Prevalence of Sleep Disorders and the Effect of Sleep Health Education on Sleep Quality in Pregnant Women With Sleep Disorders.

Objective: Sleep quality affects pregnant women's health and quality of life. The aims of the study were to investigate the prevalence of sleep disorders and the effect of sleep health education on sleep quality in pregnant women with sleep disorders. Methods: To examine the frequency of sleep disorders among pregnant women, a cross-sectional study was conducted with an initial enrollment of 370 participants. Subsequently, 162 pregnant women were recruited for a pretest-posttest quasi-experimental design study. The intervention group (n = 82) performed sleep health education for four weeks and the control group (n = 80) received standard care. Sleep quality was assessed with Pittsburgh Sleep Quality. Results: The prevalence of sleep disorder was 61.9 percent (CI 95% 56.85-66.69). It was determined that health education improved some sleep quality subscales including subjective sleep quality, sleep latency, sleep duration and habitual sleep efficiency, and sleep disturbances, daytime dysfunction, and global sleep quality. The difference was still significant after adjusting for the PSQI baseline (η2 = .311, P < .001). Conclusion: These findings provide evidence of a relatively high prevalence of sleep disorders in pregnancy. Therefore, screening for sleep disorders and providing supportive programs and models to improve sleep quality during pregnancy should be considered as part of prenatal care.

The mediating effect of self-efficacy on the relationship between social support and medication adherence in adults with type 2 diabetes.

Objective: To evaluate the status of medication adherence in diabetic patients and its effective factors. Methods: A cross-sectional descriptive study was conducted with 170 diabetic patients in Iran. Participants were assessed for medication adherence, self-efficacy, and social support. Descriptive statistics, bivariate analyses, and multiple stepwise regression were conducted to explore predictors for medication adherence. Results: Regression analysis showed that 48% of medication adherence changes stemmed from the four variables including social support, self-efficacy, income, and education levels, (R2adj = 0.480, F = 39.943, p < 0.001). According to the model, the highest effects were related to income level (ß = 0.332, t = 5.493, p ⩽ 0.001) and self-efficacy (ß = 0.330, t = 4.789, p ⩽ 0.001), respectively. Based on the final model, only the social support variable showed no significant relationship with adherence (ß = 0.002, t = 0.032, p = 0.947). Conclusion: Social support and self-efficacy were related to medication adherence in diabetic patients, and social support can improve medication adherence in patients with diabetes by affecting self-efficacy. Healthcare workers who interact with individuals with diabetes should take into account the factors mentioned above when designing health promotion interventions to address the needs of these individuals.

Resilience and its related factors among women with breast cancer.

OBJECTIVES: Breast cancer is the most challenging disease, and the level of resilience in patients determines their ability to cope with the arising stress. There is relatively limited information on the resilience of patients in clinical settings. Our study aims were to evaluate the extent of resilience and identify factors that predict resilience in women with breast cancer. PATIENTS AND METHODS: A cross-sectional study was conducted with the participation of 218 women with breast cancer who were referred to the Oncology clinic in 2022. The participants completed three scales, namely the Conner-Davidson Resilience, Schneider's Life Expectancy, and the Multidimensional Scale of Perceived Social Support, along with sociodemographic information. Descriptive statistics, bivariate, and multiple linear regression were used to explore the predictors of resilience. RESULT: The mean (SD) scores for resilience, social support, and hope were 59.22 (17.25), 38.53 (6.19), and 59.37 (16.68), respectively. Based on analysis 50.8% of the variations in resilience could be explained by 6 variables including social support, hope, women's age, employment, and income status as well as the stage of illness (R 2adj = 0.508, P < 0.001). Employment status and disease stage did not show a significant relationship with resilience and social support was the factor with the highest impact on resilience (ß = 0.516, P < 0.001). CONCLUSION: Our study showed social support, hope, age, and income level predict significant resilience in women with breast cancer. The findings emphasize the importance of fostering strong support networks, cultivating a hopeful mindset, embracing life's transitions, and addressing financial considerations in the pursuit of enhanced resilience.

Factors affecting quality of life in women with breast cancer: a path analysis.

