Study of Complexity Systems in Public Health for Evaluating the Correlation between Mental Health and Age-Related Demographic Characteristics: A General Health Study.

The main objective of this study is to evaluate the quality of nurses' work lives and mental health during outbreaks. We also use the General Health Questionnaire-28 and Walton's QWL technique to assess the association between these two and their dimensions with demographic variables and each other. First, 165 nurses from COVID-19 medical centers in Iran filled surveys for this research. In an SPSS program, the data were examined. There was a strong link between mental health and age-related demographic factors. There was no evidence of a link between the quality of nurses' work life and their psychological health. However, there was a strong link between somatic symptoms and fair and appropriate compensation, as well as constitutionalism. The worst situations for work life quality were linked to the whole living area dimension. In contrast, the worst conditions for mental health were linked to the somatic symptoms dimension.

Experiences of teachers, educators, and school counselors about the sexual and reproductive health of educable intellectually disabled adolescent girls: a qualitative study.

BACKGROUND: Adolescents with intellectual disabilities are probably twice as many people without intellectual disabilities to be sexually abused by family members, caregivers, close relatives, and others in the community. Sex education and training are essential components of children's and teenagers' education and human rights, as well as a source of worry for parents and society. While the parents are thought to be the most accessible choice as sexual educators, they often do not fulfill this role. Therefore, professional teachers and trainers who have undergone sex education courses for mentally retarded adolescents are more reliable sources to provide the sexual information in terms of their educational role. This study aimed to determine the experiences of teachers, educators, and school counselor parents regarding the sexual and reproductive health of educable intellectually disabled adolescent girls. METHODS: This was a qualitative content analysis study. 35 participants were selected via purposive sampling with maximum variation, and data were collected through in-depth individual interviews, focus group discussions and field notes, and analyzed using the conventional qualitative content analysis method simultaneously. RESULTS: Three subcategories have emerged: "knowledge and professional experience of teachers, educators, and school counselors with how to educate and care for adolescent sexual health", "proficiency of teachers, educators, and school counselors in guiding families in solving their child's sexual problems", "attitude of teachers, educators, and school counselors towards sexual behaviors and sexual education of adolescents" which formed the main category of "teachers, educators, and school counselors' inefficiency in maintaining ID adolescent girls' sexual and reproductive health". CONCLUSIONS: Teachers, educators, and school counselors encounter a variety of issues related to the sexual and reproductive health of intellectually impaired teenage females, as a consequence of the findings. As a result, efforts should be made to enhance knowledge and skill development, as well as the evolution of negative attitudes. Therefore, the teaching of sexual guidelines for teenagers with mental impairments should be included in the agenda of the country's educational policies. Teachers and educators should be taught by health experts via the holding of in-service training courses.

Achieving sexual health is a key task to develop health for all people including adolescents. Adolescents with intellectual disabilities are probably twice as many as people without intellectual disabilities to be sexually abused by family members, caregivers, close relatives, and others in the community. The role of schools and educators to manage children's sexual behaviors and provide appropriate training in this field was accepted by most societies. This research aimed to ascertain instructors', educators', and school counselors' perceptions on teenage females with educable ID's sexual health. Participants in the present study were mothers, teachers, educators, and school counselors who were selected via purposive sampling in Isfahan from July 2017 to April 2018. Data were collected from via semi­structured interviews, focus group discussions, and field notes, and analyzed using conventional content analysis. The results showed that teachers, educators, and school counselors face different challenges about the sexual and reproductive health of intellectually disabled adolescent girls. Therefore, it should be attempted to promote knowledge and skill and eliminate negative attitudes and make them aware of the sexual rights of intellectually disabled adolescent girls to protect themselves in different situations.

Comparing the effect of two educational interventions on mothers' awareness, attitude, and self-efficacy regarding sexual health care of educable intellectually disabled adolescent girls: a cluster randomized control trial.

BACKGROUND: Sexual problems of intellectually disabled adolescents are associated with their inability to understand sexuality. Given the important role of parents in forming the attitude of their adolescents towards sexuality, the present study aimed to compare the effect of two educational interventions on mothers' awareness, attitude and self-efficacy regarding sexual health care of intellectually disabled adolescent girls. MATERIALS AND METHODS: This cluster randomized control trial was conducted in six intellectually disabled adolescent education centers in Isfahan, Iran in 2018. The centers were randomly assigned to intervention groups (group training and training through booklet) and control group. Mothers of educable intellectually disabled adolescent girls (n = 81) were entered into the three groups using convenience sampling and their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls were assessed using questionnaires before and after the educational intervention. Data were analyzed using descriptive and inferential statistical methods. RESULTS: The mean score of mothers' awareness, attitude and self-efficacy in each of the "group training", "training through booklet group" and "control group" was significantly different after the intervention compared to before the intervention (p < 0.05). The mean score of mothers' awareness and self-efficacy after the intervention in the "group training" was higher than the "control group" and "training through booklet group" (p < 0.001). The mean score of mothers' awareness and self-efficacy after the intervention in the "training through booklet group" was higher than in "control group" (p = 0.005, p = 0.02). Also, after the intervention, the mean score of mothers' attitude in the "group training" was higher than the "control group" and the "training through booklet group" (p < 0.001), but there was no significant statistical difference between the mean score of mothers' attitude in "control group" and "training through booklet group" (p > 0.05). CONCLUSION: Implementation of the group training intervention for mothers of intellectually disabled adolescent girls in comparison with training through booklet was associated with a greater increase in their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls. Therefore, group training is suggested as a suitable way to educate mothers about sexual health care of intellectually disabled adolescent girls. Trial registration IRCT, IRCT20160224026756N5. Registered 22 June 2018, https://en.irct.ir/user/trial/31704/view .

