Development and psychometric properties of Iranian midwives job satisfaction instrument (MJSI): A sequential exploratory study.

BACKGROUND: Job satisfaction refers to a person's attitude toward his/her job and its various aspects. Job satisfaction improves the quality of service and employees' physical and mental health. The present study aimed to design a valid and reliable instrument to assess Iranian midwives job satisfaction instrument (MJSI). METHODS: This is a sequential exploratory study for tool design. This study in two phases; (qualitative and tool's psychometric evaluation) was conducted in Ilam, Iran, 2019 years. In the first phase, a qualitative content analysis was carried out by in-depth and semi-structured individual interviews with 10 experts. Then, the pool of items extracted from the qualitative phase was completed by reviewing the existing texts and tools. The second phase of the study involved reducing the overlapping items and validating the tool. In order to investigate the construct validity, a cross sectional study was conducted with the participation of 121 midwives with census sampling. Data analysis was performed by SPSS-19 software using exploratory factor analysis and reliability tests (Cronbach's alpha). RESULTS: In the qualitative phase and after reviewing the existing texts and tools by the research team, a 58-item questionnaire was developed and then entered into the psychometric phase. Then, the tool was finalized with five factors, including: 1) communication features, 2) professional features, 3) responsibility aspects, 4) physical-mental aspects and 5) social aspects, respectively. After the psychometric process, by removing the items in different stages, a specific questionnaire was developed to measure the midwives' job satisfaction with 25 items which explained a total of 49.95% of the total variance. Reliability of the tool was approved by Cronbach's alpha = 0.71 and test-retest with 2-weeks intervals, indicating an appropriate stability for the scale (ICC = 0.898). CONCLUSION: The 25-item self-reporting midwives job satisfaction tool had acceptable validity and reliability. We recommend the use of this tool for evaluating the job satisfaction of midwives, as well as management and research purposes.

The effect of sexual health education program on sexual function and attitude in women at reproductive age in Iran.

BACKGROUND: Female sexual dysfunction is a common and often distressing public health problem. This study aimed to determine the effect of the sexual health program on female sexual function and attitude in reproductive age in the west of Iran. MATERIALS AND METHODS: This was a field trial study. A total of 103 women attending health centers were assigned into two groups; an experiment and a control group. Data collection tool involved sociodemographic characteristics questionnaire, sexual female attitude questionnaire, and the Female Sexual Function Index (FSFI), which was completed by participants before and after the implementation of a sexual health education program. Data were analyzed using SPSS software version 22. RESULTS: The results revealed that after the intervention, female sexual function in the experiment group based on the FSFI tool was significantly improved (P < 0.01) in the domains of desire, arousal, orgasm, satisfaction, pain, and the total score compared with the control group. Besides, there was no significant difference between posttest mean score of sexual attitude in the experiment group and control group (P > 0.05). However, a significant difference was found in the mean score of sexual attitudes in the experimental group before and after the intervention (P = 0.004). CONCLUSION: The findings showed that sexual health program was effective in improving women's sexual function and attitude in the experiment group. It is recommended that the effect of other training methods remain to be addressed on women's sexual function and attitude.

Explaining the concept of maternal health information verification and assessment during pregnancy: a qualitative study.

BACKGROUND: Pregnant women use information sources for their own health and health of their children. However, despite the importance of trusting the information sources, pregnant women may not have the ability to verify the maternal health information, which could have negative consequences for their health. The purpose of this study was to explain the concept of maternal health information verification and assessment in pregnant women according to their experiences and perception. METHODS: This is a qualitative study that was conducted in 2017 in Tehran, Iran. The participants in this study consisted of 19 pregnant women who were selected by purposeful sampling. To collect data, semi-structured, in-depth and face to face interviews were conducted with participants and continued until saturation of data. Conventional content analysis method was used to analyze the data and to identify concepts and synthesize them into general classes. MAXQDA software version 10 was used to manage the data. RESULTS: In the process of data analysis, the concept of verification and assessment of maternal health information in pregnancy was explained in two main categories, including "Validity of information resources" and "Reliance on information resources." The category of Validity of information resources had two subcategories of valid and invalid sources, and the main category of Reliance on information resources had two subcategories of indicators of assurance, and confusion and trying to obtain assurance. CONCLUSION: The results indicated that pregnant women used various sources and indicators, as well as different evaluation methods to obtain information and verify it, especially when they are confused. Thus, health authorities and healthcare professionals should provide appropriate programs to familiarize mothers with credible sources, train pregnant women on standards and practices for judging the accuracy of information, and create a safe margin of information.

