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.

Designing and validation of a reproductive health need assessment tool for women experienced domestic violence.

BACKGROUND: Violence as a serious health problem and one of the main manifestations of gender inequality brings about adverse health effects for women. Therefore, it is of utmost importance to recognize the reproductive health status of women subjected to violence in order to provide the health services they need. Considering that one of the ways to determine reproductive health status is the use of valid questionnaires in this field, this study aimed to determine the components of reproductive health in domestic violated women and design a valid and reliable assessment tool. METHODS: The present study was conducted based on a mixed-method design. The first part of the study (qualitative section) was conducted based on conventional content analysis. In this part, unstructured in-depth interviews were conducted with 18 violated women and 9 experts. In the next stage, the item pool was formed and the Reproductive Health Needs of Violated Women Scale was designed based on the review of the literature and the results of the qualitative section with 39 items using the Waltz approach. For psychometric assessment of the above instrument, face and content validity, item analysis, and construct validity were examined using exploratory factor analysis. RESULTS: Based on the results of factor analysis, the four following factors were extracted with a total variance of 47.62: "men's participation", "self-care", "support and health services", as well as "sexual and marital relationships. The internal consistency of the instrument was calculated at α = 0.70-0.89 and α = 0.94 for different constructs and the whole instrument, respectively. Moreover, intra-cluster correlation coefficients were obtained at ICC = 0.96-0.99 and ICC = 0.98 for constructs and the whole instruments, respectively. CONCLUSIONS: Based on the results of the current study, the present scale is a tool that specifically assesses the reproductive health needs of violated women and has appropriate validity and reliability. The results of the assessment using the aforementioned instruments can be of great help in promoting the reproductive health of women subjected to violence.

Violence against women is a significant public health problem, as well as is a fundamental violation of women's human rights. Violence can negatively affect women's physical, mental, sexual and reproductive health. So there is obviously a need to measure this issue to provide necessary services for women experiencing violence. In current work an appropriate instrument was developed on the basis of the qualitative findings and a literature review. For this purpose, the inductive-deductive method was used to design the expressions and items of the tool. Both qualitative and quantitative methods were used to determine face and content validity. The construct validity was investigated by exploratory factor analysis; in this part of study the sample included three hundred and fifty violated women. The final version of the scale have four factors with total variance of 47.62 and 39 items which are evaluated by Likert scale. The current tool was valid and reliable to measure the reproductive health needs in domestic violated women.

Explaining breastfeeding experiences and assessing factors affecting breastfeeding self-efficacy in mothers of premature infants: a mixed method study protocol.

BACKGROUND: Breastfeeding has a great effect on health promotion and disease prevention in premature infants. However, various factors affect the success of breastfeeding process in mothers. The present study aims to: a) explain breastfeeding experiences; b) assess the factors affecting breastfeeding self-efficacy; and c) present a guideline for promoting breastfeeding in mothers of premature infants. METHODS: This mixed-methods study with a sequential explanatory design consisted of three phases. The first phase is qualitative study to explore the breastfeeding experiences in mothers of premature infants. 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 a cross-sectional approach to assess the association of the social determinants of health with breastfeeding self-efficacy in mothers of premature infants. In this phase, the multistage cluster sampling method will be used to select 360 subjects who will be visited healthcare centers in Tabriz, Iran. The third phase focused on developing strategies to increase the ability of mothers to breastfeed their premature infants, using the qualitative and quantitative results of 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 that investigated the experiences of breastfeeding and factors influencing breastfeeding self-efficacy in mothers of premature infants. For the purposes of the study, the mixed methods approach will be used which aimed to develop strategies for the improvement of healthcare services in this regard. It is worth noting that there is no strategic guideline in Iran's healthcare system for the improvement of breastfeeding, especially regarding mothers of premature infants. Therefore, it is hoped that the strategy proposed in the current study can lead to improvements in this regard. ETHICAL CODE: IR.TBZMED.REC.1398.100.