BACKGROUND: Breast cancer may negatively affect people's quality of life. We investigated the predictors of quality of life in women with breast cancer with the mediating role of resilience. METHOD: In a cross-sectional design, 218 patients completed a survey referring to the Valiasr International Hospital Oncology Center in Tabriz, Iran. Four validated self-report measures assessed HRQoL as measured by the SF-12, Resilience, Hope, and Perceived Social Support (MSPs). The mediating roles of resilience between HRQoL and the fitness of the proposed model were investigated using path analysis. SPSS version 24 software and Lisrel 8.8 software were used for data analysis. RESULTS: The results of path analysis showed that the final model had a good fit to the data (Chi-Square/ degrees of freedom (Normed Chi2) = 2.08, RMSEA = 0.014, goodness fit index = 0.99, both comparative fit index = 0.99 both CFI = 0.99 and IFI = 1). In this model, age and psychosocial factors predicted health-related quality of life. CONCLUSIONS: Age and psychosocial factors especially social support are important components in predicting health-related quality of life among those suffering from breast cancer.

Association Between Health-Promoting Behaviors and Reproductive Health Needs in Women Experiencing Domestic Violence.

Violence against women is considered as one of the most serious social problems in all the societies. It is common that the abused women experience physical, psychological, and health problems, as well as reproductive health issues. Domestic violence affects women's health behaviors and ability to seek any form of health care. This study aimed to investigate the relationship between health-promoting behaviors and reproductive health needs in women experienced domestic violence. This cross-sectional study was conducted from May 5 to September 21, 2021, on 380 abused women. Cluster sampling was performed in health centers of Karaj. Data were collected using demographic survey questions, Domestic Violence Survey, Reproductive Health Needs of Domestic Violated Women scale, and health-promoting behaviors questionnaire. The mean (standard deviation) scores for reproductive health needs and health-promoting behaviors were 158.88 (20.24) and 131.08 (20.53), respectively. Psychological violence had the highest (69.5%) prevalence among all types and 37.6% of women reported severe violence. The results of Spearman's rank correlation coefficient test indicated that all dimensions of the reproductive health needs of abused women (men's participation, self-care, support and health services, and sexual and marital relationships) positively and significantly related to the total score and various dimensions of health-promoting behaviors (interpersonal relationship, health responsibility, physical activity, spiritual growth, nutrition, and stress management). The dimensions of health-promoting behaviors together can explain 21.6% of the changes in reproductive health needs based on linear regression. Violence is a global public concern and paying attention to the various health dimensions in abused women is an important aspect of the health policies. Developing health-promoting behaviors in abused women improves their reproductive health state and society as a whole.

Effect of mindfulness on sexual self-esteem and marital intimacy in postmenopausal women: a quasi-experimental study.

BACKGROUND: Menopause is a turning point in women's lives and a major medical challenge, leading to drastic changes in sexual self-esteem and the husband-wife relationship, which can have an undeniable impact on the quality of their life. AIM: To assess the effect of mindfulness-based education on sexual self-esteem and marital intimacy in postmenopausal women. METHODS: This quasi-experimental study was conducted with 130 women who were assigned to 2 groups, intervention (n = 65) and control (n = 65), out of whom 127 completed the study. The interventional group received 8 training sessions. The mindfulness-based intervention consisted of 8 educational sessions and daily mindfulness exercises. Sexual self-esteem was assessed by the Sexual Self-esteem Index for Woman-Short Form, and marital intimacy was measured with Thompson and Walker's Intimacy Scale. The collected data were analyzed via analysis of covariance. OUTCOMES: Outcomes included changes in sexual self-esteem and marital intimacy scores. RESULTS: Participants in the intervention group demonstrated higher levels of total self-esteem posttreatment than participants in the control group (125.15 vs 119.46) and higher levels of intimacy (74.22 vs 61.59). The difference was still significant after adjusting for self-esteem (η2 = 0.312, P < .001) and intimacy (η2 = 0.573, P < .001) at baseline. CLINICAL IMPLICATIONS: Mindfulness may be used as a strategy to improve sexual self-esteem and marital intimacy. STRENGTHS AND LIMITATIONS: Unlike other treatments, mindfulness seems to be low cost and less complex in improving sexual self-esteem and marital intimacy. Limitations of this study include use of available sampling methods, nonrandom allocation of participants, and self-reporting data collection. CONCLUSION: As evidenced by the results, 8 weeks of mindfulness training could improve sexual self-esteem and marital intimacy in menopausal women. The mindfulness-based intervention should be incorporated into routine care to help menopausal women.