The association between social support and psychological factors with health-promoting behaviours in pregnant women: A cross-sectional study.

INTRODUCTION: Health promotion is one of the most important aspects in pregnancy, and health-promoting behaviors are one of the major determinants of health under the influence of various factors. This study aimed to determine the association between social support and psychological factors with health-promoting behaviors in pregnant women. MATERIALS AND METHODS: This cross-sectional was performed on 375 pregnant women when they had 24-28 weeks in Ilam, October 2018 to May 2019. Two-stage cluster sampling was performed after checking the inclusion criteria. Data collection tools consisted of four questionnaires that were completed in self-report form. The collected data were analyzed by the descriptive and inferential tests with the SPSS software version 19. RESULTS: The mean score of health-promoting behaviors was 139.87 (21.26) and self-healing and physical activity had the highest and the lowest mean 27.67 (4.84) and 16.29 (4.84), respectively. Linear regression analysis showed a significant difference between different level of stress, anxiety, depression, and social support with health-promoting behaviors (P < 0.001). The results showed that one-point increase in the score of stress, anxiety, and depression led to the 2.2%, 6.1%, and 24.1% reduction of health-promoting behaviors, respectively, and one-point score increase in social support resulted in 40% increase in health-promoting behaviors (P < 0.001). CONCLUSION: A negative association was found between psychological factors and a positive relationship with health-promoting behaviors. Although perceived moderate health promotion behaviors and perceived social support were moderate, they did not have a good status in terms of psychological factors. Given awareness of the issues under study in each region is essential and planning to improve stress, anxiety, and depression, as well as promoting and correcting inappropriate behaviors through planned interventions are required.

A review of barriers and facilitators to mammography in Asian women.

AIM: Breast cancer is the most common cancer among women in Asia and one of the major health problems in most countries in the region. Despite extensive advances in treatment, early diagnosis is one of the main methods for increasing the survival rate. It is necessary to evaluate the barriers and facilitators of screening in different societies. This study was conducted to identify the barriers and facilitators of mammography in Asia. MATERIALS AND METHODS: To identify the barriers and facilitators of mammography in Asia, a comprehensive search was carried out in databases such as Medline, Web of Science Core Collection and Scopus using keywords, including breast cancer, screening, mammography, barriers, facilitators and the names of each Asian country, as well as a combination of these keywords were used to help the search. Full-text, English language and original articles were included in this study. RESULTS: In total, 71 articles were entered into the study. The findings of this study revealed various barriers to mammography in Asian women, including knowledge, sociodemographic factors, cost and insurance, cultural factors, belief, attitude and feeling, fear, pain and embarrassment, self-efficacy, religious, psychological factors, time constraint, fatalism, professional recommendations, communication, social support and access. Also, knowledge, attitude and belief, perceived risk, professional and social factors were found to be facilitators of mammography. CONCLUSION: Knowing the barriers and facilitators to access mammography is the first step in the development of a successful screening program. Awareness and various personal, professional and social factors have emerged as the major barriers to access to mammography in most Asian countries.

Development and psychometric properties of maternal health literacy inventory in pregnancy.

