The role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function.

BACKGROUND: Sexual function plays a very important role in the sexual health of people, and the determination of their related factors reflects the importance of paying attention to sexual function in the cultural context. OBJECTIVE: The present study aimed to the role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function. METHODS: In this descriptive-analytical cross-sectional study, 592 married women of reproductive age referring to comprehensive health centers in Rasht city (North of Iran) and eligible for the inclusion criteria were selected by cluster random sampling. The data collection tools were demographic information form, Halbert's Sexual Rights Questionnaires, Women's Sexual Self-Esteem (short form), Halbert's Sexual Desire, and Female Sexual Function Index. Data analysis was done with descriptive and inferential statistical tests at a significant level (p < 0.05). RESULTS: The mean and standard deviation of sexual assertiveness, sexual desire, and sexual self-esteem scores were 56.79 ± 18.24, 49.12 ± 26.04, and 98.52 ± 6.11, respectively. Sexual assertiveness (p < 0.01, r = 0.13), sexual desire (p < 0.001, r = 0.178), sexual self-esteem (p < 0.01, r = 0.34) of the participants with the total score, and all areas of female sexual function had a significant positive correlation. CONCLUSION: Based on the findings, there is a direct and statistically significant relationship between sexual assertiveness, sexual desire, the adaptability of sexual self-esteem, and family income with sexual function in participants. However, the unemployment of the spouse had a negative effect on the female sexual function.

Anxiety, depression, and stress: a comparative study between couples with male and female infertility.

BACKGROUND AND AIM: Although infertility as a significant cause of marital crises is prevalent almost equally in men and women, infertile women are under more pressure and distress than infertile men. Therefore, this study was conducted aiming to compare anxiety, depression, and stress between couples with male and female infertility. METHODS: In this descriptive-analytical cross-sectional study, 40 couples (n = 80) with male infertility and 40 couples (n = 80) with female infertility were referred to the infertility clinic of Al-Zahra Educational and Medical Center, Rasht, Iran. Eligible infertile couples were selected by convenience sampling method. The data collection tool was a two-part questionnaire consisting of a demographic information form and a short form of the standard Depression Anxiety Stress Scale-21 (DASS-21). Data analysis was carried out using descriptive and inferential statistical tests at a significant level of p < 0.05. RESULTS: The severity of depression, anxiety, and stress also had a statistically significant difference between men and women. The severity of depression was mild in 57.5% of infertile women and moderate in 40% of infertile men. The severity of anxiety was moderate in 42.5% of infertile women and mild in 57.5% of infertile men. The severity of stress was Severe in 37.5% of infertile women and mild in 40% of infertile men. There was a statistically significant difference between infertile women and men in terms of depression (t=-4.213, df = 1619, p < 0.001), anxiety (t=-7.261, df = 2274, p < 0.001), and stress (t=-9.046, df = 2308, p < 0.001) subscales, and the total scores (t=-7.709, df = 2315, p < 0.001). The depression, stress and anxiety levels were higher in infertile women than in healthy women with infertile spouses. This difference was statistically significant (p < 0.01). The depression, anxiety, and stress levels were significantly different between infertile men and healthy men with infertile wives (p < 0.001). CONCLUSION: The results of this study indicated that depression, anxiety, and stress were more prevalent in infertile women than in infertile men. The severity levels of depression, anxiety, and stress in the wives of infertile men were higher than those in the spouses of infertile women.

Factors affecting sexual-self-esteem among Iranian women.

Introduction: The quality of marital relationships is positively impacted by women's sexual self-esteem. This study aims to determine the factors that affect sexual self-esteem among Iranian women. Methods: A total of 1176 eligible women who have been referred to comprehensive healthcare centers of Rasht, participated in this analytical cross-sectional study. A stratified two-stage cluster sampling methodology was applied to achieve samples. Data were collected using a validated Persian version of the Sexual Self-Esteem Inventory in Women-Short Form and related factors checklist. Results: The mean sexual self-esteem score of the respondents was 103.97(SD =5.29) in this study. Education level of the woman (B = 2.622, P < 0.032), employment status of the woman (B= 9.24, P < 0.01), duration of the marriage (B = 11.47, P < 0.01), body image (B = 3.446, P < 0.01), childhood sexual abuse experiences (B = -0.363, P < 0.01), was related with sexual self-esteem. The sexual self-esteem score increased with an increase in higher levels of education, employment of women, an increase in the duration of the marriage, and a positive body image. However, there was an inverse relationship between the experience of childhood sexual abuse and sexual self-esteem. Conclusions: The findings revealed that sexual self-esteem in women is influenced by background, intrapersonal, and interpersonal factors that should be approached in education, counseling, and therapy.