Association Between Serum Markers Used in the Routine Prenatal Screening with Pregnancy Outcomes: A Cohort Study.

Background: Early detection of adverse pregnancy outcomes is an important topic in prenatal care. This study aimed to evaluate the association between maternal serum markers and pregnancy outcomes. Materials and Methods: This hospital-based cohort study was performed according to the national Down syndrome screening protocol on 2923 eligible pregnant women. Pregnancies were classified into three groups of based on each biomarker. The participants were followed up until delivery, and the pregnancy outcomes were identified by hospital discharge records. Results: High levels of free BHCG were significantly associated with an increased risk of preterm birth (B = - 0.31, SE = 0.158, OR = 0.730; P = 0.046). Based on multivariate analysis the high levels of MSAFP had a direct relationship with premature birth (B = - 0.84, SE = 0.361, OR = 0.431, P = 0.020), gestational hypertension (B = - 0.59, SE = 0.354, OR = 0.549. P = 0.091), IUGR (B = - 1.46, SE = 0.433, OR = 0.231, P = 0.001), and fetal death (B = - 1.50, SE = 0.533, OR = 0.223, P = 0.005). Furthermore, an increase in the levels of Inhibin-A could more likely lead to gestational hypertension (B = - 0.63, SE = 0.235, OR = 0.533). Discussion: According to the result, maternal biomarkers, especially MSAFP, can be beneficial in identifying high-risk cases, in addition to examining the possibility of Down syndrome, facilitating achievement of the desired pregnancy outcomes.

Health-promoting behaviors and intermediary social determinants of health in low and high-risk pregnant women: an unmatched case-control study.

BACKGROUND: High-risk pregnancies require increased health and care resources to reduce the severe perinatal consequences. The adoption of a health-promoting lifestyle and social determinants is an important strategy for achieving the desired outcomes of pregnancy. This study aimed to compare intermediate determinants of social health in low and high-risk pregnant women. METHODS: This unmatched case-control study was performed with a ratio of 1: 2 and 300 pregnant women including 200 healthy and 100 pregnant women with gestational hypertension were included using the available sampling technique. Data were collected using socio-demographic and obstetrics, Health-promoting behaviors, Self-efficacy, Perceived stress, and Social support questionnaires by the self-report method. RESULTS: There was no significant difference in the demographic characteristics between the two groups, except for the spouse's education status. The total score of health-promoting behaviors and social support in the healthy group was significantly higher than women with gestational hypertension. However, the perceived stress in women with gestational hypertension was significantly higher than in the healthy group. In the multivariate analysis, those women with high stress [AOR 1.13, 95% CI (1.08-1.18)] and whose Spouse's Educational status was low [AOR 4.94, 95% CI (1.54-15.81)] had higher odds of gestational hypertension than women who haven't respectively. The development of gestational hypertension was decreased by increasing the score of social support [AOR 0.96, 95% CI (0.93-0.98)]. The results showed that the two variables of social support (ß=0.331) and self-efficacy (ß=0.215) have the greatest impact on the score of health-promotion behaviors, respectively. Based on regression analysis, 21.2% of the health-promotion behaviors changes could be explained by three independent variables. CONCLUSION: Women with gestational hypertension have unhealthier lifestyles. Having a high level of stress is a risk factor for gestational hypertension but Social support has a protective effect on it. Recognizing the risk factors of gestational hypertension could help the determination of high-risk cases and it is important to pay attention to women's psychosocial to create appropriate sources of social support and provide the necessary action to reduce stress.

Nurses' job stress and its impact on quality of life and caring behaviors: a cross-sectional study.

