Examination of the Psychometric Properties of the Persian Version of the Challenges to Stopping Smoking Scale (CSS) in Patients with Cardiovascular Disease (CVD).

Background: Smoking is one of the modifiable risk factors for cardiovascular disease (CVD) that is related to different types of chronic disorders. Many patients with CVD consider smoking cessation a difficult task due to various reasons. The goal of the present study was to translate the Challenges to Stopping Smoking Scale (CSS) into Persian and examine its psychometric properties. Materials and Methods: In this cross-sectional methodological study, a total of 341 patients with CVD [141 for exploratory factor analysis (EFA) and 200 for confirmatory factor analysis (CFA)] participated, and were selected using a convenience sampling method. Participants completed the Persian version of the CSS. Face, content, and construct validities were examined. Internal consistency was assessed using the McDonald's Omega and Cronbach's alpha coefficients, and stability was examined using the test-retest method. Results: In the EFA, two factors of Internal Challenges and External Challenges were extracted that together explained 42.619% of the total variance. Cronbach's alpha coefficients of 0.740 and 0.799 and Intraclass correlation coefficients of 0.862 and 0.869 were found for Internal and External Challenges, respectively. According to the results of CFA, the three-factor model had a good fit to the data. (RMSEA: 0.059; CFI: 0.94; GFI: 0.97; NFI: 0.90; PNFI: 0.77). Conclusion: The Persian version of the CSS has good validity and reliability, and can be used as a valid and reliable instrument in future studies.

18F-FDG PET/MRI and 18F-FDG PET/CT for the Management of Gynecological Malignancies: A Comprehensive Review of the Literature.

OBJECTIVE: Positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) or magnetic resonance imaging (18F-FDG PET/MRI) has emerged as a promising tool for managing various types of cancer. This review study was conducted to investigate the role of 18F- FDG PET/CT and FDG PET/MRI in the management of gynecological malignancies. SEARCH STRATEGY: We searched for relevant articles in the three databases PubMed/MEDLINE, Scopus, and Web of Science. SELECTION CRITERIA: All studies reporting data on the FDG PET/CT and FDG PET MRI in the management of gynecological cancer, performed anywhere in the world and published exclusively in the English language, were included in the present study. DATA COLLECTION AND ANALYSIS: We used the EndNote software (EndNote X8.1, Thomson Reuters) to list the studies and screen them on the basis of the inclusion criteria. Data, including first author, publication year, sample size, clinical application, imaging type, and main result, were extracted and tabulated in Excel. The sensitivity, specificity, and diagnostic accuracy of the modalities were extracted and summarized. MAIN RESULTS: After screening 988 records, 166 studies published between 2004 and 2022 were included, covering various methodologies. Studies were divided into the following five categories: the role of FDG PET/CT and FDG-PET/MRI in the management of: (a) endometrial cancer (n = 30); (b) ovarian cancer (n = 60); (c) cervical cancer (n = 50); (d) vulvar and vagina cancers (n = 12); and (e) gynecological cancers (n = 14). CONCLUSIONS: FDG PET/CT and FDG PET/MRI have demonstrated potential as non-invasive imaging tools for enhancing the management of gynecological malignancies. Nevertheless, certain associated challenges warrant attention.

How do new mothers describe their postpartum sexual quality of life? a qualitative study.