Approaches and styles of mothers in sex education process of children and the related factors.

INTRODUCTION: Sex education supports the development of suitable sexual behaviors in children. However, due to the limitations of sexual issues in Iran, parents may have different sex education styles. This study aimed to assess the styles of mothers in the sex education process of children and the related factors. METHODS: In a cross-sectional study, from March to May 2021, 306 mothers with a 4-12-year-old child who were referred to the comprehensive health service centers in Rasht city were entered into the study by a convenience sampling method. The tool was a questionnaire of parents' sex education styles. Data analysis was performed with independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and the multiple linear regression model using SPSS software version 16. RESULTS: The majority of the mothers had a mean age of 36.2 ± 6.4 years. The score of the authoritarian sex education style was significantly higher than the other styles (P < 0.001). According to the multivariate analysis, 40.6% of the changes in the strict style (R2 = 0.406), 32.7% of the changes in the permissive style (R2 = 0.327), and 36.1% of the changes in the authoritative style (R2 = 0.361) were explained by the personal characteristics of the participants. CONCLUSION: The authoritative style was a dominant sex education style. Identifying the factors associated with types of child sex education styles has an important role in promoting the health of children and the community. It is recommended that nursing policymakers identify related factors of sex education styles in mothers of different cultures, and therefore, implement training programs for empowering mothers.

Factors Associated With Domestic Violence Against Peri- and Postmenopausal Women.

The goal of the study was to determine factors associated with domestic violence in menopausal women. This was a cross-sectional study that 350 menopausal women participated. Data gathering used a World Health Organization's violence against women instrument. Emotional violence was recognized as one of the most experienced types of domestic violence (48%). According to the multivariate logistic regression model, the status of exposure to sexual violence (before marriage) and the partner's substance abuse was the most robust risk factors for domestic violence, while factors such as employment of women and satisfaction of income were protective against domestic violence. This study has highlighted the factors associated with domestic violence that health program managers need to address.

Domestic violence against Iranian pregnant adolescents: protective and risk factors.

Background: Domestic violence is an important health, which has serious impacts on women's health. The study aimed to discover the protective and risk factors of domestic violence among pregnant adolescents. Materials and Methods: In the analytical cross-sectional study, 255 eligible pregnant women aged 14-20 years who have been referred to Al-Zahra Hospital, in northern Iran between September 2020 and March 2022 participated. Demographical characteristics were recorded by a questionnaire. Domestic violence was assessed using the instrument of violence against women. Descriptive statistics were used to describe the basic features of the data. Results: The frequency of physical, emotional, and sexual violence was respectively 13.33%, 23.52%, and 9.01%. The risk factors included the spouse's substance use (OR 2.41, 95% CI 1.25-4.62), spouse's low education (OR 1.41, 95% CI 1.12-3.52), spouse's unemployment (OR 1.14, 95% CI 1.03-1.57) and domestic violence exposure in childhood (OR 1.85, 95% CI 1.46-2.51). Higher education for women was a protective factor for domestic violence (OR 0.70, 95% CI 0.45-0.83). Conclusions: The education level is a protective factor against domestic violence among pregnant adolescents. These results can help to design the most appropriate prevention programs to reduce the risk factors for violence among pregnant adolescents.

Shyness, emotion processing, and objective quality of life among adults with schizophrenia: an ERP study.

