May 2019, in the MS Referral Center of Tehran (Iran), 72 eligible participants were assigned to intervention and control groups (36 in each group) via simple randomization. The intervention group received group counseling based on the client-centered approach, while the control group received routine counseling. Data were collected using the Larson Sexual Satisfaction Questionnaire (LSSQ) at three different time points: before the intervention, after the final session, and one month after the intervention. The collected data were analyzed in SPSS software (version 19). In order to analyze the obtained data, independent t test, Mann-Whitney U test, paired t test, Wilcoxon test, Chi-square test, Fisher exact test, and Friedman test were used. Results: The mean score of sexual satisfaction before the intervention showed no statistically significant difference between the two groups. Based on the Friedman test in the intervention group, the trend of changes in the mean score of sexual satisfaction had a significant difference before the intervention, after the final session, and one month after the intervention (P=0.001); however, no significant difference was observed in the control group. Conclusion: Our results showed the effectiveness of group counseling with a client-centered approach based on the GATHER principles on sexual satisfaction and intimacy among women with MS. Trial Registration Number IRCT20180110038302N3.

The Relationship Between Infertility, Stress, and Quality of Life with Posttraumatic Stress Disorder in Infertile Women.

BACKGROUND: The infertility experience and its treatment are accompanied by the symptoms of posttraumatic stress disorder (PTSD). The aim of this study was determining the relationship between posttraumatic stress disorder and quality of life and the infertile women's stress. METHODS: In this descriptive-analytic study, 172 infertile women were divided in four groups. Convenience sampling was done and eligible infertile women referred to Qafqaz Infertility Center in Iran were included in the study. The data was collected between January and March 2019 through posttraumatic stress disorder checklist, The Fertility Quality of Life (FertiQoL) questionnaire, and Newton's infertility stress questionnaire. Pearson correlation, linear regression analysis, and two-way analysis of variance (ANOVA) were applied for data analysis with a significance level of 0.05. RESULTS: The results of two-way analysis of variance (ANOVA) revealed that there was no significant relationship between the type of treatment (p=0.548) and the reception of psychological intervention (p=0.450). In addition, the results of Pearson correlation showed that there was an inverse significant relationship between the total score of posttraumatic stress disorder and quality of life (r=-0.91, p<0.001) and a direct relationship between the total score of posttraumatic stress disorder and level of stress (r=0.56, p<0.001). CONCLUSION: The results of this study showed that 41.3% of the infertile women had the symptoms of posttraumatic stress disorder. Due to the relationships of posttraumatic stress disorder with the quality of life and infertility stress, providing regular designed psychological interventions is recommended for infertile individuals.

An asthmatic pregnant woman with COVID-19: A case report study.

BACKGROUND: COVID-19 represents with various clinical symptoms and infects the respiratory tract, throat, nose, and lung involvement can lead to severe lung disease and death., among asthmatic patients, infections can lead to deterioration. The severity, and prognosis of this disease are likely to be devasted in pregnant women with underlying diseases such as asthma. CASE PRESENTATION: We present an Asthmatic pregnant woman who infected with SARS-CoV-2 admitted to two hospitals in Iran. The patient's symptoms were dry coughs, dyspnea, and inability to speak, numbness, and fatigue. The initial examination indicated a body temperature of 37.9 °C, oxygen saturation (SPO2) 91%, partial pressure of oxygen (Pao2) was 25 mm Hg, respiratory rate (RR) of 20 breaths/minute (b/m), blood pressure of 100/60 mmHg, and pulse of 80 bpm (beat/minute) and fetal heart rate (FHR) = 167/min. The pregnancy terminated by Caesarean Section (C/S) due to fetal tachycardia, a healthy baby with normal range. Anthropometric characteristics were born. Our case had leukopenia and also revealed, elevated C-reactive protein and erythrocyte sedimentation rate. Our case received supportive care and antibiotic & antiviral therapy and was discharged within 8 days with a good general condition. CONCLUSIONS: The patient's condition improved after 8 days of hospitalization and the patient underwent appropriate clinical outcome in spite of underlying disease and infection with SARS-CoV-2.

The relationship among fear and anxiety of COVID-19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model.