BACKGROUND: Nursing is considered a hard job and their work stresses can have negative effects on health and quality of life. The aim of this study was to investigate the correlation between job stress with quality of life and care behaviors in nurses. METHODS: This cross-sectional survey design study was performed with the participation of 115 nurses working in two hospitals. The nurses were selected via the availability sampling method and data were collected by demographic characteristics, nurses 'job stress, quality of life (SF12), and Caring Dimension Inventory questionnaires. RESULTS: The mean (SD) total scores of job stress, quality of life and caring behavior were 2.77 (0.54), 56.64 (18.05) and 38.23 (9.39), respectively. There was a statistically significant and negative relationship between total job stress scores with quality of life (r = -0.44, P < 0.001, Medium effect) and caring behaviors (r=-0.26, P < 0.001, Small effect). Univariate linear regression showed that job stress alone could predict 27.9% of the changes in the total quality of life score (ß =-0.534, SE = 0.051, R2adj = 0.279, P < 0.001) and 4.9% of the changes in the total score of caring behaviors (ß =-0.098, SE = 0.037, R2adj = 0.049 P < 0.001). CONCLUSIONS: Job stress has a negative effect on the quality of life related to nurses' health. It can also overshadow the performance of care and reduce such behaviors in nurses, which may be one of the factors affecting the outcome of patients.

Association between perceived stress, fear and anxiety of COVID 19 with self-care in pregnant women: a cross-sectional study.

Pandemic COVID-19 has negative effects on the mental health of all people, especially pregnant women. This study aimed to determine the psychological effects of COVID-19 on self-care in pregnant women. The Cross-sectional study using the Multistage sampling technique was conducted among 215 pregnant women selected randomly from the Iranian Integrated Health System in 2020. Data were collected using demographic and obstetrics questionnaires, Pregnancy Self-Care Scale, Fear of COVID-19, COVID-19 Anxiety Scale(CDAS), and Perceived Stress Scale (PSS) by the self-report method. Data analysis was performed using SPSS software version 21 with Pearson correlation test and multivariable linear regression.The Mean (Standard Deviation (SD)) of Fear, anxiety, perceived stress, and self-care was 20.85(6.45), 18.20(10.45), 31.16 (7.65) and 40.84(4.11), respectively. The correlational analyses showed small positive significant associations between Fear (r=0.20; P=0.004) and anxiety of COVID-19 (r=0.14; P=0.03)with self-car but the association between perceived stress and self-care was small negative significant (r= -0.14; P=0.04). Based on regression analysis, 11% of the self-care changes could be explained by three independent variables (ß= 0.130, SE= 0.043, P=0.002). Based on the findings, pregnant women may benefit from psychoeducation that focuses on the effect of mental health problems on pregnant women.

Association Between Awareness, Perceived Severity, and Behavioral Control of COVID -19 With Self-Care and Anxiety in Pregnancy: A Cross-Sectional Study.

COVID-19 pandemic has caused a tidal wave of anxiety and stress among Iranians, especially pregnant women. This study aimed to assess the association between knowledge, perceived severity, and controllability of COVID-19 with self-care and health anxiety specially in pregnancy. This cross-sectional study was performed on 440 pregnant women. Data were collected using demographic-obstetrics characteristics, as well as the questionnaires of knowledge, perceived severity, and perceived controllability of the COVID-19, health anxiety, and self-care. Self-care was positively correlated with knowledge, perceived severity, and perceived controllability of the COVID-19. Nonetheless, health anxiety had a significant and inverse association with knowledge and perceived controllability, while there was a positive and significant correlation between perceived severity and health anxiety. Based on linear regression, three variables of knowledge, perceived severity, and perceived controllability of the COVID-19 could explain 46.3 and 17.5% of variations in self-care and health anxiety, respectively. It is suggested that due to the critical importance of prenatal care, managers, and health-care providers promote the use of such methods as telehealth and home-based caregivers, especially in areas with inadequate access to health care. So, the pregnant women can be followed up and receive medical care devoid of any stress and anxiety.

Association between Perceived Social Support and Health-Promoting lifestyle in Pregnant Women: A Cross-Sectional Study.