Purpose: Although individual differences in temperament have been shown to influence Quality of Life (QoL) among individuals with schizophrenia, there exists considerable heterogeneity in such outcomes suggesting moderating factors. Here we used event-related potential (ERP) methodology to examine whether the processing of facial emotions moderated the association between shyness and objective QoL among adults with schizophrenia.Methods: Forty stable outpatients with schizophrenia completed measures of shyness and QoL. Early visual ERP components (P100, N170) were recorded while participants viewed emotional faces.Results: We observed a significant interaction between shyness and P100 and N170 amplitudes in response to fearful faces in predicting Intrapsychic Foundations QoL. Patients with reduced P100 and N170 amplitudes to fearful compared to neutral faces displayed the lowest QoL, but only if they were also high in shyness. We also found a significant interaction between shyness and ERP latency at the P100 and N170 in response to happy faces. Patients who displayed longer P100 and N170 latencies to happy faces compared to neutral faces and with higher shyness levels scored lower on Intrapsychic Foundations and Interpersonal Relations QoL, respectively.Conclusion: These findings suggest that the neural processing of emotional faces and shyness interact to predict aspects of QoL among outpatients with schizophrenia.

Quality of sleep in women with menopause and its related factors.

Background: Menopausal period is one of the most critical stages of a womans life. Complications of the menopausal period including sleep disorders can affect the physical and mental state of women. As sleep disorder has a determinant role in the quality of life, this study was conducted to evaluate postmenopausal womens quality of sleep and its related factors. Material and Methods: This cross-sectional-analytical study was conducted on 323 postmenopausal women based on convenience and consecutive sampling. The data-gathering tool consisted of two parts; sociodemographic characteristics and the Pittsburgh Sleep Quality Index (PSQI). Data analysis was performed using descriptive and inferential statistical tests at a significance level of p<0.05. Results: Sleep disorder was determined in 49.9% of participants. The mean PSQI score was 5.32 ± 3.881. There was a significant correlation between PSQI and age (ß = 0.29, p < 0.001) indicating that sleep disorder increased with an increase in age. There was a significant correlation between body mass index (ß = 0.599, p < 0.001) and undesired sleep quality. Conclusions: Regarding the presence of sleep disorder in almost half of the study participants, and the relationship between sleep quality and body mass index and age, it is recommended that decision and policymakers design educational consultation interventions to improve the quality and quantity of sleep in menopause women.

Relationship between Primigravid women's awareness, attitude, fear of childbirth, and mode of delivery preference.

INTRODUCTION: Fear of childbirth is the main factor, which has decreased the tendency toward selecting natural birth. The immoderate increase in the number of C-sections has increased maternal and neonatal morbidity and mortality. The present study investigates the relationship between awareness, attitude, fear of childbirth, and mode of delivery preference in Primigravid women referring to healthcare centers in Khorramabad, Iran. METHOD: In this descriptive-analytic study, 179 nulliparous pregnant women with the gestational age of> 2,0 weeks who visited selected healthcare centers in Khorramabad for routine pregnancy care in 2020 were selected in two stages and studied. The data were collected via the childbirth attitude questionnaire (CAQ), awareness, attitude, demographic characteristics, current pregnancy characteristics, midwifery history, and history of infertility treatment questionnaires. The data were analyzed via the Chi-squared test. RESULTS: The participants had a mean gestational age of 33.73 ± 4.71 weeks. There was a significant different between the level of awareness, and mode of delivery preference (p = 0.005). The majority of the participants (57.5%) had a moderate level of awareness about the mode of delivery. There was a significant different between the level of, attitude, and mode of delivery preference (p = 0.001).) Most of the participants (71.5%) had a negative attitude towards the mode of delivery. There was also a significant different between fear of childbirth and mode of delivery preference (p < 0.001), and most of the participants (71.5%) showed fear of childbirth. CONCLUSION: According to the results of this study, the majority of participants had afraid of childbirth, moderate awareness of mode of delivery, and negative attitudes. So, the healthcare providers should pay special attention to the fear of childbirth and the relevant factors during pregnancy.

Factors associated with the reproductive health of women living with HIV in Iran.