INTRODUCTION: Coronavirus pandemic causes stress and anxiety for pregnant women worldwide. The present study was conducted for the path analysis of the relationship among fear and anxiety caused by coronavirus, pregnancy experience, and the mental health of pregnant women. METHODS: This cross-sectional study was conducted on 222 pregnant women who were referred to Kamali Hospital in Alborz province in 2020. The eligible individuals entered the study through convenience sampling, and data were collected using five questionnaires including the Fear of COVID-19 Scale, the Anxiety of COVID-19 Scale, the pregnancy experiences Scales, Depression Anxiety Stress scale, and demographic checklist. The obtained data were then analyzed using SPSS-16 and Amos software. RESULTS: According to results of the path analysis, the anxiety of COVID-19 and concerns during pregnancy were variables that were positively and significantly correlated with mental health only through one path, which was direct, and anxiety of COVID-19 had also the highest positive direct correlation among them (B = 0.32). The next variable was the happiness during pregnancy experiencing, which had a significantly negative and direct correlation with mental health disorder (B = 0.29). Moreover, fear of COVID-19 through the mediating concerns of pregnancy experiences was shown to have a significant positive relationship with mental health through an indirect path (B = 0.05). CONCLUSION: Based on the result of this study, it is necessary to pay more attention to the mental health of pregnant women during a pandemic. In addition, it is recommended to provide a virtual training group to reduce anxiety caused by coronavirus and pregnancy concerns, as well as emphasizing the feeling of enjoying happiness caused by pregnancy experience during a pandemic.

The Effect of Health Literacy Counselling on Self-Care in Women after Mastectomy: a Randomized Clinical Trial.

Introduction: Breast cancer has a high prevalence, constituting a major cause of mortality in women around the world. Health literacy has a vital role in the self-care of chronic diseases such as cancer and is an essential element in the ability of each person to engage with health promotion. The aim of this study was to determine effect of health literacy counselling on self-care in women after mastectomy. Methods: This study is a randomized, controlled, clinical trial carried out on 72 women with breast cancer after mastectomy in Fars province. The eligible women entered the study using convenience sampling and were then divided into an intervention and a control group through randomized blocks of four. Health literacy questionnaire and self-care questionnaire were distributed among the participants before, immediately after and three weeks following the intervention. Data analysis was performed in SPSS ver.13. Results: The results showed no significant differences between the two groups in terms of their health literacy and self-care scores before the intervention (P=0.299 and 0.059). A comparison of the mean values showed a greater increase in the mean score of health literacy and score of self-care immediately and three weeks after the intervention in the intervention group compared to the control group. Also, the mean score of the dimensions of self-care in chemotherapy increased over time in the intervention group. Conclusion: The findings of this study confirm the higher effectiveness of counseling with a health literacy approach on overall self-care in chemotherapy and all its dimensions.

The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial.

OBJECTIVE: The aim of the study was to assess the effect of mindfulness-based stress reduction (MBSR) on anxiety and self-efficacy in coping with childbirth. MATERIAL AND METHODS: This randomized controlled trial was conducted on 70 pregnant women in Abyek city of Qazvin province in Iran. The convenient sampling method was recruited. Samples were assigned to control and intervention groups using random blocks. In addition to routine care, individuals in the intervention group received 6 MBSR training sessions. The data gathering questionnaire in this study included mindfulness, Pregnancy-Related Anxiety Questionnaire, and self-efficacy in coping with childbirth questionnaire. RESULTS: There was no statistically significant difference between the demographic characteristics in the control and intervention groups. The results of the analysis of variance (ANOVA) with repeated measures indicated the effect of time on the change in the total score of anxiety in the intervention group (p = .001). There was a significant difference between the two groups (p = .001). Also, the results of ANOVA with repeated measures showed that time had no impact on the score of self-efficacy in delivery coping (p = 0/1) and that there was no significant difference between the two groups in this respect (p = .6). CONCLUSION: The result of this study showed that mindfulness reduces anxiety of pregnant mothers, and it is suggested that mindfulness programs be educated for healthcare providers and pregnant mothers to reduce maternal anxiety and improve pregnancy outcomes and delivery.

Effects of Group Counseling on Stress and Gender-Role Attitudes in Infertile Women: A Clinical Trial.