BACKGROUND: Pregnancy is one of the most sensitive and important stages of women's life. Maternal health literacy is the key to achieving a healthy pregnancy. It also affects pregnancy outcomes by improving the quality of health care in this period. The aim of this study was to develop and evaluate the psychometric properties of maternal health literacy inventory in pregnancy (MHELIP). METHODS: This sequential, exploratory and mixed study was carried out in two parts (qualitative study and psychometric evaluation of the tool) in Tehran in 2016-18. The first part involved a qualitative content analysis with a traditional approach using in-depth, semi-structured and personal interviews with 19 eligible pregnant women. Then, the pool of items extracted from the qualitative part was completed by reviewing the existing literature and tools. In the second part, the overlapping items were summarized and the tool was validated. In order to evaluate the construct validity, a cross-sectional study was conducted with the participation of 320 pregnant women. Data analysis was performed by SPSS-19 software using exploratory factor analysis and reliability tests (Cronbach's alpha and ICC). RESULTS: Findings of qualitative part produced a pool of 120 items that reached to 124 items after reviewing the literature. After confirming face and content validity by calculating CVI and CVR for each item, 53 items remained in the pool. Finally, the results of exploratory factor analysis confirmed a tool with 48 items in four factors, explaining 46.49% of the variance of total variables of the tool. Reliability of the tool was approved by Cronbach's alpha = 0.94 and test-retest with 2-weeks intervals, indicating an appropriate stability for the scale (ICC = 0.96). Finally, the tool was finalized with 48 items in 4 dimensions, including "Maternal Health Knowledge", "Maternal Health Information Search", "Maternal Health Information Assessment" and "Maternal Health Decision Making and Behavior". CONCLUSION: The designed tool is a multidimensional, reliable and validated scale for assessing maternal health literacy during pregnancy. This tool can be used to evaluate different aspects of maternal health literacy in pregnant women, which was prepared based on their experiences during a qualitative study.

Relationship between dental plaque formation and salivary cortisol level in pregnant women.

PURPOSE: Understanding how increased level of salivary cortisol contributes to the development of dental biofilm during pregnancy can help inthe prevention of dental caries and periodontal diseases. This study aims to evaluate the relationship between salivary cortisol level and dental biofilm formation in pregnant women. PATIENTS AND METHODS: This descriptive-analytic study was conducted in Hamadan, Iran in 2011. Forty consecutive pregnant women with no history of abortion, stillbirth, or any known physical or psychological disorders at weeks 25 and 33 of gestation were included. Salivary samples were collected for measurement of cortisol levels by Enzyme Linked Immunoabsorbent Assay (ELISA) method. The amount and extension of dental biofilms were determined by using a disclosing agent. Data were analyzed using descriptive and analytical statistics in SPSS version 16. RESULTS: The mean levels of salivary cortisol at weeks 25 and 33 of gestation were respectively, 2.45 ± 1.56 µg/dl and 5.24 ± 4.07 µg/dl which demonstrates a significant difference (P<0.001). Evaluation of dental biofilm at two time intervals revealed a significant increase in amount of dental biofilm at week 33 of gestational period (34.65 ± 10.9% vs. 42.45 ± 12.35%, P<0.001). Elevated levels of dental biofilm were significantly correlated with salivary cortisol levels at week 33 (r=0.494, P=0.001),however, it was not significant at week 25 of gestation (r=0.148, P=0.361). CONCLUSION: The findings suggested that increased levels of salivary cortisol can predict dental biofilm formation and accumulation in pregnant women in the last weeks of gestation.

Do the Fertility Drugs Increase the Risk of Cancer? A Review Study.

Aim: All over the world, many couples cannot conceive a child and have problems with pregnancy. Ovulation-inducing drugs are among the most important drugs used for the treatment of infertility. In recent years, there have been many debates about the relationship between fertility medication and cancer. Due to the lack of comprehensive study of this matter, and as understanding the relationship between the use of fertility drugs and cancer is of importance, the present study was conducted to investigate the relationship between infertility drugs and cancer in women. Materials and Methods: To determine the relationship between infertility treatment and cancer, a comprehensive search was carried out in databases such as; Medline, Web of Science Core Collection, and Scopus using keywords words; "infertility," "ovulation induction," "cancer," "infertility treatment," "ART," "tumor," "controlled ovarian stimulation," "fertility agents," and "neoplasms." Full-text, English language, and original articles were included in this study. Results: In total, 81 articles were entered into the study. The relationship between fertility medications and breast, ovary, endometrial, uterus, colon, thyroid, skin, cervical, and non-Hodgkin's lymphoma cancers were studied. Although the relationship between fertility medications and cancer is theoretically justifiable, most studies have shown that risk of cancer will not increase after fertility treatment. Conclusion: The results of this study did not show that fertility medications increase the risk of cancer among users. In summary, the relationship between infertility treatment and cancer incidence remains an open question.