BACKGROUND: Insight on reproductive health status in women living with HIV is associated with improved psychological well-being, health behaviors, and physical wellness. The overall aim of this paper is to gain insight into the reproductive health of women living with HIV and related factors. METHOD: An analytical cross-sectional study was carried on women living with HIV (N = 112) attending high-risk behavior consultation centers in Rasht and Tehran, Iran. The sampling of respondents was in the form of consecutive and available. The data gathering including questionnaires that were divided into three parts: sociodemographic and health characteristics, reproductive behaviors information, and reproductive health assessment tool for women living with HIV. RESULT: The sub-dimension of responsible behavior received the highest total mean score (54.27 ± 22.18). The mean scores in the sub-dimension of coping with the diagnosis, life instability, disease disclosure, disease-related concerns, and support needs for self-care were 50.14, 49.23, 44.27, 40.08, 38.25, and 33.25 respectively. CONCLUSION: The results clearly showed that the reproductive health situation of women living with HIV needs particular attention. Strategic planning and context-specific interventions are needed to improve women's access and utilization of reproductive health services.

Tool for the assessment spiritual care after the COVID-19 pandemic: a sequential exploratory study.

Background: The present study aimed to develop a tool to assess spiritual care after the COVID-19 Pandemic. Materials and methods: This study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative phase, through 14 in-depth semi-structured individual interviews with clerics, specialists in Islamic jurisprudence and principles, specialists in education and health promotion, and using the content analysis approach, tool items were designed. Purposeful sampling was performed with maximum diversity of experts and enthusiasts in the field of spiritual health. Results: Content analysis of the data obtained from interviews led to explaining the concept of spiritual care after the COVID-19 Pandemic in four main themes: spiritual care needs, spiritual care characteristics, outcomes of spiritual care, and the challenge of providing spiritual care. The average content validity index of the tool was 0.94. Exploratory factor analysis showed 4 factors that explained more than 62.83% of the variance. The correlation of spiritual cares scale score for COVID-19 Pandemic with spiritual care tool was (0.86, p <0.001). Conclusion: Spiritual care tool is a valid and reliable tool, with 38 items to assess the spiritual care after the COVID-19 Pandemic.

The effect of mobile-based training on maternal breastfeeding self-efficacy: a randomized clinical trial.

Background: The Aim of this study is to determine the effect of mobile-based training on maternal breastfeeding self-efficacy. Materials and Methods: This trial was conducted from November May to December 2020 on 198 women referring to healthcare centers in Guilan, Iran. The samples of this study were selected using the convenience sampling method, and random block sampling was used for the allocation of groups. The data collection tool was a two-part questionnaire including questions about demographic data and Dennis's self-efficacy. The questionnaires were completed before and 8 weeks after the intervention in both groups. Results: The mean and standard deviation of self-efficacy before the education in the experiment and control group were 48.26+ 6.49 and 49.11 + 7.36, respectively. After the education, the experimental group was 53.78 + 12.61 and control group was 41.90 + 17.98. The difference between the pretest and posttest scores indicated that the breastfeeding educational intervention increased the women's self-efficacy in breastfeeding (p<0/001). Conclusion: The results showed that mobile-based training could improve maternal breastfeeding self-efficacy. It is therefore recommended, this training program as an available and convenient method to improve breastfeeding self-efficacy.

Exploring the Structure of a School-Based Sexual and Reproductive Health Education Program: A Qualitative Study.

OBJECTIVE: Training programs on sexual and reproductive health rank among the most effective strategies to empower individuals and engage in self-care in this field. This study aimed to explore the structure of a school-based sexual and reproductive health education program. METHODS: A qualitative, inductive, content-analysis approach was used in this study. Participants were selected through a purposeful sampling method. Data were collected through individual in-depth interviews with 21 students; 7 key informants; and 3 focus group discussions with parents. Interviews were recorded and transcribed into text manually. Data analysis was carried out using the content analysis method and the MAXQDA11 software. RESULTS: Three categories of health services emerged from the analysis of participant experiences: 1) empowerment-based education model; 2) optimal educational characteristics; and 3) adolescent-friendly sexual and reproductive health services. CONCLUSIONS: The study found that sexual and reproductive health education programs for adolescent girls should be based on empowerment, desirable educational characteristics, and adolescent-friendly mechanisms.