BACKGROUND: Sexuality plays a critical role in a woman's postpartum quality of life and also has a strong impact on the quality of her relationship. Given the sparse body of published literature on the subject, we aimed to explore how new mothers explain their postpartum sexual quality of life. METHOD: A qualitative study was carried out in Iran and Switzerland from December 2018 to March 2019. Focus groups and semi-structured in-depth interviews (IDIs) were conducted with mothers in the first four months after parturition. Mothers who were older than 18 years, were married or in a stable relationship, and experienced a low-risk vaginal birth or cesarean section participated in the study. We used Graneheim and Lundman's approach for analyzing the data. Multiple data collection methods, maximum variation sampling, and peer checks were applied to enhance the rigor of the data. RESULTS: We achieved data saturation after two focus group discussions (FGDs), 15 IDIs in Iran, and 13 IDIs in Switzerland. We extracted three themes for postpartum sexual quality of life: (a) sexual worldview, (b) interpersonal relationship, and (c) postpartum sex storm. The participants described sexual worldview as "sexual beliefs", "sexual perceptions", and "sexual behaviors". The interpersonal relationship consists of "changes in postpartum interpersonal relationships" and "supportive role of the husbands/partners". The last one, postpartum sex storm, has three categories including "direct changes in sexual life", "indirect changes in sexual life", and "resumption of sexual intercourse". Differences between the two cultures were identified in some subcategories such as "sexual interests", "comparable to the first intercourse in life", "negative sexual behaviors of husbands/partners", "positive sexual behavior of mothers", "helping with child care and housework", and "emotional support". CONCLUSION: New mothers explained postpartum sexual quality of life as a three-theme phenomenon. Although most results were similar in both cultures, there were some differences. Our study's results suggest that sexual quality of life is a topic that encompasses international as well as cultural aspects.

Dental cleaning behavior and related factors among hemodialysis patients in the West of Iran: A cross-sectional study.

OBJECTIVES: Oral health-related behaviors in hemodialysis patients are reduced, potentially leading to adverse consequences. The aim of the present study was to evaluate dental cleaning behavior (DCB) and related factors among hemodialysis patients. METHODS: This cross-sectional study was carried out in Sanandaj city, in the west of Iran in 2022. Using the census method, 115 hemodialysis patients from the dialysis center of Tohid Hospital were recruited. Data were gathered by a three-section questionnaire. The first section included demographic characteristics, the second section involved variables related to the health belief model (HBM), and the third section assessed stages of DCB change based on the trans-theoretical model. Analysis of data was done by assessing frequency, descriptive and inferential statistics such as t test, correlation coefficient, and regression. RESULTS: Only 26.1% of participants reported DCB, defined as tooth brushing at least twice daily; 30.4% were in the precontemplation stage, 26.1% in contemplation, and 17.4% in the preparation stage. Perceived self-efficacy was lower among patients who did not perform DCB. The odds of DCB increased with perceived self-efficacy (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.19-1.92, p < .05), cues to action (OR = 1.63, 95% CI = 1.03-2.55, p < .05), and decreased with perceived barriers (OR = 0.68, 95% CI = 0.47-0.97, p < .01). CONCLUSIONS: DCB of patients on hemodialysis requires improvement. Perceived self-efficacy, cues to action, and perceived barriers constructs of the HBM should be considered in interventional programs targeting to increase oral health as well as in future research in the field.

Marital satisfaction in Iranian infertile women: A systematic review and meta-analysis.

Background: Infertility is a severe crisis in life that, in addition to creating psychological problems and disrupting a parent's identity and role, negatively impacts couples' marital satisfaction. Different studies in this field have reported different results, so this systematic review and meta-analysis was conducted to estimate the marital satisfaction standard score among infertile Iranian women. Method: The databases of PubMed, Scopus, Web of Science, Embase, Scientific Information Database, and MagIran were searched without a time limit. We used the meta-analysis and a random-effects model to estimate the marital satisfaction pooled score. The heterogeneity of studies was examined with the I 2 index and Cochrane's Q test. The correlation between the pooled score with the publication year and the mean age of women was evaluated using meta-regression. We assessed the publication bias by the Egger test. Results: Seventeen studies with a sample size of 2,421 people were analyzed. The marital satisfaction pooled score of infertile women was 49% (95% CI: 39-60%). The marital satisfaction score in region 1 of the country (54, 95% CI: 42.7-65.3%) was higher than in other regions (45, 95% CI: 40-58%). Also, the marital satisfaction pooled score based on the Enrich scale (54, 95% CI: 39-69%) was higher than the score reported on other scales (45, 95% CI: 29-61%). Publication bias was not significant. Conclusion: Infertile women have moderate to low marital satisfaction, rooted in the culture and context of Iranian society. It seems necessary to provide measures to strengthen marital satisfaction, strengthen family relationships and prevent family disintegration in these women.

Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review.

BACKGROUND: Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology. AIM: To review the published literature on sexual function and mood disorders among peri- and postmenopausal women. METHODS: The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method. OUTCOMES: The main outcome measures used for the review were sexual dysfunction and mood disorders. RESULTS: We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women. CLINICAL IMPLICATIONS: In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well. STRENGTHS & LIMITATIONS: The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted. CONCLUSIONS: While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.

Accuracy of the Triple Test Versus Colposcopy for the Diagnosis of Premalignant and Malignant Cervical Lesions.

BACKGROUND: Despite the World Health Organization (WHO) recommendations concerning the use of alternative tests for the detection of cervical cancer precursor lesions in low-income countries, the accuracy of these tests is a debated issue. In the present study we compare the diagnostic accuracy of the triple test with that of colposcopy for the diagnosis of premalignant and malignant cervical lesions. METHODS: A cross-sectional study was performed in 328 women referred to the gynecology clinic at Shahid Sadoughi Hospital, affiliated to Yazd University of Medical Sciences (SSUMS), Yazd, Iran, from March 2016 to June 2018. As the first step, a Pap smear was obtained from all participants. Visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) was performed in accordance with the known protocol. A colposcopy was then conducted in all participants, biopsy samples were obtained, and histological features studied. Finally, the results were compared by statistical analysis. RESULTS: The age range of the participants was 30 - 50 years. Of 328 women, 60 (18.3 %) were postmenopausal. Two-hundred and five patients (62.5 %) had an abnormal Pap smear, 165 (50.3 %) had abnormal results on colposcopy, and 141 (43 %) had abnormal histopathology reports. The VIA was positive in 129 patients (39.3 %) and the VILI in 177 (54 %). The results of the triple test were reported to be positive in 205 cases (51.52 %). The sensitivity of the triple test in the detection of premalignant and malignant cervical lesions was 78.7 % and 69 %, respectively. The sensitivity and specificity of colposcopy in the detection of premalignant and malignant cervical lesions was 80.1 % and 72.2 %, respectively. The diagnostic accuracy of the triple test and colposcopy in the detection of premalignant and malignant cervical lesions was 73 % versus 75 %. CONCLUSION: Since the results of the study showed that the diagnostic accuracy of the triple test is equivalent that of colposcopy, the former may be used in low-income countries and areas lacking access to colposcopy.

Development and psychometric assessment of the sexual health education necessity scale: An exploratory mixed method study.

Background: Sexual health education is a controversial issue within the Iranian context. Thus, the present study was conducted to explore the necessity of sex education among young single women and develop and examine the psychometric properties of the Sexual Health Education Necessity Scale. Methods: This was an exploratory mixed method study. Young single women (51 women in the first phase and 110 women in the second phase of the study) aged 18-34 years were recruited in the study. In the first phase, qualitative methods were applied to generate items. In the second phase, psychometric properties, such as face, content, and construct validity, and reliability of the Sexual Health Education Necessity Scale were evaluated. In the first phase, an item pool was developed that included 17 statements related to sexual health education necessity. In the second phase, item reduction was applied using exploratory factor analysis and the final version of the questionnaire containing 9 items was developed. Also, content, face, and construct validity were assessed. Moreover, Cronbach's alpha coefficient and test-retest were calculated to evaluate the reliability of the questionnaire. SPSS software (version 21) was used for data analysis and p value less than 0.05 was considered as significant. Results: In the qualitative phase, 4 key themes emerged regarding sex education, which included the effects of sex education, principles of sex education, content of sex education, and organizations responsible for sex education. An item pool containing 17 statements was generated and used for psychometric evaluation. The results of the exploratory factor analysis showed a 2-factor solution for the scale, which collectively accounted for the 56.04% of the variance. Final CVR and CVI were found to be 0.96 and 0.97, respectively. The Cronbach's alpha coefficient and test-retest of the instrument was found to be 0.78 and 0.80, respectively. Conclusion: Sexual Health Education Necessity Scale can be used for exploring dominant beliefs that may be obstacles for providing sex education in conservative societies; therefore, correcting these beliefs could help to design an appropriate sexual health education program.