Ovarian cancer in the world: epidemiology and risk factors.

Aim: Ovarian cancer is one of the most common gynecologic cancers that has the highest mortality rate. Considering the fact that knowledge on the incidence, mortality of ovarian cancer, as well as its risk factors is necessary for planning and preventing complications, this study was conducted with the aim of examining the epidemiology and risk factors of ovarian cancer in the world. Materials and methods: In order to access the articles, Medline, Web of Science Core Collection, and Scopus databases were searched from their start to the year 2018. Full-text, English observational studies that referred to various aspects of ovarian cancer were included in the study. Results: In total, 125 articles that had been published during the years 1925-2018 were entered into the study. Ovarian cancer is the seventh most common cancer among women. Increased risk factors of cancer have led to an upward trend in the incidence of cancer around the world. In 2018, 4.4% of entire cancer-related mortality among women was attributed to ovarian cancer. Although the incidence of cancer is higher among high Human Development Index (HDI) countries, the trend of mortality rate tends to be reversing. Various factors affect the occurrence of ovarian cancer, from which genetic factor are among the most important ones. Pregnancy, lactation, and oral contraceptive pills play a role in reducing the risk of this disease. Conclusion: This study provides significant evidence about ovarian cancer. Considering the heavy burden of ovarian cancer on women's health, preventive measures as well as health education and early detection in high risk groups of women are highly recommended. Although some risk factors cannot be changed, a focus on preventable risk factors may reduce the risk of ovarian cancer. More studies are needed to explore the role of unclear risk factors in ovarian cancer occurrence.

Effect of counseling on sexual function and behavior in postmenopausal women and their spouses: a randomized, controlled trial (RCT) study.

Sexual dysfunction is present the most important problem among menopausal women and thus counseling may have a major role for improving menopausal sexual state in this population. We aimed to assess effects of counseling on sexual function of menopause women and their spouses. An interventional trial study was performed on 120 consecutive Iranian couples (menopause women and their spouses) who were resident in Hamadan, Iran in 2015. The subjects were randomly assigned to receive counseling service (n = 60) or did not receive this service (n = 60). Couples were asked to complete a standardized validated questionnaire assessing sexual function and behaviors. The frequency of sexual intercourse was considerably increased following first and second counseling sessions compared with the time before counseling in former group, while sexually state was remained unchanged in those who not received these counseling. Furthermore, dyspareunia in interventional women with counseling was significantly reduced after the first and second counseling, whereas this complaint was not significantly removed in the control group within the study period. Also, unsuccessful intercourse was significantly decreased in men who received counseling sessions, while this parameter was remained unchanged in other men. In addition, talking with the partner about sexually and Satisfaction degree of wife's love was significantly improved in both men and women in interventional groups compared with the control groups. Active and structured counseling effectively improve sexual functions and behaviors in menopausal women and their spouses.

Quality of life of postmenopausal women and their spouses: a community-based study.

