Effect of alternative and complementary medicine on male infertility: An umbrella review.

Background and Aims: There is increasing interest worldwide in using alternative and complementary approaches for treating male infertility. This interest has spawned a multitude of published systematic reviews and meta-analyses. The aim of this Umbrella review was to consolidate the available evidence regarding the effect of complementary and alternative medicine on male infertility to inform clinical decision-making processes. Methods: A comprehensive search was conducted to identify systematic reviews and meta-analyses pertaining to the effects of complementary and alternative medicine on male infertility. This search encompassed various databases including MEDLINE, CINAHL, PubMed, Scopus, Proquest, Google Scholar, SID, EMBASE, Magiran, Cochrane Library, Iranmedex, ScienceDirect, SAGE. Subsequently, two researchers independently extracted the data from the selected meta-analyses and systematic reviews, and evaluated their methodological quality using the assessment of multiple systematic reviews 2 (AMSTAR2). Results: This analysis encompassed 11 studies, with four originating from Iran, two from Korea and five from China. The results regarding the effectiveness of complementary and alternative medicine are controversial, indicating a need for further research. The methodological quality of the systematic reviews and meta-analyses appraised by AMSTAR 2 was rated as low or critically low. This assessment is attributed to inadequate examination of publication biases in the reviews and a lack of discussion regarding the effect of risk of bias. Conclusion: The existing evidence regarding the effectiveness of alternative and complementary medicine in addressing male infertility is limited. Furthermore, the overall methodological quality of the published systematic reviews and meta-analyses may have been underestimated as the use of AMSTAR2 appears to be a more precise appraisal instrument compared to its predecessor.

Investigating the effect of educational interventions on maternal competence: A systematic review and meta-analysis.

There have been many studies on maternal competence, but in the studies conducted in this field, different methods have been applied to educate mothers on maternal competence, which do not have a unified approach. This study aims to investigate the effect of educational interventions on maternal competence using a meta-analysis method. In this meta-analysis, a search was made in MEDLINE, CINAHL, PubMed, Scopus, Proquest, Google scholar, SID, and Magiran databases using Mesh and non-Mesh keywords between January 1992 and September 2022. The inclusion criteria included: Studies in which educational and counseling interventions on maternal competence have been investigated, studies that have used the Parenting Sense of Competence Scale (PSOC), RCT or interventional studies, participants who were primiparous women, articles that were published in English and Farsi, studies that reported sample size, mean and standard deviation of maternal competence scores in the intervention and control groups, and studies that scored at least 3 on the Jadad scale. Data were analyzed using Review Manager 5 (RevMan 5.3). In this meta-analysis and systematic review, finally, seven articles met the criteria for entering the research. The number of samples in the intervention group was 430 and in the control group was 429. The average maternal competence score with a 95% confidence interval was 3.51. This meta-analysis showed that educational interventions during pregnancy and after delivery could affect improving the competence of primiparous mothers. Education has increased the maternal competence score in the intervention group by 3.51 units compared to the control group.

Effect of maternal role training program based on Mercer theory on maternal self-confidence of primiparous women with unplanned pregnancy.

