Factors of the childbirth fear among nulliparous women in Iran.

BACKGROUND: Fear of childbirth is an anxiety associated with childbirth, which manifests itself in physical and concentration problems. It is often associated with requesting a cesarean section, and it is prevalent in nulliparous women. This is a study aimed to summarize the published research on the factors for fear of childbirth in nulliparous women in Iran. METHODS: This study was conducted based on the PRISMA statement. A literature search was performed on nine electronic databases (Web of Sciences, Since Direct, Scopus, PubMed, Cochrane Library, ProQuest, and Persian databases including Scientific Information Database, Irandoc, and Magiran) using keywords related to fear of childbirth, factors, nulliparous, and Iran from 2000 to 2020. This study included cross-sectional studies with full-text in English or Persian in Iran. The quality of the selected studies was evaluated independently by two authors and via the STROBE checklist. RESULTS: In this study, 93 articles were identified,13 duplicate articles were excluded, 80 articles were screened by title and abstract, 62 were excluded, and the full-text of 18 articles was assessed for analysis. Of these, 12 were excluded, and six articles were reviewed. Six studies were conducted in different provinces of Iran. Based on the study results, factors of the fear of childbirth in nulliparous women were: biological (the process of labor and childbirth and labor pain, concern for the baby (harm to the baby and baby infirmity), psychological (painful injections during labor and suturing in childbirth), and individual (loss of control during labor). CONCLUSIONS: This study identified four main factors that affect fear of childbirth status in nulliparous women, and concern for the baby was a more common factor in this study. In conclusion, these factors can be reduced by increasing their assurance about child health, training during pregnancy, talking about positive experiences, and holding workshops.

Effect of a health education program on puberty knowledge among visually impaired female adolescent students.

Background: One of the most important aspects of life is reproductive health, which receives less attention in public policy considerations because of its sociopolitical sensitivities. The aim of this study was to evaluate the effect of a designed health education program on knowledge about puberty health among visually impaired female adolescent students during 2011 and 2015. Methods: This quasi-experimental study was conducted on 100 visually impaired female students aged 10 to 19 years. Data collection tool was a researcher-made questionnaire. Participants were recruited using convenience sampling method from Narjes educational center in Tehran. The educational needs assessments survey was used to learn about important issues and problems faced by this group to design effective educational programs. The effectiveness of the designed program was assessed by comparing the students' knowledge at the baseline and at 1-month follow-up. Data were analyzed in SPSS V.21 by using parametric descriptive statistics. The significant level was set as p<0.05 Results: The results showed that the puberty knowledge of participants was increased in all educational domains after intervention compared to the baseline (p<0.05). The knowledge about the onset of puberty changes showed the highest increase (from 2.02 at baseline to 7.51 at follow-up) and the knowledge about personal hygiene had the least change after the intervention (from 6.67 to 8.23). The majority of students did not have any information resources regarding puberty health, and about one quarter of them reported their mother as the main resource of puberty information. Conclusion: Providing educational programs during puberty has a crucial role in young girls' knowledge increase. Providing a continuous health educational program that is tailored to the needs of this group of students using suitable strategies is recommended.

Evaluating the Consistency Between Conceptual Frameworks and Factors Influencing the Safe Behavior of Iranian Workers in the Petrochemical Industry: Mixed Methods Study.

BACKGROUND: Unsafe worker behavior is often identified as a major cause of dangerous incidents in the petrochemical industry. Behavioral safety models provide frameworks that may help to prevent such incidents by identifying factors promoting safe or unsafe behavior. We recently conducted a qualitative study to identify factors affecting workers' unsafe behaviors in an Iranian petrochemical company. OBJECTIVE: The aims of this study were to (1) conduct a review of the relevant research literature between the years 2000 and 2019 to identify theoretical models proposed to explain and predict safe behavior in the workplace and (2) to select the model that best reflects our qualitative findings and other evidence about the factors influencing safe behaviors among petrochemical workers. METHODS: This research used mixed methods. Initially, we conducted a qualitative study of factors that Iranian petrochemical workers believed affected their safety behavior. Four themes emerged from the semistructured interviews: (1) poor direct safety management and supervision; (2) unsafe workplace conditions; (3) workers' perceptions, skills, and training; and (4) broader organizational factors. Electronic databases, including PubMed, Embase, Scopus, Google Scholar, EBSCOhost, and Science Direct, were then searched for eligible studies on models to explain and predict safe behaviors, which were published between the years 2000 and 2019. Medical subject headings were used as the primary analytical element. Medical subject headings and subheadings were then extracted from the literature. One researcher conducted the search and 3 researchers performed screening and data extraction. Then, constructs described in each study were assessed to determine which were the most consistent with themes derived from our qualitative analysis. RESULTS: A total of 2032 publications were found using the search strategy. Of these, 142 studies were assessed and 28 studies met the inclusion criteria and were included in the review. The themes identified in the qualitative study most closely matched 3 scales included in Wu et al's model that measured safety behavior and performance, safety leadership, and safety climate in petrochemical industries. Poor direct safety management and supervision matched with safety leadership and its subscales; unsafe workplace conditions matched with safety climate and its subscales; workers' perceptions, skills, and training matched with safety performance and its subscales; and broader organizational factors matched with some subscales of the model. CONCLUSIONS: This is the first literature review to identify models intended to explain and predict safe behavior and select the model most consistent with themes elicited from a qualitative study. Our results showed that effective safety leadership and management and safety climate and culture systems are the most frequently identified factors affecting safe behaviors in the petrochemical industry. These results can further help safety researchers and professionals design effective behavior-based safety interventions, which can have a more sustainable and persistent impact on workers' safety behaviors. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20170515033981N2; https://www.irct.ir/trial/26107. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-019-7126-1.