BACKGROUND: Most women spend more than one-third of their lives after menopause. Due to physiologic changes in that period, menopause can cause a series of symptoms such as vasomotor symptoms, psychologic problems, and sexual dysfunction, which can affect the women's quality of life (QoL) and other family members, especially their spouse. OBJECTIVES: The present study aimed to determine the association between the QoL of postmenopausal women and their husbands. PATIENTS AND METHODS: This descriptive-inferential cross-sectional study was conducted according to the census of 2006 in Iran. A total of 400 postmenopausal women aging 50 to 59 years and their spouses in 80 cluster heads of Ilam City residents were selected and studied in collaboration with the Statistical Center of Iran. The required data were gathered using the short-form health survey (SF-36) questionnaire and demographic questionnaire developed by the researcher-trained interviewers. Data were analyzed by SPSS 18 through Kruskal Wallis test, Wilcoxon signed ranks test, and correlation. RESULTS: The participants' mean age was 54.2 ± 2.8 years for women and 61.1 ± 6.1 years for their spouses. More than half of the women (57%) and about one-third of men (32.8%) were illiterate. The employed educated women aging 50 to 54 years had a higher mean score of SF-36 domains. The difference in education was significant in all domains except for mental health. There was a significant difference in age in all domains except in general health. The mean score of all domains of QoL was significantly less in the illiterate men than in the literate ones (P < 0.05). The results of the present study showed a significant correlation (P < 0.05) between the couples' QoL, vasomotor symptoms, and aging. Spearman test showed a significant positive correlation in all domains of QoL between postmenopausal women and their spouses (correlation coefficient, 0.48-0.63). CONCLUSIONS: Based on the results of the present study and other performed studies in this regard, menopause, aging, vasomotor symptoms, and education had significant association with the QoL of postmenopausal women. The reduced QoL in postmenopausal women could eventually lead to the reduced QoL of their spouses. Therefore, it is necessary to plan for the education of these women and their husbands to broaden their understanding of the changes of menopause and ways to improve their QoL.

A comparative study on the efficacy of glucose and sucrose on the vaccination pain: a randomized controlled clinical trial.

OBJECTIVES: This study was performed to compare the effectiveness of two analgesics for the management of vaccination pain. MATERIALS AND METHODS: A total of 90 neonates to be vaccinated against Hepatitis B were assigned to Glucose, Sucrose and control groups at Shahid Mostafa Khomini hospital. 2cc oral Glucose 25% and 2cc oral Sucrose 25% with Syringe were given for 30 sec then 2 min later Hepatitis-B vaccine injected by vaccinator and pain intensity measured by Neonatal Infant Pain Scale (NIPS) during 1-2 min. The third group (control) no intervention was performed. The collected data were analysed by SPSS18 Software and ANOVA and LSD tests were used. RESULTS: Research results showed that there were no significant differences between groups in term of Apgar score, delivery type, sex, head circumstance, weight and height. By comparison of pain severity in two groups, mean and Standard deviation of pain, group that received Glucose solution had more intensity than Sucrose group (3 ± 1.66 vs. 2.90 ± 1.44), but this difference was not significant statistically (p=0.78). Comparison of pain intensity in control and intervention groups showed that the pain intensity in control group is higher than intervention groups (p<0.001). CONCLUSION: Patients who received Glucose or Sucrose had lower pain intensity in comparison with the other. The pain intensity in patients who received sucrose was less than the glucose group, but this difference was not significant statistically.

The effect of oral propranolol plus oxytocin versus oxytocin only on the process and outcome of labor: A double-blind randomized trial.

BACKGROUND: Prolonged labor can lead to maternal and neonatal complications. The purpose of this study was to investigate the effect of oral propranolol plus oxytocin versus oxytocin only on the process and outcome of labor. MATERIALS AND METHODS: In a randomized, double-blind, controlled trial performed in Ilam Mustafa hospital, a total of 146 nulliparous pregnant women at gestational age of 40-42 weeks were randomly allocated to receive 20 mg oral dose of propranolol or placebo plus oxytocin infusion (73 participants in each group). The outcome measures were the mean duration of labor stages, type of delivery, and neonatal outcome. RESULTS: The mean duration of active phase and the second stage of labor were significantly shorter in the propranolol group than in the placebo group on both the first and the second days of induction. The mean duration of third stage of labor was shorter in the propranolol group than in the placebo group, but the difference was not significant statistically on the first (P = 0.159) and second (P = 0.065) days. Frequency of cesarean section deliveries significantly decreased in the propranolol plus oxytocin group compared to the placebo plus oxytocin group (P = 0.005, P = 0.015) on the first and the second days, respectively. No significant difference in the neonatal outcome measures, such as Apgar scores at 1 and 5 min and the need for neonatal intensive care unit (NICU) admission, was found between the groups. CONCLUSIONS: This study showed that oral propranolol is an effective agent in both shortening the labor duration and reducing the frequency of cesarean section.

A comparative study of the attitudes of managers, employees and clients in the field of social barriers of family planning counseling in health care centers of Isfahan in 2012.

