The severity of hypogonadism symptoms and its risk factors among male employees of Tehran University of Medical Sciences.

OBJECTIVES: The current study was conducted to examine the severity of hypogonadism symptoms and their risk factors among the male employees of Tehran University of Medical Sciences (TUMS). METHODS: This cross-sectional study was conducted on 80 male employees aged 40-60 years, with hypogonadism, at TUMS. The participants were selected through census sampling. The data collection tools included the demographic questionnaire and the Aging Male Symptoms (AMS) questionnaire. The participants first completed the demographic questionnaire and then the AMS questionnaire. SPSS statistical software version 22 (Chicago, IL) was used to analyze the data, and one-way ANOVA tests, Pearson's correlation coefficient, and stepwise multivariate logistic regression were applied. RESULTS: Based on our findings, the mean overall score of hypogonadism symptoms was 41.71 ± 9.20. Based on Pearson's correlation coefficient results, there was a statistically significant association between the severity of hypogonadism symptoms and age (p < .001). Furthermore, there were significant associations between the economic status, cigarette consumption and hours of sleep and the severity of hypogonadism symptoms (p < .001). CONCLUSIONS: The current study's results showed that certain factors can affect hypogonadism in males. Thus, it is important to reduce the severity of hypogonadism symptoms and to modify the factors related to this phenomenon.

The Effect of Virtual Education on Midwifery Students' Knowledge of Child Sexual Training.

BACKGROUND: Midwives, as the first family trainers, play a significant role in the proper formation of children's sexual identity. Virtual education allows flexible learning for an unlimited number of students. This study aims to examine the influence of virtual education on midwifery students' knowledge of child sexual training. MATERIALS AND METHODS: This study was conducted as a clinical trial from March 2015 to March 2016, on 75 midwifery students studying in two state universities in Tehran, Iran. By flipping a coin, universities were randomly divided into intervention and control groups. Through census sampling, all students of one university were recruited as the intervention group (40 students) and those of the other university were recruited as the control group (35 students). The education offered to the intervention group included eight 1-h virtual education sessions consisting of PowerPoint, audio and video files. Both groups' knowledge was assessed before and 3 months after the completion of the course. A researcher-made questionnaire was used to measure students' knowledge based on certain scenarios. T-pair and t-test (p < 0.05) were used for within-group and between-group analyses, respectively. RESULTS: The mean score difference of sexual knowledge before and after education was 17.60 and 1.59 in the intervention and control groups, respectively; an independent t-test showed a significantly higher level in the intervention group (t73 = 6.86, p = 0.001). CONCLUSIONS: When in-class learning in the field of child sex training is not feasible for various constraints, virtual education can be used as a feasible and effective method.

Examining the effect of the computer-based educational package on quality of life and severity of hypogonadism symptoms in males.

OBJECTIVE: The objective of this study was to determine the effect of the computer-based educational package on men's QoL and the severity of their hypogonadism symptoms. METHODS: A quasi-experimental study was conducted on 80 male employees. The data collection tool included the 'Aging Male Symptoms' (AMS) and 'Short Form-36' (SF36) questionnaires. Four sessions were held for the intervention group over a period of 4 weeks. Two months after training, QoL and the severity of hypogonadism symptoms were measured in both the intervention and control groups. The data were analyzed with SPSS 22 software and statistical tests, such as χ2, independent t-test, Fisher's exact test, and paired t-tests. RESULTS: Significant statistical changes were observed in the intervention group before and 2 months after the training in the QoL score in the overall dimensions of physical-psychological health and all its domains except for three domains of emotional role, social function, and pain. Furthermore, the paired t-tests showed significant differences between 2 months before and after the training in all the domains and the overall hypogonadism score in the intervention group. CONCLUSIONS: Based on our findings, the computer-based educational package has a positive effect on QoL and reduction of hypogonadism symptoms.