Factors associated with unsafe work behaviours in an Iranian petrochemical company: perspectives of workers, supervisors, and safety managers.

BACKGROUND: The petrochemical industry is hazardous, in part because of the inherently dangerous nature of the work conducted, and incidents frequently result in significant financial and social losses. The most common immediate cause of incidents and injuries in this industry is unsafe worker behaviour. Identifying the factors encouraging unsafe work behaviours is the first step in taking action to discourage them. The aim of this study was to (a) explore workers', supervisors' and safety managers' attitudes and perceptions of safety in a petrochemical company in Iran, and (b) identify the factors that discourage safe work behaviours. METHODS: A qualitative study was conducted by applying the steps described by Graneheim and Lundman (2004). Twenty participants were recruited from an Iranian petrochemical company using a multi-stage approach, with initial purposive sampling followed by snowball sampling to enhance recruitment. Individual face-to-face and semi-structured interviews were conducted to gain an in-depth understanding of factors acting as barriers to safe behaviour. The interviews were recorded and transcribed in Persian and then translated into English. Conventional content analysis was performed. RESULTS: The main themes emerging from the interviews were: (i) poor direct safety management and supervision; (ii) unsafe workplace conditions; (iii) workers' perceptions, skills and training; and (iv) broader organisational factors. CONCLUSIONS: The findings give insights into practical organisational measures that can be implemented by management to promote workers' commitment to safety and engage in safe behaviours in their workplace. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT20170515033981N2 . Retrospectively registered 19 June 2018.

A randomised controlled trial of an educational intervention to promote safe behaviours in petrochemical workers: a study protocol.

BACKGROUND: The worldwide concern about safety has created a need for new and effective strategies to improve safety in the workplace. Based on reported studies, approximately 90% of workplace accidents are due to unsafe behaviour and human error. Therefore, the most important strategy in reducing the rate of these accidents is training workers regarding safe behaviour and avoiding human error. There is limited research on understanding the barriers to promoting safe behaviour amongst petrochemical workers. This paper presents a protocol for an intervention study, using training sessions in combination with an educational software (application). The intervention aims to both promote workers' safe behaviour and reduce the rate of occupational accidents. METHODS: One hundred seventy-six workers will be recruited to this study from an Iranian petrochemical industry. The study is Mixed Methods Research (MMR) which will be carried out in two phases. In the first phase, using a qualitative approach, in-depth interviews will identify the causes of unsafe behaviour in the petrochemical industry. In the second phase, models of safe behaviour used in workplaces and the petrochemical industry will be investigated. The findings of the first phase will be matched with the constructs of these models to produce a well-suited conceptual model. Questionnaires and an educational intervention will be designed based on the results of the two phases. The workers will receive training interventions using direct methods, involving training sessions and workshops, and in an indirect method for which educational software will be designed. A randomised controlled trial (RCT) will assess comparability between the intervention group and the control group at baseline, after the intervention, and at a three-month follow up. DISCUSSION: This research will provide a practical approach for promoting safe behaviours and reducing occupational hazards amongst industrial workers. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT20170515033981N2 . Registered 19 June 2018.

The paradox of acceptance: A content analysis of Iranian married female adolescent in confronting pregnancy.