INTRODUCTION: Maternal confidence is an extremely important factor in playing the mother's role and her identity formation. Loss of self-confidence occurs in primiparous women due to the lack of maternal skills. Obtaining the behaviors of maternal role and self-confidence, the mother provides better care for her child. Hence, the aim of this study was to examine the effect of maternal role training program based on Mercer theory on maternal self-confidence of primiparous women with unplanned pregnancy. METHODOLOGY OF THE RESEARCH: This clinical trial was performed on 67 primiparous women referring to Mashhad health centers. Individuals were randomly divided into intervention and control groups. A maternal role training program based on Mercer theory was carried out for intervention group (three sessions of group training in the 34th, 35th, and 36th weeks of pregnancy and one individual training session before discharge from the hospital and then, weekly follow-up over the phone for 4 weeks). The control group received the normal pregnancy care. The research tools were questionnaires of demographic characteristics, London, DASS 21, Edinburgh Postnatal Depression Scale, Parenting Sense of Competence, General Impressions on Infant Temperament Questionnaire, and Six Simple Questions. Maternal self-confidence was measured before training, 4 weeks after delivery, and 4 months after delivery. Data analysis was carried out using independent t-test, Chi-square test, paired t- test, Mann-Whitney test, one-way ANOVA, and Wilcoxon test. P < 0.05 was considered statistically significant. RESULTS: There was a significant difference between mean maternal self-confidence changes (before training and 4 weeks after delivery (P = 0.003) and before training and 4 months after delivery (P = 0.001) in both groups. After eliminating the effect of interventional variables, the mean scores of maternal self-confidence after training in the intervention group had a statistically significant difference with that in the control group (P = 0.001). CONCLUSIONS: Maternal role training program based on Mercer theory increases maternal self-confidence in primiparous women with unplanned pregnancy. Teaching maternal role is recommended to all health-care providers.

Effect of a maternal role training program on maternal identity in primiparous women with unplanned pregnancies.

AIM: Primiparous women with unplanned pregnancies experience greater levels of anxiety that reduce their ability to perform their maternal role. METHODS: This clinical trial was conducted in 2014 on 67 primiparous women with unplanned pregnancies visiting the health centers of Mashhad, Iran, who were randomly divided into an intervention and a control group. The intervention group received maternal role training based on Mercer's Maternal Role Attainment Theory, and the control group received the routine pregnancy care. Maternal identity was measured before training and 4 weeks and 4 months after delivery. RESULTS: Four months after delivery, 28 women (80%) in the intervention group and 18 women (56%) in the control group successfully formed a maternal identity (P = 0.036). CONCLUSION: A maternal role training program given based on Mercer's theory facilitates the formation of maternal identity in primiparous women with unplanned pregnancies.

The effect of maternal role training program on role attainment and maternal role satisfaction in nulliparous women with unplanned pregnancy.

INTRODUCTION: The maternal role is one of the most basic and important roles played by women during their lifetime. The process of the maternal role starts during pregnancy and to continue and develop after postpartum with the growth of suckling. However, unplanned pregnancy may jeopardize achieving the maternal role and reduce maternal role satisfaction. Therefore, the researcher conducted the present study to determine the impact of maternal role training program on attainment of role and role satisfaction in nulliparous women with unplanned pregnancy. METHODOLOGY OF THE RESEARCH: In this clinical trial, the researcher divided 67 nulliparous women with unplanned pregnancies into two groups at random by drawing lots. For the intervention group, in addition to the usual pregnancy care, the researcher conducted 3 group training sessions at weeks 34, 35, and 36 of pregnancy and an individual training session in the 1st day after delivery before release; then, during the next 4 weeks, the researcher made follow-up phone calls each week. The control group received the usual pregnancy care. The research tools included London questionnaire to measure unplanned pregnancy, Myself-As-Mother Scale (SD-Self), My-Baby Scale (SD-Baby), Perceived Competence Scale to measure maternal role attainment, and Parenting Sense of Competence Scale to measure maternal role satisfaction. The researcher measured the maternal role attainment and maternal role satisfaction before training and 4 weeks after delivery. The researcher analyzed the data using SPSS software version 21 and statistical tests such as independent t-test, Chi-square, paired sample t-test, Mann-Whitney, one-way analysis of variance, and Wilcoxon. The amount of P was supposed to be <0.05. RESULTS: The mean age of research units was 24.10 ± 4.3. Twenty-one persons (60%) in the intervention group and ten persons (31.3%) in the control group attained the maternal role (P = 0.019) and changes to achieve the maternal role in intervention group were significantly more than the control group (P = 0.002). Changes in the mean scores of maternal role satisfaction in the intervention group were significantly more than the control group (P = 0.023). CONCLUSION: Maternal role training for nulliparous women with unplanned pregnancy during pregnancy and postpartum period can help them in maternal role attainment and maternal role satisfaction.