Prevalence of obstructive sleep apnea in patients with type 2 diabetes: A systematic review and meta-analysis.

Obstructive sleep apnea (OSA) is highly prevalent among patients with diabetes, intensifying the complications of the disease. Various studies in Iran have reported different prevalence rates. This systematic review and meta-analysis was performed to determine OSA prevalence in patients with type 2 diabetes in Iran. In this study, we evaluated five articles published in Persian and English. The articles were searched using the keywords of obstructive sleep apnea, sleep disordered breathing, sleep apnea, OSA, diabetes mellitus and Iran and all possible combinations of these terms in national databases of Scientific Information Database (SID) and Magiran and international databases of Google Scholar, Web of Science, PubMed and Scopus with no time limit. Data were analyzed using the meta-analysis and random effects model. In addition, the heterogeneity between studies was assessed using I2 statistic, and data analysis was performed in Stata version 11. In this study, five articles with a total sample size of 2360 were evaluated. According to the results, the prevalence of OSA in diabetic patients was reported to be 54.50% (95% Confidence Interval [CI]: 39.90-69.09). In addition, the results were indicative of a lower prevalence of OSA in men (63.26%; 95% CI: 43.26-83.26), compared to women (66.22%; 95% CI: 57.60-74.84). According to the results of the study, there was a high OSA prevalence in patients with type 2 diabetes. Therefore, it is crucial to recognize diabetic patients at risk of OSA to decrease the adverse effects of this condition.

Prevalence of metabolic syndrome among Iranian women with polycystic ovary syndrome: A systematic review and meta-analysis.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with an increased the risk of metabolic syndrome (MetS) and hence increased cardiovascular diseases in women. This systematic review and meta-analysis aimed at examining the prevalence of MetS in Iranian women with PCOS. This was a systematic review and meta-analysis of English and Persian studies, using the following keywords: Polycystic Ovary Syndrome, Hyperandrogenism, Metabolic Syndrome,"MetSyn", X Syndrome, and Iran in several national and international databases (Scientific Information Database (SID), Magiran, Web of Science, Google Scholar, PubMed, and Scopus from inception to February 2019. Heterogeneity among the studies was assessed using the Cochran's Q test. The random effects model was then used to estimate the overall prevalence of MetS. ALL the analyses were performed using STATA, version 12. Overall, 10 studies were included in the study. The overall prevalence of MetS among Iranian women with PCOS was 26.6% (95% CI: 16.60-31.70). In addition, the mean body mass index (BMI) was 27.47 (95% CI: 25.46-29.48) and the mean waist circumference was 87.94 (95% CI: 84.28-91.60). According the meta-regression results, there were no significant associations between the prevalence of MetS and sample size, year of publication, waist circumference, BMI, and age. One-fourth of Iranian women with PCOS have MetS. Given the overlap between anthropometric and metabolic abnormalities in PCOS and the features of MetS, accurate identification of patients with MetS is important to ensure early diagnosis and subsequent interventions to effectively manage the condition.

Factors affecting dental cleaning behaviour among pregnant women with gingivitis.