Adolescent pregnancy is a major health problem significantly associated with adverse effects on the health of both adolescents and their newborns. However, there is a lack of clarity over adolescent pregnancy from adolescents' perspective, particularly in the low- and middle income countries including Iran. This study aimed to explore the experiences of Iranian married female adolescent in confronting pregnancy. This qualitative research was conducted using conventional content analysis approach. Unstructured interviews with 24 female adolescents (aged 14-18 years) were used for data collection, and data analysis was done simultaneously. In this study, the participants were recruited from urban and rural primary healthcare centers (PHCs). The PHCs were selected randomly from several towns and villages of Guilan Province, Iran. The participants were recruited through a purposive sampling method. After data analysis, four categories were extracted from 24 interviews, including "actively accepting pregnancy", "passively accepting pregnancy", "hope and satisfaction" and "frustration and regret". These categories formed the main theme of "paradox of acceptance" in confronting pregnancy. The concepts that have emerged based on the results of the study can potentially help develop comprehensive and age-tailored health promotion programs to confront pregnancy more successfully for female pregnant adolescents. Further research, particularly on the long-term effects of teenage motherhood is suggested.

The effect of an educational intervention in early pregnancy with spouse's participation on optimal gestational weight gain in pregnancy: a randomized controlled trial.

Gaining weight above the Institute of Medicine recommended range contributes to the development of obesity, which increases risk for diseases. We evaluated the effectiveness of an educational program with the spouse's participation on the optimal gestational weight gain (GWG) in pregnancy. We conducted a randomized controlled trial on 128 nulliparous women attending Najmieh Hospital-Antenatal Clinic based in Tehran-Iran. Participants randomly allocated into two groups of interventions and one control group. In group A, the women received education with their spouse's participation. In group B, the women received education without the participation of the spouses. In the control group, women received only routine prenatal care. Data were analysed by the ANOVA and Chi-square coefficient. The mean of the total GWG in the groups A and B was significantly lower than the control group (13.50 ± 3.85, 13.55 ± 3.20 and 15.53 ± 4.20 kg, respectively, P > 0.05). The rate of optimal GWG in groups A and B was 1.97 and 1.77 times of the control group, respectively (P < 0.05). The percentage of non-optimal GWG significantly decreased (P < 0.05). Groups A and B were not significantly different indicating no effect of spousal presence.

Sexual Life During Pregnancy: Effect of an Educational Intervention on the Sexuality of Iranian Couples: A Quasiexperimental Study.

The sexual life of couples and their needs during pregnancy receive little attention in practice. The aim of this study was to evaluate an educational intervention delivered to pregnant couples to improve their sexual function and satisfaction. This quasiexperimental study was conducted on 128 couples, allocated into two groups of intervention (group A: couples, group B: pregnant women) and one control group (C). Postintervention, the mean of the total score of sexual function and satisfaction of the couples was significantly higher in the intervention groups compared with the control group (p < 0.05). It seems sexuality education specific for prenatal care would be effective.

Brushing behavior among young adolescents: does perceived severity matter.

BACKGROUND: Oral health is a basis for general health and well-being and affects physical and psychological aspects of the human life. The aim of this study was to determine the power of the health belief model in general and the role of perceived severity and its components in particular in predicting tooth brushing behavior among young adolescents. METHODS: This was a cross sectional study of a sample of female students grade four in Rasht (a metropolitan in north Iran) in 2012. A systematic random sampling method was applied to recruit students. They were asked to respond to a designed questionnaire containing items on brushing behavior based on the health belief model. In this study for the first time perceived severity and perceived barriers were divided into two parts, perceived subjective and objective severity and perceived physical and psychological barriers and were treated as independent variables. Logistic regression analysis was performed in order to identify the variables that predict the desirable behavior (brushing twice a day or more). RESULTS: In all 265 female students were entered into the study. Of these, only 17.4% reported that they were brushing at least twice a day (desirable behavior). The results obtained from the logistic regression analysis indicated that perceived objective severity (OR = 0.37, 95% CI = 0.21- 0.66, P = 0.001) and feeling less perceived psychological barriers (OR = 2.60, 95% CI = 1.50- 4.52, P = 0.001) were the significant predicting factors for brushing twice a day. CONCLUSION: The findings suggest that perceived objective severity and perceived psychological barriers play important role in adapting a desirable health behavior among young adolescents.

Effects of lecturing on selfcare oral health behaviors of elementary students.