Introduction: Adopting health-promoting lifestyle might be affected by a variety of factors. The existing evidence suggests that social support can improve health by fulfilling physical and mental needs. This study aimed to investigate the association between social support and health-promoting lifestyle in Pregnancy. Methods: Using multistage cluster sampling method, this cross-sectional study was conducted on 360 pregnant women. Data were collected using three questionnaires, including a self-reported demographic and obstetric, health-promoting lifestyle profile and perceived social support questionnaires. Data were analyzed using a t-test, repeated measures ANOVA, and multivariate linear regression model with SPSS software ver. 21 with. Results: The mean (SD) of health-promoting behaviors was 135.21(20.03). Amongst the different dimensions of health-promoting behaviors, the highest mean was detected in spiritual growth 26.84 (4.90) and nutrition 26.17 (4.22), respectively. Meanwhile, the lowest scores were detected in sub-domains of stress management 19.80 (3.78) and physical activity 16.71(4.14), respectively. The mean (SD) of perceived social support was 60.31 (14.75), and 51.7% of the participants had intermediate social support. Results indicated a significant difference between the mean score of Health-Promoting Lifestyle at different levels of social support. There was a direct and significant association between the scores of social support and health-promoting behavior (r=0.36; P<0.001). Conclusion: Pregnant women with better perception of social support had a better performance in adopting health-promoting Lifestyle. However, the status of health behaviors and social support was not favorable. Thus, there is a need to intervene and design programs to help pregnant women and improve their health.

Association between Fear of COVID-19 with Self-care Behaviors in Elderly: A Cross- Sectional Study.

This study aims to determine the association between fear of COVID-19 with self-care in the elderly. This is a cross-sectional study, in which data were collected using the online survey method with three questionnaires: social demographic characteristics, fear of COVID-19, and elderly self-care. The 350 elderly people were selected by multi-stage sampling from the list of households registered in the integrated health system. According to the result, the mean (SD) age of participants was 69.91 (5.19) and two-thirds of them were married, also the majority of the participants (55%) had an education level less than a diploma. A direct and statistically significant correlation was observed between fear of COVID-19 and self-care. Linear regression analysis showed that the self-care rate decreases with increasing of the COVID-19 fear (B = -0.395, SE = 0.001, R2 = 0.154). The lowest scores were related to self-care which can be due to the restrictions applied and limited family relations during the COVID-19 epidemic. Therefore, it is recommended that purposeful training programs and appropriate psychological support interventions are developed to help overcome COVID-19 fear and help elderly people use preventative behaviors.

Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study.

INTRODUCTION: Male sexual dysfunction is a common problem, and there are many self-report questionnaires for measuring sexual function among men; however, the Brief Male Sexual Function Inventory (BSFI) is a tool that has 5 subscales, which is more complete than others. a validated self-report questionnaire, in the local language with modest expressions is required for men. AIM: To determine the validity and reliability of the Persian version of the BSFI among men. METHODS: This cross-sectional study was conducted on 200 males. The sampling process was performed in several stages from health centers. After the accomplishment of the standard process of back-translating the questionnaire from English to Persian, its face, content, and construct validity were evaluated. The collected data were analyzed using confirmatory factor analysis, multivariate analysis of variance, and Pearson correlation coefficient. To determine the reliability of the instrument, the test-retest method was used with 2 weeks interval and the Cronbach's alpha coefficient method was applied to check the internal homogeneity. MAIN OUTCOME MEASURES: Reliability (internal consistency and test-retest) and validity were assessed RESULTS: According to the research findings, confirmatory factor analysis had an acceptable fit. By modifying the measurement model and fitting the final model, the fitting indices were obtained as the following: Chi-square statistic = 21.63, NPAR = 36, P = .001 > 0.05; Tucker-Lewis index = 0.956; comparative fit indices = 0.976; Normed Fit Index = 0.952; and root mean square error of approximation = 0.068. These values indicated that the obtained model had a good fit for the data. Moreover, Cronbach's alpha and intra-cluster correlation coefficients of the whole questionnaire were calculated at 0.893 and 0.893, respectively (confidence interval between 0.811-0.950), showing the internal consistency of the items in the whole questionnaire and domain. CONCLUSION: The BSFI questionnaire showed a 5-factor structure similar to the original structure and the 11-item Persian version of the questionnaire of male sexual function can be considered a valid and reliable tool to assess the level of male sexual function. Rezaei N, Sharifi N, Fathnezhad-Kazemi A, et al. Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study. Sex Med 2021;9:100409.

