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BACKGROUND: Depression and anxiety are the most common reaction in infertile couples. Several studies have been conducted to examine the psychiatric disorders among infertile and fertile couples. OBJECTIVE: This meta-analysis was conducted to compare the depression and anxiety in fertile and infertile couples in various studies. MATERIALS AND METHODS: The authors searched articles published in multiple databases including World Health Organization, PubMed, Cochrane Library, Scopus, Science Direct, Medline EMBASE and Persian databases including Scientific Information Database (SID) and IranMedx between 2005 and 2017. The main keywords used for searching the databases were: depression, anxiety, infertility, and fertility. Statistical analyses were performed using Comprehensive Meta-Analysis/2.0 software. RESULTS: The authors found 42 related articles after searching the databases. 11 articles entered the meta-analysis after considering the inclusion and exclusion criteria. Finally, eight articles were chosen for the comparison of depression and anxiety, two published articles for the comparison of depression, and one published article to compare anxiety in fertile and infertile couples. The results of the heterogeneity test showed a significant heterogeneity among all articles that were analyzed in this meta-analysis in the field of depression and anxiety. The results showed that depression (p = 0.0001; Hedges'g = 1.21; 95% CI 0.63-1.78) and anxiety (p = 0.00001; Hedges'g = 0.63; 95% CI 0.54-0.73) were higher in infertile couples than fertile couples and that the possibility of a publication bias does not exist in this study. CONCLUSION: The analysis of articles used in this meta-analysis showed that depression and anxiety scores in infertile couples were higher than fertile couples.
RESUMO
INTRODUCTION: The uptake of Pap smear among Iranian women is low, resulting in a high rate of casualties from cervical cancer in Iran. The present study used the Health Belief Model (HBM) and the Stages of Change theory as theoretical frameworks for understanding the predictors of the behaviour of Iranian Women Health Volunteers (WHVs) with respect to cervical cancer screening. METHODS: Data from the 1,253 WHVs were analyzed using path analysis to assess the effects of cognitive factors (including knowledge, perceived susceptibility to cervical cancer, perceived severity of cervical cancer, Pap smear benefits, Pap smear barriers, and Pap smear self-efficacy) on the stages of change for Pap-smear behaviour. RESULTS: The majority of the respondents (71.5%) reported that they had not taken previous Pap smear tests; only 3% had received a regular Pap test. The perceived benefits to cervical cancer screening, the perceived barriers to cervical cancer screening, and the perceived self-efficacy to perform cervical cancer screening emerged as the predictors of cervical cancer screening's stages of change; perceived threat to cervical cancer, however, did not. DISCUSSION: Uptake of regular cervical screening for Iranian WHVs was very low. Different interventions, such as media campaigns and educational interventions could provide an opportunity to improve women's knowledge on cervical cancer and Pap test benefits, address any misconceptions or fears about the procedure of the Pap test, and finally increase the cervical screening uptake by Iranian women.