Evaluating the related factors to healthimprovement style and the value of health among middle aged women referring to comprehensive health centers of Isfahan in 2016 / Evaluar los factores relacionados con el estilo de mejora de la salud y el valor de la salud entre las mujeres de mediana edad que se refieren a los centros de salud integrales de Isfahan en 2016

Introducción. El presente estudio se realizó para evaluar los factores relacionados con el estilo de vida de mejora de la salud y el valor de la salud entre las mujeres de mediana edad. Material y Métodos: El presente estudio fue una investigación descriptiva-correlacional que se realizó con la participación de 278 mujeres de mediana edad que remitieron a los centros de salud de Isfahan y fueron seleccionadas al azar en 2016. Los datos se recopilaron mediante el cuestionario de características demográficas, Walker's Health Promoting Lifestyle Profile II (HPLPII) y un cuestionario realizado por un investigador para el valor de la salud que fueron completados por los participantes. Los datos se analizaron utilizando el software SPSS con prueba de coeficiente de correlación de Pearson, análisis de regresión lineal, prueba de Mann-Whitney y prueba de Wilcoxon. Resultados: De acuerdo con los resultados del presente estudio, hubo una relación directa entre la puntuación del valor de la salud y la puntuación total del estilo de vida y las puntuaciones de todos sus dominios (p <0,05). Hubo una relación significativa entre el empleo de mujeres de mediana edad y los dominios de las relaciones personales y el estilo de vida de crecimiento espiritual y también entre las enfermedades de fondo y el estrés físico y el manejo del estrés del estilo de vida para mejorar la salud (p <0,05). También se observó una relación significativa entre la edad de las mujeres de mediana edad y el valor de la salud y el dominio de la responsabilidad del estilo de vida de mejora de la salud (p <0,05). Conclusiones: Para mejorar el nivel de mejora de la salud y el valor de los estilos de vida de salud entre este grupo de mujeres, es necesario prestar atención a cuestiones tales como el apoyo, la facilitación y los factores personales y sociales en los programas de atención médica para estas mujeres

Introducction. The present study was conducted to evaluate the related factors to health-improvement lifestyle and value of health among middle aged women. Material and Methods: The present study was a descriptivecorrelational research that was conducted with participation of 278 middle aged women who referred to the health centers of Isfahan and were selected randomly in 2016. Data were collected using demographic characteristics questionnaire, Walker's Health Promoting Lifestyle Profile II (HPLPII) and a researcher-made questionnaire for the value of health that were completed by the participants. Data were analyzed using SPSS software with Pearson correlation coefficient test, linear regression analysis, Mann-Whitney test and Wilcoxon test. Results: According to the results of the present study there was a direct relation between the score of value of health and the total score of lifestyle and the scores all of its domains (p < 0.05). There was a significant relation between the employment of middle aged women and the domains of personal relationships and spiritual growth lifestyle and also between background diseases and physical stress and stress management of the healthimprovement lifestyle (p < 0.05). Also a significant relation was observed between the age of the middle aged women and the value of health and the domain of responsibility of the heath-improvement lifestyle (p < 0.05). Conclusions: To enhance the level of the health-improvement and value of health lifestyles among this group of women it is necessary to pay attention to matters such as support, facilitation and personal-social factors in the healthcare programs for these women

The effect of educational classes during pregnancy on the level of sexual satisfaction after delivery in nulliparous women.

BACKGROUND: In the postpartum period, changes in sexual desire and marital satisfaction can be seen. Learning and giving enough information on changes in pregnancy and postpartum can help to increase marital satisfaction. The purpose of this study was to determine the effect of prenatal training on the level of postpartum marital satisfaction in nulliparous women. METHODS: This study is a semi-experimental two-group study in which 150 nulliparous women were divided into two groups: control and intervention groups. The samples into intervention group received routine prenatal care and eight sessions of prenatal education with a training package (educational pamphlet on sexual health and sexual issues and an educational CD on pregnancy and pelvic exercises), and the control group received only routine prenatal care along with a pregnancy education pamphlet. Marital satisfaction was measured before intervention during pregnancy and 3 months after delivery (after intervention) using the ENRICH Marital Satisfaction Scale. Data were analyzed using t-test, paired t-test, Mann-Whitney, and Chi-square test. RESULTS: There was no significant difference in demographic and obstetric variables and pregnancy status between the two intervention and control groups (P > 0.05). There was no significant difference in marital satisfaction during pregnancy between the two groups (before intervention) (P > 0.05). However, there was a significant difference in the level of postpartum marital satisfaction in the intervention group (P < 0/05). So that, the average marital satisfaction is increased from 52.2 to 64.6. CONCLUSION: The results of this study show that eight sessions of prenatal education class with a training package (educational pamphlet on sexual health and sexuality and training CD of prenatal and pelvic floor exercise) can improve postpartum marital satisfaction in women.

