Investigating depression, anxiety, perceived stress and resilience in fathers faced with their spouse's abortion in Iran: a longitudinal study.

BACKGROUND: Abortion is a stressful event that can often affect the mental health of both parents. It seems that resilient people can adapt to stressful situations. The mental health of fathers plays an important role in improving the mental health of the family, but few studies have been conducted in this regard. Therefore, this study aimed to investigate depression, anxiety, perceived stress and resilience of fathers faced with their spouse's abortion. METHODS: This longitudinal study was conducted on 125 spouses of women hospitalized in the post-partum department of Shiraz hospitals in 2023. Data collection tools included questionnaires of demographic and fertility characteristics, hospital depression and anxiety (HADS), Cohen's perceived stress, and Connor's resilience. The data were analyzed through Spss24 software using Friedman's tests and post hoc tests, Adjusted Bonferroni, Kruskal-Wallis and Mann-Whitney tests. RESULTS: The mean age of the fathers was 35.02 ± 6.22. The scores of the father's anxiety, depression, and perceived stress from 24 h to 12 weeks after abortion were decreased significantly. However, their resilience score increased significantly. Also, there was a significant relationship between the fathers' age, education, job, duration of marriage, type of abortion, number and history of abortion, unwanted pregnancy, number of children and economic status with the mean score of anxiety, depression, perceived stress, and resilience in fathers over time. CONCLUSION: This research pointed out the effect of abortion on depression, anxiety, and perceived stress in fathers; also, resilience as a coping factor could affect these disorders and improve the fathers' mental health. Therefore, screening and managing mental disorders in them are important to improve family health.

Paternal postnatal depression: prevalence and the associated demographic and maternal reproductive factors among Iranian fathers.

BACKGROUND: Paternal postnatal depression (PPND) is a critical mental health issue that may harm family members' health and relationships. The Edinburgh Postpartum Depression Scale (EPDS) is the most common self-reported questionnaire for postnatal depression screening among mothers and fathers worldwide. However, identifying fathers with postnatal depression and determining the related factors have been neglected in some countries. AIMS: The present study aimed to determine the prevalence of PPND and then to identify its predictive demographic and reproductive factors. Two cut-off points (10 and 12) for the EPDS were used to detect PPND. METHODS: This cross-sectional study was conducted on 400 eligible fathers selected via multistage sampling. Data were collected using a demographic checklist and the EPDS. RESULTS: None of the participants had previously been screened for PPND. The mean age of the participants was 35.53 ± 5.47 years, and most of them were self-employed and had university degrees. The prevalence of PPND was 24.5% and 16.3% using the EPDS cut-off scores 10 and 12, respectively. An unwanted pregnancy and an abortion history were the predictors of PPND at both EPDS cut-off scores, with gravidity and the number of abortions also being associated with PPND at the cut-off score of 10. CONCLUSION: In line with the related literature, our results revealed a fairly high prevalence of PPND and its related factors. This indicates the need for a screening program for fathers during the postnatal period to detect and adequately manage PPND and prevent its adverse effects.

Association of thyroid function test abnormalities with preeclampsia: a systematic review and meta-analysis.

BACKGROUND: Preeclampsia is a life-threatening disorder during pregnancy and postpartum periods. Preeclampsia can affect the activity of many organs. It is very important because if this disorder is associated with changes in thyroid function, it can affect the results of maternal and fetal tests. Accordingly, the aim of this meta-analysis study was to assess the abnormalities in thyroid function tests in preeclampsia. METHODS: Studies were selected through a systematic search of the MEDLINE/PubMed, Scopus, Web of Science Core Collection, and Google Scholar databases in 31st August 2021. Also, reference lists of review articles and relevant studies were manual-searched to identify other potentially eligible studies. English studies that compared TSH, T4 and T3 of normal pregnant with preeclamptic women (Known to be normotensive before pregnancy; gestational age 20 week or more; singleton pregnancy; no previous history of thyroid dysfunction) were screened. Data sets were screened for eligibility by two independent reviewers. Articles were assessed by the Newcastle-Ottawa Scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels. RESULTS: After reviewing 886 published studies, 63 observational studies were selected and used for this meta-analysis. The study population included 21,528 pregnant women. The findings revealed that TSH (SMD = 1.70, 95%CI: 1.39 to 2.02; p < 0.001) was significantly higher in preeclamptic women. TT4 (SMD = -0.82, 95%CI: -1.16, -0.49; p < 0.001), TT3 (SMD = -0.88, 95%CI: -1.36 to -0.41; p < 0.001) and FT3 (SMD = -0.59, 95%CI: -0.91 to -0.27; p < 0.001) were less in preeclamptic women. There was no statistically significant difference in FT4 between two groups (SMD = 0.002, 95%CI: -0.27 to 0.27; p = .990). The results of publication bias and sensitivity analysis confirmed the reliability and stability of this meta-analysis. The quality of evidence was regarded as moderate, low, and very low for these risk factors according to the GRADE approach. CONCLUSIONS: Findings of this meta-analysis indicated preeclamptic women were more at risk of changes in thyroid function tests. In order to prevent thyroid disorders, it is recommended that thyroid function tests be performed in women with pre-eclampsia.

