The relationship between social determinants of health and girls' age at menarche based on the world health organization model: path analysis.

Objectives: Given the descending trend of menarche age and the effect of social determinants of health on menarche, the present study was conducted to examine the relationship model of social determinants of health with menarche age of girls. Materials and methods: The present cross-sectional study enrolled 840 mothers and their 6-17 year-old daughters in the city of Kashan, Iran (2020). Questionnaires used included: demographic-family questionnaire for mothers and daughters, question about age at menarche, Perceived Social Support, Physical Activity, Socioeconomic Status, Spiritual Health, General Health Questionnaire, the quality of couple's relationship and the family communication pattern. The statistical analysis was performed in SPSS-16, and the relationship model was examined using path analysis method in LISREL-8.8. Results: The girls' menarche age was directly affected by sister's (b = 0.83) and mother's menarche age (b = 0.05), BMI (b = 0.01), physical activity (b = -0.06), conversation orientation (b = -0.002), socioeconomic status (b = -0.01) and maternal general health (b = 0.009). It was also indirectly affected by mother's menarche age, social support, socioeconomic status, and maternal spiritual health and parents relationships. Conclusions: The results showed that the numerous factors affect the girls' age at menarche directly and indirectly. Considering mutual interaction of factors revealed in the proposed model, it is recommended this model be used as an appropriate framework in research, design and implementation of programs relating to adolescent girls.

A systematic review and meta-analysis on dropout of infertility treatments and related reasons/factors.

Dropout of infertility treatments is a common phenomenon and many patients avoid continuing infertility treatments. Determining the total rate of treatment dropout, and related factors was the objective of the present systematic review and meta-analysis study. We performed an electronic literature search in Web of Science, Scopus, Embase, Cinhal, ProQuest and Medline databases and a manual search in Google scholar by using a set of Standard keywords. We included descriptive studies in English or Persian, from August 2000 to 2019. Finally, we extracted data of 25 papers for systematic review and 11 papers for meta-analysis. Data analysed by RevMan software. The results of the meta-analysis analysed by the random-effects model and studies heterogeneity analysed using the I2 calculation index. We tried to control high heterogeneity (because of the small amounts of p value and chi-square and large amount of I2) with statistical methods such as subgroup analysis and using random-effects model. The results showed that factors related to treatment, psychological and demographic/personal factors are the most common factors for dropout. It seems that educational and supportive programs on psychological, financial, therapeutic, demographic and personal factors can play an important role in reducing the incidence of infertility treatment's drop out before completing the course of treatment.

The Effect of Self-care Education Based on Self-efficacy Theory, Individual Empowerment Model, and Their Integration on Quality of Life among Menopausal Women.

BACKGROUND: Menopause has adverse physical and emotional effects on the quality of life. The aim of this study was to determine the effect of self-care education based on self-efficacy theory, individual empowerment model, and their integration on the quality of life among menopausal women. METHODS: In this quasi-experimental study, 186 menopausal women, aged 45-60 years at Kashan health centers entered the study using cluster sampling for health centers and simple random sampling inside each center from the list of the population from December 2019 to March 2020. The intervention was performed in 3 groups, using empowerment training, self-efficacy training, and their integration for 4 sessions each lasting 1-1.5 hours of weekly training. Three study groups were selected from different centers to minimize information exchange. Menopausal women's quality-of-life questionnaire was used to assess the quality of life. Questionnaires were completed pre-intervention and one and three months after completing the intervention. SPSS16 software and ANOVA, Chi-square, and repeated measure tests were used. RESULTS: The mean±SD score of quality of life in pre-intervention measurement was 32.96±10.62 in empowerment, 31.93±12.54 in self-efficacy, and 34.07±11.7 in integrated groups. The intervention was effective in improving the quality of life of all three groups (P values were<0.001 for time, 0.92 for group, and 0.38 for time*group interaction). CONCLUSION: This study showed that empowerment and enhancing self-efficacy could improve menopausal women's quality of life. This can help health professionals to better educate postmenopausal women about self-care in menopausal complications.

Attitude and Participation of Men Regarding Prenatal Care, Childbirth, and Postpartum Care in Kashan City, Iran.

BACKGROUND: Men's involvement in perinatal care has benefits including reduced preterm childbirth, and better development of children. This study was conducted with the aim to determine the attitude and participation of men in prenatal, childbirth, and postpartum care. MATERIALS AND METHODS: This cross-sectional study was performed on 280 men in industrial units in Kashan city, Iran (November 2014-March 2015). The participants were selected using cluster sampling method. They completed a researcher-made three-part questionnaire. The data were analyzed using independent-samples t test and analysis of variance (ANOVA). RESULTS: The mean (SD) score of men's attitude and practice regarding perinatal care were 40.12 (5.00) and 61.65 (6.87), respectively. A significant difference was observed between the practice of men with different education levels (F2,75 = 3.63, p = 0.001). CONCLUSIONS: The participation of men in perinatal care was low. It is recommended that healthcare providers make visits in the presence of husbands and simultaneously provide training for the couples during the perinatal period.

Psychometric properties of the Iranian version of Birth Satisfaction Scale-Revised.