BACKGROUND: Despite the efforts, the level of dental caries remains prevalent in developed countries; It hasincreased in developing countries due to dietary changes. The aim of this study was to assess the effect of an educational intervention on the oral health of students in Chabahar city. METHODS: This quasi-experimental study carried out on 200 students selected with systematic cluster sampling from schools located in Chabahar city, (100 students in each case and control groups). The data was collected using a questionnaire before the intervention, that was lecturing on oral health, and immediately and 3 months later. Data were analyzed using the SPSS software version 11. RESULTS: The mean age of participants was 11.3 ± 1.3 years. The findings indicated that rate of oral self-care behaviors were significantly increased in the case group compared to the control group after the intervention (tooth brushing for twice a day 69%, Flossing tooth 34%, mouthwash 69%, and regular visiting a dentist 6% in case group versus 47% (p< 0.002), 14% (p< 0.001), 57% (p< 0.03) and 5% (p< 0.007) in the control group (, , , respectively. CONCLUSION: Lecturing is an effective and cheap method on the promotion of oral health preventive behaviors particularly in deprived areas like Chabahar city.

Evaluation of a health education program for head lice infestation in female primary school students in Chabahar City, Iran.

BACKGROUND: An important health problem in students is pediculosis capitis (head lice infestation) which causes physical, mental, and social complications. Social stigma induces feeling of shame, anger, and embarrassment for families and may prevent people from coming forward. METHODS: This study was a quasi-experimental (case - control) study which was done during periods of 2008 - 2009. Data collection tools were questionnaire, checklist, and head examination. Two schools were randomly selected among female primary schools in Chabahar, where 153 students were divided into case and control groups. After collecting the data, an educational program was designed and performed in the experimental group and was evaluated after two months. RESULTS: The results showed a significant difference in knowledge, attitude, and practice of the students in the case group, before and after the intervention (P < 0.0001), but  in the control group it was not significant (P > 0.05) .The infestation rate was 69.3% in the case group before the intervention, and 82.1 % in the control group, which decreased to 26.7% in the case group after the education (P < 0.0001), but there was no significant difference in the control group (P < 0.05). CONCLUSION: The health education program had a positive effect on the reduction of pediculosis capitis among students; thus, it is suggested to perform and evaluate educational programs in students and their parents.

Exercise Effects on Risk of Cardiovascular Disease among Iranian Women.

PURPOSE: Physical inactivity is more prevalent among women than men, varies by ethnic group, and becomes increasingly prevalent with age. The aim of this study was to examine the effects of a 12-week exercise program on the cardiovascular disease risk and fitness of Iranian middle aged women. METHODS: This was a randomized controlled trial study. Participants in the training group (n=20) performed treadmill running exercise at a high intensity (70-80% of maximum heart rate, 0% grade) for 30 min/day, 3 days/week. On the other hand, participants in the control group (n=20) were asked to maintain their habitual lifestyle and not change their activity or dietary habits. Measurements of body mass index, waist/hip ratio, blood pressure, total cholesterol, and lipoprotein subtractions were taken before program and after 12 weeks. Changes in 10-year risk scores for coronary heart disease were calculated using Framingham risk equation. RESULTS: Significant decreases in systolic and diastolic blood pressure, reduction in 10-year risk of coronary heart disease, and reduction in lipid levels were found within the training group between baseline and 12-week measurements. No changes were found in these parameters within the control group. CONCLUSIONS: The study provides evidence for the positive effects of exercise training on the reduction of cardiovascular disease risks among women aged 40-55 years.

Withdrawal users' experiences of and attitudes to contraceptive methods: a study from Eastern district of Tehran, Iran.

BACKGROUND: The aim of this study was to explore withdrawal users' experiences of and attitudes to contraceptive methods in Tehran, Iran. METHODS: This was a cross-sectional study. A sample of women attending a health care center in Tehran, Iran was entered into the study. To collect data structured interviews were conducted. RESULTS: In all 300 women who were using withdrawal took part in the study. Of these, 210 women (70%) indicated that they were used modern contraceptive methods previously. The mean duration for withdrawal use was 6.5 (SD = 4.9) and for modern contraceptive it was 2.3 (SD = 2.9) years. The most common reasons for using withdrawal were: no cost involvement, did not need medical advice, having fewer side effects and easier to use than other methods. The main obstacles to use modern contraceptives were: health concerns, fear of side effects, misinformation, lack of confidence and sexual dissatisfaction. CONCLUSION: The study results suggest that withdrawal users carry misconceptions about modern contraception and exaggerate its related health problems. Indeed these are important issues for the understanding of attitudes and experiences of women in Iran. The findings from this study might be essential for making evidence-based policy decisions, and for planning, monitoring and evaluating reproductive health programs in Iran and elsewhere.