Development and Psychometric Properties of Pregnant Women's Decision-making Questionnaire for Choosing a Prenatal Care Provider (CPCP-60): A Research From Southwest of Iran.

Background: The selection of a competent prenatal care provider for women is of a major concern. The purpose of this research was to design a questionnaire for pregnant women's decision-making regarding choosing a prenatal care provider and to assess its psychometric properties. Methods: This study used an exploratory mixed method. In the qualitative phase, a semi-structured individual interview was done with 33 participants in Shiraz, Iran. Based on the outcomes of the previous step and the literature study, the items of the questionnaire were designed in the quantitative phase. Then, the Cosmin criteria were developed to consider the psychometric properties of the questionnaire. In order to examine the validity of the CPCP-60 questionnaire, an exploratory factor analysis was performed. Reliability was assessed by the Cronbach alpha coefficient test and retest. Data were analyzed using the SPSS Version 21. Results: The CPCP-60 questionnaire included 60 items. After the exploratory factor analysis, 4 factors were extracted that expressed 60.52% of the total variance: professional and communication skills, personal traits of prenatal care providers, and characteristics of pregnancy and childbirth centers. The content validity index and the content validity ratio were 0.90 and 0.76, respectively. A Cronbach alpha of 0.941 and a test-retest of 0.951 demonstrated excellent reliability for the CPCP-60 questionnaire. The responsiveness and the interpretability were acceptable. The minimal detectable change (MDC) of the questionnaire (9.70) was less than the minimal important change (MIC) (12.91). Conclusion: Considering the reliability and validity of the CPCP-60 questionnaire, and its compatibility to the culture of the Iranian society, it can be used in clinical research to evaluate the decision-making of pregnant women on choosing a competent prenatal care provider in Iran.

Paternal Postnatal Depression During COVID-19 Pandemic: The Role of Health Care Providers.

BACKGROUND: The fast spread of COVID-19 can cause some psychological disorders for men. One of the psychological disorders is paternal postpartum depression (PPD). The aim of the present research was to review studies that have investigated paternal postpartum depression during the COVID-19 pandemic. MATERIALS AND METHODS: For this narrative review, databases such as Google Scholar, Scientific Information Databases (SID), Magiran, PubMed, Web of Science, and Scopus were searched for the full texts of published studies in the Persian and English languages in the period of 2019 to 2021. Finally, 3 articles were selected and reviewed in this study. RESULTS: The results of this review study were classified into 3 main categories such as (1) The psychological status of men during the COVID-19 pandemic, (2) The effect of paternal PPD on children's development and family psychological status during the COVID-19 pandemic, and (3) The role of healthcare providers in the management of paternal PPD. The findings of the studies showed that paternal PPD increases the rate of child maltreatment, maternal depression, and domestic violence. The promotion of the interpersonal skills of healthcare providers with fathers suffering from depression or psychological problems is the determinant factor of successful results. CONCLUSIONS: The results showed that paternal PPD has a wide range of consequences in this pandemic. Therefore, it would be recommended that healthcare staff have close contact with families and screen fathers for paternal PPD during the COVID-19 pandemic.

Assessment of Prenatal Care Providers' Competencies From the Perspective of Pregnant Women: An Iranian Study.

Background: Pregnant women have expectations from their providers; sometimes their expectations are somewhat different from the current situation. Objective: to assess of competencies of prenatal care providers according to the views of pregnant women in Iran. Method: This is a descriptive-analytical study. Sampling were 300 pregnant women. A researcher-made questionnaire with appropriate validity and reliability was used. These competencies were divided into 4 dimensions of professional skills, communication skills, individual characteristics of prenatal care providers, and the characteristics of pregnancy and childbirth centers. Results: The percentage of the expected status of professional skills' score of prenatal care providers (97.17) did not significantly differ from the current status (96.07). Nevertheless, there was a significant difference between the percentages of scores of expected (95.61) and the current statuses (90.89) of communication skills. The percentage of expected status (94.74) and the current status (84.17) scores of individual characteristics of prenatal care providers. The percentages of the expected status scores (95.24) and the status quo (89.61) of characteristics of pregnancy and childbirth centers were a significant difference. Conclusion: It is needed to upgrade some competencies of prenatal care providers. So, providers should focus their efforts on strengthening the expected skills of their pregnant women.