Cervical Cancer Screening in Iranian Women: Healthcare Practitioner Perceptions and Views

Background: Although regular screening for cervical cancer with the Papanicolaou test is an important element for reducing the incidence and mortality of cervical cancer, the actual screening program in Iranian women is not sufficiently comprehensive at present. The purpose of this study was to explore healthcare provider perceptions of factors affecting cervical cancer screening in Iranian women. Methods: In this qualitative study performed from September 2015 to August 2016 in Hamadan, Iran, we conducted semi-structured in depth interviews with 14 healthcare providers selected purposefully. All interviews were recorded, transcribed and analyzed according to a conventional thematic analysis approach. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted from data: "Inefficient management of cervical cancer screening process, Personal and professional characteristics of health care providers, Individual barriers and facilitators, Need for health system authorities to pay attention". Conclusion: Increased official attention to screening, and identifying challenges and providing strategies based on these challenges will help in achieving a successful screening program. It is necessary to attend to professional features of medical science students and increase the skills of interaction with clients in addition to academic training. Efforts should be made to increase trust in healthcare providers regarding the Pap test and receptiveness of society to this screening modality through informing the public, with encouragement through the media.

Sexual function and help seeking for urinary incontinence in postmenopausal women.

Urinary incontinence (UI) is a common condition, especially in middle-aged and older women. UI is known to affect sexual function. Many women with UI do not consult a doctor about their condition. The aim of this study was to determine the relationship of sexual function and help seeking in postmenopausal women with urinary incontinence. This cross-sectional correlation study took place from March to May 2012. The subjects were selected by a clustered sampling method from various zones of Rasht (North of Iran). The data were collected using personal data forms, Questionnaire for Urinary Incontinence Diagnosis, Incontinence Severity Index, and Incontinence Quality of Life questionnaire. Data were analyzed by SPSS17 at the significant level of P < .05 and then were compared by parametric and nonparametric tests. A total of 313 menopausal women aged 45 to 60 years (mean 52.9) were recruited for the study. The mean sexual function score was 31.07 ± 7.52. Only 27.3% of subjects seek care for urinary incontinence. There was a significant correlation between sexual function and help seeking. The results of this study indicate that there is a significant correlation between sexual function and help seeking in postmenopausal women who participated in the present study. Health-care professionals should pay more attention to sexual symptoms of UI and make patients aware of available treatments.

"Stain in life": The meaning of urinary incontinence in the context of Muslim postmenopausal women through hermeneutic phenomenology.

INTRODUCTION: UI is a worldwide chronic condition among postmenopausal women. Little is known about the meaning of lived experiences of urinary incontinence of these women's viewpoints in their context. OBJECTIVE: The aim of this study was to illuminate the experience of Muslim community-dwelling postmenopausal women who were living with urinary incontinence (UI). METHODS: Seventeen women with UI (range: 52-68 years) who had experienced it for more than ten years were interviewed. A phenomenological hermeneutic method was used to analyze and interpret the interview texts. RESULTS: The women's experiences of living with urinary incontinence have been presented in terms of three main themes: disruption of normal functioning, self-imposed restriction, and feelings of despair. Disruption of normal functioning meant emotional, spiritual, physical, and daily life disruption. Self-imposed restriction meant suppression of delights and needs and avoidance of social interactions. Feelings of despair referred to predictions of a bad and dark future of living with urinary incontinence, ambiguity, and hopelessness. The meaning of living with UI has been considered a 'stain in life'. Health care providers should be familiar with the different manifestations of urinary incontinence for early diagnosis and prevention of the negative effects of this condition to improve quality of life. In addition, symbolic interactionism theory can help health care providers to understand the meaning of urinary incontinence for women.

Portrait representation of postmenopausal women's experiences of living with urinary incontinence.

This study explored the meaning of the experiences of community-dwelling postmenopausal women who were born and grew up in a Muslim country when drawing a picture about their lived experiences of urinary incontinence. Hermeneutic phenomenology underpinned the study's interpretive research approach. In-depth, semistructured interviews were conducted in two sessions with nine postmenopausal women. The participants were asked to draw a picture about their lived experiences of urinary incontinence in a self-portrait. Three themes emerged to illuminate the meaning of urinary incontinence, including "disruption of normal functioning," "self-imposed restrictions," and "feeling of despair." Discussion of these themes was presented, and practice and research implications were suggested.

Priority Setting for Improvement of Cervical Cancer Prevention in Iran.

BACKGROUND: Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. METHODS: We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. RESULTS: From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. CONCLUSION: A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran.

Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12): psychometric validation of the Iranian version.

INTRODUCTION AND HYPOTHESIS: Sexual health is an important aspect of women's health. Women with urinary incontinence (UI) and pelvic organ prolapse (POP) have more complaints about sexual dysfunctions than do women without. In Iran, there is no questionnaire to assess sexual function in women who with UI; thus, this study aimed to translate the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and provide evidence for psychometric properties. METHODS: This cross-sectional study was conducted from April 2012 to October 2012 in a sample of women who attended an urogynecology clinic. Participants were divided into two groups (incontinent with or without POP and normal). All types of UI were assessed. The PISQ-12 was translated into Iranian based on international standards, and its reliability was assessed using test/retest reliability and internal consistency. In addition, its validity was evaluated using face and content validity, comparison with known groups, and convergent validity. Both exploratory and confirmatory factor analyses were conducted. RESULTS: Mean participant age was 47.52 years. Cronbach's alpha coefficient was 0.84 for PISQ-12 and 0.70-0.79 for all domains. Pearson's correlation coefficient between PISQ-12 and the Female Sexual Function Index (FSFI) was 0.73. Exploratory factor analysis loaded three factors; confirmatory factor analysis confirmed factor structures. DISCUSSION: This study showed that the Iranian version of PISQ-12 was a short, useful, valid, reliable, and condition-specific instrument to assess sexual function in women with UI/POP.

Quality of life (QoL) and help-seeking in postmenopausal women with urinary incontinence (UI): A population based study.

OBJECTIVE: UI is a common condition among women. UI adversely impacts upon QoL and participation in everyday activities. The aim of this study was to determine the relationship of QoL and help-seeking in postmenopausal women with UI. DESIGN: This cross-sectional correlation study took place from March to May 2012; the subjects were selected by multi stage sampling method from various zones of Rasht City (North of Iran). The data were collected using personal data form, Questionnaire for Urinary Incontinence Diagnose (QUID), Incontinence Severity Index (ISI) and Incontinence QoL questionnaire (I-QoL), data were analyzed by SPSS at the significant level of P<0.05 and then were compared by parametric and non-parametric tests. RESULT: Three hundred and thirteen menopause women aged 45-60 years (mean 52.9) were recruited in the study. Mean QoL score was 46.18 ± 19.91. Only 27.3% of subjects seek care for UI. There was no significant correlation between the QoL and help-seeking. CONCLUSION: According to the findings although QoL was impaired in women with UI, their help-seeking was low. Most of them did not consider UI an important problem; health professionals should educate patients and aware patients of available treatments.

Effect of counseling on quality of marital relationship of infertile couples: a randomized, controlled trial (RCT) study.

BACKGROUND: Infertility is a major cause of marital problems and sexual dissatisfaction. This study was conducted to determine the effects of counseling on infertile couple's marital relationship and sexual satisfaction. MATERIALS AND METHODS: This study was performed as a randomized controlled trial (RCT) in which 100 infertile couples (200 participants) who visited Reproductive Health Research Center Tehran, Iran were randomly assigned into two groups: intervention (n = 50 couples, 50 wives and 50 husbands) and control (n = 50 couples, 50 wives and 50 husbands). Intervention was defined as three counseling sessions per week, each lasting 60-90 min. Counseling in the intervention group was conducted separately for each couple. Demographic characteristics and marital and sexual satisfaction were investigated using three questionnaires through interviews. The outcomes, including changes in marital satisfaction and sexual satisfaction, were compared between the two groups 3 months later. RESULTS: Based on the data collected 3 months after the intervention period, the mean scores of marital and sexual satisfaction in intervention and control groups for wives were 49.62 ± 11.09 versus 54.97 ± 12.64 (P = 0.036) and 36.00 ± 8.37 versus 40.04 ± 7.69 (P = 0.019), respectively. Respective scores for husbands were 45.48 ± 9.55 versus 50.08 ± 11.43 (P = 0.042) and 33.37 ± 7.09 versus 36.63 ± 6.52 (P = 0.025), respectively. It should be noted that higher scores in questionnaires inspecting marital and sexual satisfaction indicate lower satisfaction. CONCLUSIONS: Infertility counseling improves marital and sexual satisfaction in infertile couples.