OBJECTIVE: Despite the importance of oral health during pregnancy and its consequences for mother and child, dental cleaning behaviour is ineffective among pregnant women; therefore, the prevalence of gingivitis is high in this group. The aim of this study was to determine the factors affecting dental cleaning behaviour among pregnant women with gingivitis. METHODS: This cross-sectional study was carried out in Sanandaj city, in the west of Iran in 2017. Using simple random sampling, 340 pregnant women from five health comprehensive service centres were recruited in the study. Data were gathered by a two-section questionnaire. The first section included demographic information, and the second section involved variables of trans-theoretical model, fear of dental care and social support. Analysis of data was done by SPSS software by frequency, descriptive, Student t-test, ANOVA, chi-square, correlation coefficient and regression. RESULTS: About 50% of the pregnant women were in the first stages of dental cleaning behaviour change. The mean score of gingival index (P = 0.01), perceived barriers (P < 0.001) and fear of dental care (P = 0.04) was higher in the initial stages of behaviour change (P < 0.001). Perceived self-efficacy was directly correlated with social support and perceived benefits (P < 0.01). Dental cleaning behaviour increased 1.59 times and 1.42 times when perceived self-efficacy and social support were increased one unit, respectively. CONCLUSIONS: The results showed the majority of pregnant women had a low perception of the benefits of dental cleaning behaviour, did not have adequate incentive for doing the behaviour and did not receive the required social support.

Exploring Self-Care Needs of Pregnant Women with Gingivitis: A Qualitative Study in Iran.

BACKGROUND: Oral self-care behaviors are not satisfactory among pregnant women; incidence of gingivitis is high in them and training programs have slightly improved their gingivitis. This study was aimed to explore self-care needs of pregnant women suffering from gingival inflammation. MATERIALS AND METHODS: This study was carried out in Sanandaj, west of Iran, in 2017. Twenty pregnant women with gingivitis were included in the study. Data were collected via semi-structured individual and group interviews and note-taking, and were analyzed by conventional content analysis. To confirm the accuracy and strength of the data, credibility, confirmability, and transferability components were taken into account. RESULTS: The results of data analysis yielded six major categories, including "organizational support," "dentist's professional competence," "increasing perceived threat," "increasing self-efficacy," "increasing perceived benefits," and "culture-making." Increased self-efficacy was the most important concern of pregnant women. CONCLUSIONS: The findings showed that self-care behaviors to prevent gingivitis in pregnant women are influenced by various factors. It is essential to consider the cooperation of the media and organizations, support of society, and attention of families and authorities to oral health education and disease prevention among women.

Perceived barriers to methadone maintenance treatment among Iranian opioid users.

BACKGROUND: Opioid use is a severe problem in Iran. Despite methadone maintenance treatment (MMT) programs being one of the most important treatment strategies for reducing individual and public harms associated with opioid use, a large proportion of Iranian patients refuse to participate in such treatment programs. METHODS: The present study aims to explore the beliefs and attitudes toward MMT programs of opioid-dependent patients who were participating or had participated in methadone therapy. In-depth interviews were conducted with 23 opioid users between 27 and 58 years of age from Kurdistan provinces. RESULTS: Overall, six themes were discovered to be key barriers relating to methadone treatment, including financial barriers related to methadone treatment, lack of awareness about methadone treatment, negative attitudes regarding using methadone, worries about methadone's side effects, social stigma ascribed to methadone therapy, and systemic barriers to methadone treatment. CONCLUSION: Our study revealed that the cost of treatment is a major obstacle to attending and continuing at MMT programs and that addicts and their families are not always accurately informed about the duration of MMT programs and the side effects of methadone treatment.

Status of Violence in a Selected Faculty: The Students' Experience.

The present study is aimed at examining the status of violence among the students of nursing, midwifery, and operating room. A self-reporting questionnaire with two sections of demographic characteristics and experience of violence was used. The data obtained were analyzed, using SPSS software. 58.7 percent of the students had a history of violence in the previous year. The maximum percentage of violence exposure belonged to the students of operating room (76.9%). The highest incidence of violence was verbal (76.4%), happened in patients' rooms (32.9%) and was in the form of insult (75.1%). Accordingly, preventive actions are required to prevent and control violence and support students. Informing students about violence, communicative skills, reaction, and coping with violence during studying is necessary. Therefore, educational authorities and theoretical and clinical instructors should take appropriate measures in order to prevent violence and create supportive mechanisms for the students.