The association between social support and psychological factors with health-promoting behaviours in pregnant women: A cross-sectional study.

INTRODUCTION: Health promotion is one of the most important aspects in pregnancy, and health-promoting behaviors are one of the major determinants of health under the influence of various factors. This study aimed to determine the association between social support and psychological factors with health-promoting behaviors in pregnant women. MATERIALS AND METHODS: This cross-sectional was performed on 375 pregnant women when they had 24-28 weeks in Ilam, October 2018 to May 2019. Two-stage cluster sampling was performed after checking the inclusion criteria. Data collection tools consisted of four questionnaires that were completed in self-report form. The collected data were analyzed by the descriptive and inferential tests with the SPSS software version 19. RESULTS: The mean score of health-promoting behaviors was 139.87 (21.26) and self-healing and physical activity had the highest and the lowest mean 27.67 (4.84) and 16.29 (4.84), respectively. Linear regression analysis showed a significant difference between different level of stress, anxiety, depression, and social support with health-promoting behaviors (P < 0.001). The results showed that one-point increase in the score of stress, anxiety, and depression led to the 2.2%, 6.1%, and 24.1% reduction of health-promoting behaviors, respectively, and one-point score increase in social support resulted in 40% increase in health-promoting behaviors (P < 0.001). CONCLUSION: A negative association was found between psychological factors and a positive relationship with health-promoting behaviors. Although perceived moderate health promotion behaviors and perceived social support were moderate, they did not have a good status in terms of psychological factors. Given awareness of the issues under study in each region is essential and planning to improve stress, anxiety, and depression, as well as promoting and correcting inappropriate behaviors through planned interventions are required.

Prevalence of obesity and association between body mass index and different aspects of lifestyle in medical sciences students: A cross-sectional study.

Aim: The global obesity pandemic is a major health problem with adverse effects on physical and mental health. The aim of this study was to investigate the prevalence of obesity and the association between BMI and different aspects of lifestyle. Design: A cross-sectional study. Methods: Data collected from 380 medical sciences students using demographic characteristics and Eating Behavior, Physical Activity and Perceived Stress Questionnaires were analysed using descriptive and inferential statistics, namely analysis of variance (ANOVA), t test, Pearson's test and multivariate linear regression model. Results: The prevalence of obesity and overweight was 3.2% and 25.3%, respectively. There was a positive and significant statistical association between emotional eating (r = .542), extrinsic eating (r = .488) and perceived stress (r = .489) with BMI, also significant and an inverse association was obtained between emotional eating (r = -.488) and total physical activity score (r = -.394) with BMI. Factors such as sex, total physical activity score and leisure time activity, external eating behaviours, emotional eating, restricted eating and perceived stress had a significant role in explaining BMI changes. Conclusion: There is a need to develop interventions to improve dietary behaviours, management stress and access to sports facilities by health-promoting activities and the provision of online health resources.

Death of a neonate with suspected coronavirus disease 2019 born to a mother with coronavirus disease 2019 in Iran: a case report.

INTRODUCTION: A novel coronavirus named severe acute respiratory syndrome coronavirus 2, was first reported in Wuhan, China, in December 2019. The virus, known as COVID-19, is recognized as a potentially life-threatening disease by causing severe respiratory disease. Since this virus has not previously been detected in humans, there is a paucity of information regarding its effects on humans. In addition, only limited or no information exists about its impact during pregnancy. CASE PRESENTATION: In the present case study, we report the death of a neonate born to a 32-year-old mother with coronavirus disease 2019 in Ilam, Iran, with Kurdish ethnicity. We report the infection and death of a neonate in Iran with a chest X-ray (CXR) marked abnormality 2 hours after birth demonstrating coronavirus disease 2019 disease. The neonate was born by elective cesarean section, the fetal health was assessed using fetal heart rate and a non-stress test before the birth, and there was no evidence of fetal distress. All the above-mentioned facts and radiographic abnormalities suggested that coronavirus disease 2019 is involved. CONCLUSIONS: In this case study, we report the death of a neonate born to a mother with coronavirus disease 2019, 11 hours after birth. There is a paucity of data on the vertical transmission and the adverse maternal-fetal consequences of this disease, so vertical transmission from mother to child remains to be confirmed.