BACKGROUND: Infertility stress can have a devastating impact on the lives of couples and influence their physical and psychological health. The purpose of this study was to investigate the effects of group counseling on female stress and gender-role attitudes in infertile women. METHODS: The present study is a randomized clinical trial conducted on 90 infertile women referred to Rooyesh Infertility Treatment Center in the city of Karaj, Iran. The convenience sampling method was used. Samples were divided into intervention and control groups through four-block random allocations. Accordingly, the intervention group received five-session group counselling and the control group only received routine care. Newton's fertility problem inventory (FPI) and gender role questionnaire (GRQ) were used for collecting data before, after, and one month after the intervention. The significance level was set at 0.05. RESULTS: The result showed a significant relationship between gender role attitude and stress in infertile women (p=0.03) and indirect association between of them (r=0.13). And also repeated measures test indicated that length of time had affected the total scores of infertility stress (p<0.001) and gender role attitude scores (p= 0.001) and there was a significant difference between the two groups in infertility stress scores (p<0.001) and gender role attitude scores (p=0.001). CONCLUSION: Group counseling can be used in stress reduction and also improved gender role attitude of infertile women.

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 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.

Perceived Social Support and Maternal Competence in Primipara Women during Pregnancy and After Childbirth.

BACKGROUND: Developing maternal competence in first time mothers has a significant impact on neonate's growth psychosocial development and neonates growth and psychological development. Social support can be an important element for becoming a new mother. We aimed to investigate how social support and maternal competence change during pregnancy and 4 months after it and examine the relationships among social support and maternal competence. METHODS: This longitudinal study was conducted on 100 first time mothers attending health centers in Alborz city, Alborz Province, between February 2015 and January 2016. Data were collected through perceived social support questionnaire that consisted of 12 questions and Parenting Sense of Competence Scale consisting of 17 items scored based on Likert's scale. The collected data were analyzed by SPSS software, version 16. Repeated-measure test and Pearson's correlation coefficient were used. P<0.05 was considered significant. RESULTS: Maternal competence significantly reduced during the study (P=0.008), while perceived social support did not show any significant reduction (P=0.286). A direct relationship was found between social support and maternal competent six weeks after childbirth (r=0.19, P=0.049), and also social support and maternal competence sixteen weeks after childbirth (r=0.23, P=0.01). CONCLUSION: Considering the reduction of maternal competency during the study, social support by healthcare providers may be helpful for the mothers' transition to motherhood, and midwives must design specific interventions to promote the sense of maternal competence and perceived social support in first time mothers.

The effect of cognitive-behavioral counseling on anxiety in the mothers of infants in the NICU: A randomized controlled trial.

Background: Pressures and tensions in everyone's life can cause a wide range of mental disorders such as anxiety. One of these tensions is the birth of a baby who requires special care, which can cause personal and social problems for the mother if no appropriate measures are taken to help them. The present study was conducted to determine the effect of cognitive-behavioral counseling on anxiety in the mothers of infants in the Neonatal Intensive Care Unit. Methods: This randomized controlled trial recruited 90 women presenting to Kowsar Hospital in Qazvin in 2016. They were enrolled by convenience sampling and randomly assigned to control and intervention groups. Eight sessions were held for each group. Beck Anxiety Inventory was filled by mothers at the beginning of intervention, at the end of the eighth session and three weeks after the intervention. The data was analyzed by generalized estimating equations (GEE) method. Results: According to the results, maternal anxiety showed no significant differences between the two groups before intervention (p = 0.408 and p = 0.881). Based on GEE test, the mean score of anxiety was significantly different in the two groups (p = 0.026) immediately and three weeks after the intervention in that it was lower in the intervention group. Friedman test results also confirmed the reducing trend of mean score of anxiety in the three stages (p = 0.000). Conclusions: Counseling has a positive effect on reducing the anxiety of mothers of children with special needs, therefore it can be used to improve their condition.

Fertility Desire in Iranian Women with HIV: A Qualitative Study.

BACKGROUND: Childbearing is a cause of concern for women living with HIV. To improve reproductive right of women with HIV and prevent the spread of HIV; it is needed to understand fertility experiences of infected women with HIV. The aim of this study was to explore fertility intentions and experiences of HIV-infected women in Iran. METHODS: Totally, 15 in-depth interviews were conducted with HIV- infected women who were at reproductive age and had referred to Imam Khomeini Hospital Consultation Center for Clients with Risky Behaviors in Tehran, Iran. Data were analyzed using the conventional content analysis method in MAXQDA 10. RESULTS: Analysis of the meaning units of interviews showed themes in describing of fertility desires of HIV women as follows: 1) Motherhood as a way for stability of life; 2) Uncertainties about the future; and 3) Unpleasant experience of pregnancy and delivery. This theme has three sub-themes as stigma, discrimination and weakness in health care system. CONCLUSION: Health care provider and community should respect the right of infected women and inform them on sexual and reproductive health.