Mother-infant relationship and its Predictors.

OBJECTIVE: Creating attachment between mother and infant is an extremely sensitive process in the postpartum period. In this regard, understanding the predictive features of the mother-infant relationship (MIR) can help health care providers in designing and implementing MIR enhancement interventions. Therefore, we ran this study to determine the degree of attachment between mother and infant and its predictors. METHODS: This was a cross-sectional study on 406 mothers referred to comprehensive healthcare centers in Rasht. We used the multi-stage cluster random sampling. Our data collection tools included: a data collection form to determine the predictors of maternal and infant attachment, which was designed by researchers and the standard MIRscale. The significance level of the test was considered less than 5%. RESULTS: The mean MIR score was 12.7±8.1. The highest score of attachment between mother and infant was in the area of risk of infant harassment and the lowest score was in the field of the mother-infant bond. The results of the logistic regression test showed that the MIR scores were statistically significant with spouse age, spouse education, number of deliveries, and breastfeeding problems (p<0.05). CONCLUSIONS: The findings showed that there was a significant relationship between MIR and spouse age, spouse education, number of deliveries, and breastfeeding problems. Therefore, attention to these issues should be considered in planning to improve the MIR.

The effect of Matricaria chamomile on menstrual related mood disorders.

OBJECTIVE: A significant percentage of reproductive-age women experience mood symptoms during the days before menstruation that can affect different aspects of a person's life, the use of some medicinal plants can be helpful in controlling premenstrual emotional symptoms. The aim of this study was to evaluate the effect of chamomile capsules on menstrual-related mood disorders. STUDY DESIGN: This clinical trial study was performed on 118 students of Guilan University of Medical Sciences. Participants were divided into two groups of chamomile and placebo. Both groups received one capsule every 8 h for 7 days before the onset of menstrual bleeding. The data collection tool was a Premenstrual Symptoms Screening Tool (PSST). Data analysis was performed using Mann-Whitney, independent t-test, Wilcoxon, and analysis of covariance. RESULTS: According to the results of the Mann-Whitney test Chamomile capsules were more effective than placebo in reducing menstrual-related mood disorders (p < 0/001). The results of the analysis of covariance showed that after controlling the associated variables, the changes in the severity of mood symptoms between the two groups were significantly different (p < 0/05). CONCLUSION: The results of this study show that the use of chamomile capsules can be an effective treatment in alleviating emotional symptoms related to menstrual cycles.

Efficacy of mobile app-based training on health literacy among pregnant women: A randomized controlled trial study.

OBJECTIVE: : Health literacy of mothers during pregnancy shows social and cognitive skills indicating the motivation and ability of mothers to receive and use useful knowledge to maintain and promote the health of themselves and their children. The present study was conducted aimed to determine the effect of mobile app-based training on health literacy among pregnant women. STUDY DESIGN: A random allocation clinical trial was conducted on 140 eligible mothers. All participants were randomly allocated to the experimental and control groups. Data collection tools included personal information and maternal health literacy questionnaires. The questionnaires were completed and then a mobile app-based training intervention was performed for the experimental group. The participants of the experimental group were asked to read the contents of the software once a week for 8 weeks. The questionnaires were completed again after 8 weeks of the training intervention. The data were analyzed using SPSS software version 21. Independent t-test, Mann-Whitney U, Wilcoxon, Fisher, Chi-square, Kruskal-Wallis, and one-way analysis of variance was used for this purpose. RESULTS: The participants showed no statistically significant difference in terms of demographic-social information (p > 0.05). The mean change in health literacy scores after the intervention was statistically significant between the experimental and control groups (p < 0.001). Also, the mean change in health literacy scores before and after the intervention in the experimental group was statistically significant (p < 0.001). But this change in the control group was not statistically significant (p = 0.609). CONCLUSIONS: For the first time we used mobile app-based training and results showed that it is effective in the health literacy of pregnant women especially in situations like the Corona Virus pandemic. Therefore, it is suggested that health care providers, especially midwives, use this training method to promote the health literacy of pregnant women.