The Viewpoint of Iranian Gynecologists and Midwives on the Expectations of Pregnant Women: A Content Analysis Study.

BACKGROUND: Prenatal care providers play an important role during pregnancy. Because healthcare providers provide comprehensive support to pregnant women, they must pay attention to pregnant women's expectations and efforts to meet their expectations. Understanding of pregnant women's expectations is associated with continuation of care and improving the health of the community. The present study is carried out to investigate the viewpoints of Iranian gynecologists and midwives on the expectations of pregnant women. MATERIALS AND METHODS: This qualitative study was carried out on 10 prenatal care providers in Shiraz in 2018. Sampling method was purposive. Sampling continued until data saturation. Structured, face to face and in-depth interviews were used for data collection. Implementation and coding of interviews were performed simultaneously with data collection. The data were analyzed using conventional content analysis approach. The Lincoln and Guba criteria were used to increase the trustworthiness of the data. RESULTS: Two main categories were emerged after analyzing of the data. The main category of "competent prenatal care providers" consisted of three subcategories: professional skills, communication skills, and individual characteristics. Another main category was the "appropriate pregnancy and childbirth centers" that included two subcategories of personnel-facilities and management system. CONCLUSIONS: According to the results, prenatal care providers have been aware that women during pregnancy period expect to have competent providers. Also, they tend that receive pregnancy care and delivery from appropriate pregnancy and childbirth centers.

Midwives' Educational Needs in Iran: A Narrative Review.

BACKGROUND: Midwives have a major role in the improvement of health indicators in every country. In order for midwives to be able to play their role well, they must have sufficient updated knowledge. For this purpose, it is necessary to review their educational needs. The aim of the present research was to review Iranian studies that have investigated midwives' educational needs. MATERIALS AND METHODS: In this narrative review, PubMed, Scopus, Web of Science, Google Scholar, ProQuest, Ovid, SID, and Magiran databases were searched for the full texts of Iranian studies published in Persian and English languages in the period of 2000-2018. Review, descriptive, and interventional articles consistent with the research aim were included in this study. RESULTS: Of the 53 found articles, 23 articles that were relevant to midwives' educational needs in Iran were investigated. The findings of the studies showed that the educational needs of the midwives can be categorized into the four groups of knowledge and performance, communication skills, occupational rules/regulations, and religious rules. CONCLUSIONS: The results showed that midwives in Iran have different educational needs. Because the midwifery practice leads to the promotion of public health, it is imperative that midwives have comprehensive knowledge and the skills necessary for providing optimal care. In order to achieve this, short-term and long-term training programs tailored to the needs of midwives are recommended.

Comparison of Social, Economic and Familial Empowerment in Married Women in Three Cities of Iran.

BACKGROUND: Women's empowerment was defined as their ability to achieve awareness and control their personal, social, economic and political forces aiming at taking measures in order to improve their lives. This study aimed to compare the empowerment of the married women in medical sciences university in social, economic and familial domains in three cities, IRAN. METHODS: This was a descriptive-analytical study conducted in 2016 on 399 married and employed women. Data collection instrument was a four-part questionnaire consisting of demographic, social, economic and familial domains and made by researchers. Collected data were analyzed using SPSS, version 16. Using paired t-test for intra-group and Chi-square and t-test for between groups comparisons. The significance level was set at<0.05. RESULTS: The total score of empowerment in Rasht (126.34±17.51) was more than the two cities of Shiraz (123.46±15.62) and Bandar Abbas (123.42±12.34). There was a significant relationship between the mean score of the total empowerment and monthly income of the participants in Bandar Abbas (P=0.04), and job of their husbands in Rasht (P=0.004). The mean score of family empowerment of the women was significantly interrelated with the number of their children in Rasht (P=0.001), and with the education of the participants' husbands in Shiraz (P=0.002). CONCLUSION: The score of social empowerment in Rasht was more than two other cities. In economic domain, the scores of Rasht and Bandar Abbas were more than those of Shiraz. Scores of Rasht and Shiraz were more than Bandar Abbas in the familial domain. It is useful to carry out qualitative studies aiming at determining the effects of various factors on women's empowerment and strategies for improving it.