BACKGROUND: Appropriate family planning counseling for informed choice, the right and responsible use of contraceptive methods is very important. Various barriers such as social barriers can have the effect on family planning counseling. In addition, investigation of those barriers from the perspective of managers, staff and clients, who are major members in health care system, has great importance. The present study was conducted with the goal of comparing managers', employees', and clients' viewpoints about social barriers in family planning counseling in health care centers in Isfahan in 2012. MATERIALS AND METHODS: This is a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 employees, and 126 clients in medical health care centers in Isfahan in 2012. Managers and employees were selected by census sampling and the clients were recruited through convenient random sampling. The data collection tool was a researcher made questionnaire, which was designed in two sections of fertility and personal characteristics and viewpoint measurement. Descriptive and inferential statistical test were used to analyze the data. RESULTS: The obtained results showed significant difference between mean scores of viewpoints in three groups of managers, employees, and clients concerning social barriers in family planning counseling (P = 0.001). In addition, most of the managers and employees reported social barriers as the barriers in process of family planning in a large level and clients reported it in moderate level. CONCLUSION: The results express the necessity of health services managers' planning to modify or delete social barriers, especially the agreed barriers from the viewpoint of managers and employees that effect on family planning counseling and quality of service provided by them.

Comparison of the perspectives of managers, employees and clients regarding the individual barriers of family planning counseling in healthcare centers of isfahan in 2012.

BACKGROUND: Family planning is a lifestyle that is selected voluntarily and is based on the knowledge, attitude and responsible decision making by couples in order to promote the health and welfare of the family and the advancement of the society. In this regard, family planning counseling plays an important role in making informed decisions if used properly and in a responsible way. Detection of individual barriers in family planning counseling based on the viewpoints of managers, employees and clients who are key participants in the healthcare service provision is a major step towards appropriate planning to modify or eliminate such barriers. OBJECTIVES: The present study was conducted with the goal of comparing managers', employees' and clients' viewpoints about individual barriers in family planning counseling in health care centers in Isfahan in 2012. PATIENTS AND METHODS: This was a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 employees and 126 clients in medical health care centers in Isfahan in 2012. The managers and employees were selected by census sampling, and the clients were recruited through convenient random sampling. The data collection tool was a researcher-designed questionnaire, which was designed in two sections of fertility and personal characteristics, and viewpoint measurement. Descriptive and inferential statistical tests were used to analyze the data. RESULTS: The obtained results showed significant differences between mean scores of viewpoints in three groups of managers, employees and clients concerning individual barriers in family planning counseling. In addition, most of the managers, employees and clients reported individual barriers as an intermediate level barrier in the process of family planning counseling. CONCLUSIONS: Results indicate that subjects in three studied groups hold different views regarding the individual barriers in family planning counseling. This difference in the perspectives may be a factor that affects the quality of the provided services. Therefore, it is necessary for the healthcare providers to consider the main concerns of their clients regarding family planning.

A comparative study on managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012.

BACKGROUND: Organizational and structural obstacles are a group of major obstacles in achievement of appropriate family planning counseling. Detection of these obstacles from the viewpoint of managers, staffs and clients who are key members in health services providing system is a major step toward appropriate planning to modify or delete this group of obstacles. The present study was conducted with the goal of comparing managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012. MATERIALS AND METHODS: This is a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 staffs and 126 clients in medical health-care centers in Isfahan in 2012. Managers and the staffs were selected by census sampling and the clients were recruited through convenient random sampling. The date collection tool was a researcher made questionnaire, which was designed in two sections of fertility and personal characteristics and viewpoint measurement. Descriptive and inferential statistical test were used to analyze the data. RESULTS: The obtained results showed no significant difference between mean scores of viewpoints in three groups of managers, staffs and clients concerning organizational and structural obstacles in family planning counseling (P = 0.677). In addition, most of the managers, staffs and clients reported organizational and structural obstacles as the obstacles in the process of family planning in moderate level. CONCLUSION: The results showed the necessity of health services managers' planning to modify or delete organizational and structural obstacles especially the agreed obstacles from the viewpoint of managers, staffs and clients.