Parental Experiences about the Sexual and Reproductive Health of Adolescent Girls with Intellectual Disability: A Qualitative Study.

BACKGROUND: Intellectually disabled persons, as compared with normal people, experience different changes during the adolescence period including the appearance of secondary sexual characteristics. However, owing to their low intelligence quotient, these changes are usually accompanied by more problems and challenges. The present study was conducted to determine the experiences of parents regarding the sexual and reproductive health of educable intellectually disabled adolescent girls. MATERIALS AND METHODS: This qualitative study was carried out on 52 participants (adolescent girls, parents, teachers, healthcare providers, and managers) who were selected via purposeful sampling in Isfahan between July 2016 and April 2017. Data were collected through semi-structured interviews, focus group discussions and field notes, and analyzed using conventional content analysis. RESULTS: Five sub-categories were extracted: "unawareness about sexual needs of the adolescent girl and her potential vulnerability," "inappropriate actions in directing the sexual behaviors of the adolescent," "insufficient supervision and care over the adolescent's sexual health," "inappropriate actions toward marrying off the adolescent," and "inappropriate actions regarding the menstrual and genital health" which formed the main category of "parents' inefficiency in maintaining adolescent girls' sexual and reproductive health." CONCLUSIONS: Based on the results, parents face different challenges about the sexual and reproductive health of intellectually disabled adolescent girls. Hence, empowering the parents especially mothers through teachers and healthcare providers with the knowledge and skills to maintain the sexual and reproductive health of intellectually disabled adolescent girls would make them emboldened to find the ability to protect themselves in different situations.

A comprehensive sexual health care program for educable intellectually disabled adolescent girls: protocol for a mixed methods study.

BACKGROUND: Protection and promotion of sexual health is of great importance for educable intellectually disabled adolescent girls; since they are prone to high risk sexual vulnerabilities and consequences, such as unwanted pregnancy, sexually transmitted infections, and acquired immune deficiency syndrome. Although the rights of intellectually disabled adolescents have been emphasized through the recent years, their sexual health care is still a challenge for parents, teachers, caregivers, and service providers. This study aims to present a comprehensive sexual health care program for educable intellectually disabled adolescent girls. METHODS: This study is carried out by an exploratory sequential mixed qualitative-quantitative methods approach including three sequential phases. The researcher represents sexual health state of educable intellectually disabled adolescent girls using a qualitative approach. In the onset of the second phase, a comprehensive sexual health care program is designed for educable intellectually disabled adolescent girls. In this regard, in addition to qualitative studies, some related papers and texts are used. The suggested program of expert panel is approved based on prioritization guidelines. Then, in the third phase and after different stages of finalization of the program, its affectability is evaluated regarding improvement of sexual health state of educable intellectually disabled adolescent girls. DISCUSSION: It is expected that from the results of the present mixed methods study, by presenting a comprehensive sexual health program for educable intellectually disabled adolescent girls, lead to improvements in the sexual health of these girls. Moreover, it wants to reduce risky sexual behaviors, sexual abuse and harassment, and their consequences in adolescent girls in order to improve sexual health state of the society. If this program works, it can become one of the leading education and care guidelines for sexual health care of intellectually disabled adolescent girls. TRIAL REGISTRATION: IRCT20160224026756N5 . Registered 22 June 2018.

The relationship of hemoglobin and hematocrit in the first and second half of pregnancy with pregnancy outcome.

BACKGROUND: Considering the relationship of low and high levels of hemoglobin and hematocrit with some pregnancy complications, we decided to study their relationship with pregnancy outcome. This study also aimed to investigate the changes in hemoglobin and hematocrit values during the second and first half of pregnancy and its relationship with pregnancy outcome. MATERIALS AND METHODS: In a prospective cohort study, 520 Iranian pregnant women, aged 15 to 45 years that were supported by health centers in Isfahan, Iran, were recruited using quota sampling method. Exclusion criteria comprised of 36 conditions that were related to the maternal and infant outcomes. Hemoglobin and hematocrit were measured in eligible mothers during the 6(th)-11(th) weeks and 26(th)-30(th) weeks of pregnancy. They were monitored until delivery and the data regarding their pregnancy outcome were collected. FINDINGS: Low levels of hemoglobin during the first half of pregnancy was associated with preeclampsia (p = 0.024). Moreover, low levels of hemoglobin during the second half of pregnancy was associated with the risk of preterm premature rupture of membranes (p = 0.01). In addition, mothers with lower blood dilution, as a physiological process during pregnancy, were more prone to preeclampsia (p = 0.04). CONCLUSIONS: Hemoglobin levels in the first and second half of pregnancy can predict preeclampsia and premature preterm rupture of membranes. Increased hematocrit levels in the second half of pregnancy or lack of reduction of hematocrit levels in the second half compared to the first half can estimate preeclampsia.