Challenges of Iranian adolescents for preventing dental caries.

BACKGROUND: Oral health plays a vital role in people's general health and well-being. With regard to the costly treatments of oral diseases, preventive programs need to be designed for dental caries based on children's perspectives. OBJECTIVES: The purpose of this study was to describe and explore challenges for caring dental health based on children's perspectives. PATIENTS AND METHODS: A qualitative design with content analysis approach was applied to collect and analyze the perspectives of students about factors influencing oral and dental care. Eighteen Iranian students in 8 guidance schools were chosen through the purposive sampling. Semi-structured interviews were held for data gathering. In order to support the validity and rigor of the data, different criteria such as acceptability, confirmability, and transferability were utilized. RESULTS: During data analysis, four main themes developed: "barriers to dental health," "maintaining dental health," "uncertainty in decision-making" and "supportive factors". "Uncertainty in decision-making" and "barriers to dental health" were the main challenges for preventing dental caries among adolescents. CONCLUSIONS: "Certainty in decision-making" to maintain dental health depends on overcoming the barriers of dental health. Further research is needed to confirm the findings of this study.

Impact of education on interdental cleaning behaviour based on the transtheoretical model.

PURPOSE: To determine the impact of education on stages of change of behaviour in Iranian senior high school students for interdental cleaning based on the transtheoretical model. MATERIALS AND METHODS: This experimental study took place from April to November 2010. 306 students were selected by multistage cluster sampling and placed into two groups: control (153 students) and intervention (153 students). Appropriate instruments and the intervention programme were designed with the purpose of improving stages of interdental cleaning behaviour, perceived benefits and self-efficacy, as well as reducing perceived barriers and gingival index (GI). The impact of the intervention programme was assessed after 24 weeks and the GI of each student was recorded for both groups before and after intervention. The data were analysed using SPSS software and the chi-square, t test, ANOVA, paired t test, Mann-Whitney U-test and sign test. RESULTS: The intervention had a significant, positive impact on improvement of the stages of interdental cleaning behaviour, increase in self-efficacy, perceived benefits, decrease in perceived barriers and improvement of GI (P < 0.001). After the intervention, the average grades of self-efficacy, perceived barriers and perceived benefits in the control group vs the intervention group were significantly different (P < 0.001 to 0.01). CONCLUSION: The programme was found to positively influence the stages of change and potential indicators of interdental cleaning behaviour and GI. It is suggested that this model be used for interventions in the other population groups.

Interdental cleaning behaviour and its relationship with psychological constructs based on the transtheoretical model.

PURPOSE: The aim of this study was to test the applicability of the Transtheoretical Model (TTM) to gain an understanding of interdental cleaning behaviour change in senior high school students (12th grade) in Iran. MATERIALS AND METHODS: Multistage cluster sampling was employed to recruit 361 senior high school students from 8 schools in Yazd City, Iran. This cross-sectional study took place from November 2008 to March 2009. Appropriate instruments were used to identify the stages of interdental cleaning behaviour and psychological attributes, including interdental cleaning behaviour, decisional balance, and self-efficacy. The statistical analysis of the data included descriptive statistics, t-test and ANOVA. RESULTS: Of the 361 students, nearly 12.5% were in the maintenance stage, while 49.6% were in the pre-contemplation stage, with the rest distributed among the other stages of interdental cleaning behaviour change. There was a statistically significant difference in the stages of interdental cleaning behaviour change by gender. Self-efficacy and decisional balance differed significantly across the stages of interdental cleaning behaviour change. CONCLUSION: The TTM was found to be useful in determining the stages of interdental cleaning behaviour change among students. This study suggests the development of theory-based and empirically supported intervention strategies and programs to improve interdental cleaning behaviour with an emphasis on improving students' self-efficacy in this area.