BACKGROUND: The precise measurement of childbirth satisfaction demands a reliable tool specifically designed for maternal care and birth satisfaction. It was designed to measure the degree of women's satisfaction with childbirth. The purpose of the present study was to translate and analyze the psychometric properties of the Birth Satisfaction Scale-Revised (BSS-R) in Iranian women. MATERIALS AND METHODS: This is a methodological cross-sectional study. Five health centers in various regions of Kashan were affiliated to Kashan University of Medical Sciences, Kashan, Iran. Two hundred and twelve mothers who were referred to the health centers and had childbirth during the last year were included. The face and content validity were obtained after backward-forward translation of the Iranian version of BSS-R by 12 faculty board members in midwifery and reproductive health fields. The construct validity of the tool was determined using confirmatory factor analysis on 212 women in the postpartum period. The internal consistency and reliability of the tool was evaluated by Cronbach's alpha coefficient and intraclass correlation coefficient (ICC). The collected data were analyzed in SPSS (version 16.0) and EQS 6.1. RESULTS: The result of face and content validity was minor modifications in some words. Confirmatory analysis results indicated that there was an acceptable fit with a three-factor model. Cronbach's alpha was estimated for the whole tool 0.74, and the alpha of the three subscales ranged from 0.698 to 0.801. ICC for determining reliability was 0.77. CONCLUSION: The Iranian version of BSS-R was a reliable and valid tool for assessing the women's satisfaction with their childbirth care.

Men's educational needs assessment in terms of their participation in prenatal, childbirth, and postnatal care.

BACKGROUND: Despite the importance of men's role in prenatal care and its impact on the outcome of a high-risk pregnancy, in many countries, including Iran, men are not aware of their real needs. Since the first step in designing any health plan is to identify the needs of the target population and that no program can be effective without considering the actual needs of the target group, this study aimed to identify men's educational needs for participation in prenatal, childbirth, and postnatal care. MATERIALS AND METHODS: In this descriptive cross-sectional study, 280 men were selected in Kashan city, Iran, in 2015. The sampling method was cluster sampling. The data collection tool was questionnaire designed based on Mortazavi and Simbar's studies that included demographic characteristics of the subjects (14 questions) and their educational needs in terms of the content of the training program, the training method, trainer, time, place of training, all of which were measured by Likert scale and completed by the interview. Data were analyzed by SPSS software version 16 using descriptive statistics. RESULTS: The findings showed that the mean age of the men participating in the study was 35.15 ± 5.83 years. Most men had high school education (45%). The three most important educational needs of men regarding participation in prenatal and postnatal care were maternal nutrition (87.5%), sexual health (86.8%), and warning signs during pregnancy (81.8%). Men preferred to receive information from a physician (93.2%), before pregnancy (91.8%) in healthcare centers (90%). Family was the most important source of information. CONCLUSION: According to men's suggestions, suitable educational programs must be implemented by physicians in healthcare centers in classes of preparation for labor and childbirth or during prenatal care.

The effect of progressive muscle relaxation and guided imagery on stress, anxiety, and depression of pregnant women referred to health centers.

BACKGROUND: If anxiety and depression do not detect in pregnant women, they may cause complications for the mother, child, and family, including postpartum depression. With regard to the administrative capability of relaxation in health centers, this study was conducted to determine the effect of progressive muscle relaxation and guided imagery on stress, anxiety, and depression in pregnant women. MATERIALS AND METHODS: This randomized clinical trial was conducted on pregnant women in the city of Kashan at 28-36 weeks. At the onset of the study, demographic questionnaire, Edinburgh Depression Scale, and Depression, Anxiety, and Stress Scale-21 (DASS-21) were completed. Providing obtaining score of mild-to-moderate in the stress, anxiety, and depression scale and score of 10 or higher in Edinburgh Depression Scale, individuals were divided randomized to the intervention group (n = 33) and control group (n = 33). DASS-21 was again completed in the 4th-7th weeks of beginning of the study by all women. RESULTS: Analysis of variance with repeated measures indicated significant differences in mean of scores of stress, anxiety, and depression at three different times in relaxation group (P < 0.05) whereas found no significant differences in the mean of scores of stress, anxiety, and depression in the control group. CONCLUSIONS: In this study, relaxation could reduce stress, anxiety, and depression in pregnant women during six sessions. Due to the simplicity and low cost of this technique, it can be used to reduce stress and anxiety in pregnant women and improve pregnancy outcomes.

A comparative study of the effects of problem-solving skills training and relaxation on the score of self-esteem in women with postpartum depression.

BACKGROUND: Self-esteem is a determinant factor of mental health. Individuals with low self-esteem have depression, and low self-esteem is one of main symptoms of depression. Aim of this study is to compare the effects of problem-solving skills and relaxation on the score of self-esteem in women with postpartum depression. MATERIALS AND METHODS: This clinical trial was performed on 80 women. Sampling was done in Mashhad healthy centers from December 2009 to June 2010. Women were randomly divided and assigned to problem-solving skills (n = 26), relaxation (n = 26), and control groups (n = 28). Interventions were implemented for 6 weeks and the subjects again completed Eysenck self-esteem scale 9 weeks after delivery. Data analysis was done by descriptive statistics, Kruskal-Wallis test, and analysis of variance (ANOVA) test by SPSS software. RESULTS: The findings showed that the mean of self-esteem scale scores was 117.9 ± 9.7 after intervention in the problem-solving group, 117.0 ± 11.8 in the relaxation group, and 113.5 ± 10.4 in the control group and there was significant difference between the groups of relaxation and problem solving, and also between intervention groups and control group. CONCLUSIONS: According to the results, problem-solving skills and relaxation can be used to prevent and recover from postpartum depression.