The Association between Sexual Self-Efficacy and the Quality of Life among Menopausal Women.

OBJECTIVES: The present study aimed to determine the association between sexual self-efficacy (SSE) and quality of life (QOL) among menopausal women. METHODS: In this analytical cross-sectional study, 558 menopausal women were enrolled. Consecutive and available sampling was performed for the sample collection. The instruments used for data collection included a three-part questionnaire consisting of demographic information, Menopausal-Specific Quality of Life Questionnaire (MENQOL), and SSE questionnaire. RESULTS: Overall, the maximum and minimum scores of SSE were related to sexual desire (2.88 ± 0.60) and orgasm (0.85 ± 0.17). The highest and lowest scores of QOL were related to psychosocial (4.14 ± 1.24) and sexual activity (3.03 ± 1.74) domains. A significant correlation was observed between the QOL and the domains of SSE (P < 0.001). The maximum and minimum correlation of QOL were related to sexual desire (P < 0.001, r = 0.030) and orgasm (P < 0.001, r = 0.108), respectively. Furthermore, a significant correlation was observed between the SSE score and all domains of QOL except for the vasomotor domain. With regard to the SSE score, the maximum association was found with the sexual activity score (P < 0.001, r = 0.466). CONCLUSIONS: Based on the findings of this study, a significant direct correlation was observed between the QOL and SSE of menopausal women. Thus, further research and developing education and consultation as intervention programs for enhancing SSE can promote the QOL among women.

Challenges and strategies to end child marriage.

OBJECTIVES: Child marriage is one of the most important challenges of the current era that threatens women's health and violates human rights. The present study aimed to systematically review studies evaluating the challenges and strategies to overcome child marriage. CONTENT: Medical databases (CINAHL, EMBASE, MEDLINE, EMBASE, PsycINFO, SCOPUS, Web of Science, ProQuest Nursing and Allied Health Source, and Social Science Research Network, as databases for English studies and IranMedex, Google Scholar, SID, Magiran, and Iran Doc as databases for Persian studies) were systematically searched from January 2010 to February 2020. To better identify appropriate studies, reference lists of relevant studies were searched. All potentially relevant abstracts and full-text were screened by two independent reviewers. Disagreements between two reviewers that could not be resolved were resolved via arbitration or consultation of a third author. SUMMARY AND OUTLOOK: From 225 articles included in this review, 16 research articles met our inclusion criteria. Most of the articles were dedicated to negative health outcomes related to child marriage. Ten studies addressed the program of overcoming the Child marriage and six studies reported challenges of it. Although, many studies have shown the efficacy of strategies to decline Child marriage. On the basis of the available evidence, it seems there are a number of obstacles to end Child marriage. To delineate the most effective strategy to end Child marriage is required further research.

Revisiting Shyness and Sociability in Schizophrenia: A Psychometric Examination of Measurement Invariance and Mean Level Differences.

Although there is a long and rich empirical history of demonstrating differences on psychological self-report measures between people with schizophrenia and healthy controls, the question of whether both groups respond to psychological measures in the same way has gone largely unexplored. That is, is there measurement equivalence, or invariance, across the samples? To our knowledge, there have been no published studies on measurement equivalency in personality measures across groups diagnosed with and without schizophrenia. Here we examined the question of measurement invariance on two widely used questionnaires assessing temperament, the Cheek and Buss Shyness and Sociability Scales (CBSHY and CBSOC, respectively) between 147 stable adult outpatients with schizophrenia and 147 healthy age- and sex-matched controls. Results supported measurement invariance of the CBSHY and CBSOC across our clinical and non-clinical groups. These findings suggested that stable adult outpatients with schizophrenia and age- and sex-matched controls respond to the shyness and sociability items in the same way. We found that adults with schizophrenia reported higher levels of shyness and lower levels of sociability than healthy controls, consistent with prior studies. Findings are discussed concerning their relevance more broadly to self-report assessments of personality and psychological traits in clinical populations.