The effectiveness of healthy lifestyle interventions on weight gain in overweight pregnant women: A cluster-randomized controlled trial.

Aim: Interventions based on adopting a healthy lifestyle have been less successful. The aim of this study was to investigate the effectiveness of healthy lifestyle interventions on weight gain in overweight pregnant women. Design: A cluster randomized controlled trial. Methods: Health centres were selected by simple random sampling; then, 66 overweight pregnant women were enrolled by convenience sampling and divided into intervention and comparison groups. Intervention group received individual nutritional counselling and physical activity training. The data were collected in several stages with the demographic and obstetric questionnaire, maternal weight record, food frequency and international physical activity questionnaire. Results: Pregnancy weight gain-4.75(CI 95%: -4.02, -5.48) was significantly lower in the intervention group (p < .001). Comparing between groups with adjustment for baseline values indicated that there was a statistically significant difference in terms of total calorie 95.46 (CI 95%: -22.37, 213.30), carbohydrate 23.45 (CI 95%: 2.12, 44.78), protein -7.16 (CI 95%: -12.85, -1.47) and fat 8.82 (CI 95%: 2.21, 15.67) intake. Despite the higher level of physical activity in the intervention group, there was no statistically significant difference between the two groups. Conclusion: Counselling interventions for healthy living during pregnancy can lead to controlling weight gain, improving dietary habits and increasing the physical activity in overweight pregnant women.

Weight gain during pregnancy and its associated factors: A Path analysis.

Aim: Weight gain during pregnancy is an important indicator in the prediction of morbidity and mortality in infants and mothers. This study aimed to determine the association factors for weight gain during pregnancy. Design: A longitudinal study. Methods: A total of 734 women were selected using multistage cluster sampling. Data were collected using demographic and midwifery questionnaires, economic and social status, psychological factors, domestic violence, perceived social support and food insecurity. Results: Of participants 28.7%, 49.6% and 21.7%, respectively, received insufficient, adequate and excessive weight gain in pregnancy respectively. Among health determinants entered in the model, mother's age, prepartum body mass index and direct and indirect prenatal care, size of households, food insecurity, stress, anxiety, stress and pregnancy-specific stress as well as violence had a positive and increasing effect on weight gain during pregnancy. Conclusion: Considering the effect of inappropriate weight gain during pregnancy on undesirable pregnancy outcomes, related factors such as nutritional status, stress and depression in prenatal care should be assessed. Healthcare providers should consult, educate pregnant women.

Explaining the experience of prenatal care and investigating the association between psychological factors with self-care in pregnant women during COVID-19 pandemic: a mixed method study protocol.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a novel global public health emergency. Prenatal care (PNC) providing institutes should identify the needs and demands of pregnant women by optimizing the means of PNC services during the COVID-19 pandemic. The present study aims to: a) explain prenatal care experiences; b) assess the factors affecting self-care, and c) present a prenatal care guideline and Strategies to improve the PNC. METHODS: This mixed-methods study with a sequential explanatory design consists of three phases. The first phase is a qualitative study exploring the prenatal care experiences among pregnant women. In this phase, the subjects will be selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. Finally, the conventional content analysis approach will be employed for data analysis. The second phase is quantitative and will be used as a cross-sectional approach for assessing the association between psychological factors of self-care. In this regard, a multistage cluster sampling method will be used to select 215 subjects who will be visited in health care centers of Tabriz, Iran. The third phase will be focusing on developing a prenatal care guideline and Strategies, using the qualitative and quantitative results of the previous phases, a review of the related literature, and the nominal group technique will be performed among experts. DISCUSSION: The present research is the first study to investigate the prenatal care experiences and factors influencing self-care among pregnant women during COVID-19 pandemic. For the purposes of the study, a mixed-methods approach will be used which aims to develop strategies for improving health care services. It is hoped that the strategy proposed in the current study could lead to improvements in this regard. ETHICAL CODE: IR.TBZMED.REC.1399.003.