Predictor role of marital conflict on maternal competency with mediating role of perceived stress and concerns during pregnancy: A structural equation model.

AIM: Pregnancy prepares the mother for the transition to motherhood. Maternal concerns during pregnancy cause reduced time spent with the spouse and lack of social support; additional stresses such as marital conflicts could impact maternal competency. This study aimed to assess the predictive effect of marital conflicts with the mediating role of perceived stress and pregnancy concern on maternal competency. METHODS: This was a longitudinal study. It was done on 250 mothers referred to selected health centers in Alborz province. The sampling method was convenient. Marital conflicts, perceived stress, and pregnancy concerns questionnaires were completed in the third trimester of pregnancy, and the maternal competency questionnaire was completed 6 weeks after delivery. Data were analyzed by SPSS software and smart partial least squares. RESULTS: The results of structural equations showed that marital conflicts have a negative and significant effect on maternal competency (ß = -0.14), marital conflicts have a positive and significant effect on perceived stress (ß = 0.42), and marital conflicts have a positive and significant effect on pregnancy concern (ß = 0.31). Also, perceived stress negatively and significantly affected maternal competency (ß = -0.36). DISCUSSION: Results of the study showed the necessities for screening and identifying mothers with conflicts and assessing the perceived stress of mothers will improve the mental health of pregnant mothers and consequently increase maternal competency.

Social networks and internet emotional relationships on mental health and quality of life in students: structural equation modelling.

BACKGROUND: Social networks and relationships create a sense of belonging and social identity; hence, can affect mental health and the quality of life, especially in young people. The present study was conducted to determine the predicting role of social networks and internet emotional relationships on students' mental health and quality of life. METHODS: The present cross-sectional study was conducted in 2021 on 350 students at Alborz University of Medical Sciences selected by convenience sampling. Data were collected using five questionnaires: socioeconomic status, social networks, internet emotional relationships, stress, anxiety, depression scale (DASS-21), quality of life, and a checklist of demographic details. Data were analyzed in SPSS-25, PLS-3, and Lisrel-8.8. RESULTS: According to the path analysis, the DASS-21 score had the most significant positive causal association with internet emotional relationships in the direct path (B = 0.22) and the most negative association with socioeconomic status (B = - 0.09). Quality of life had the highest negative causal association with the DASS-21 score in the direct path (B = - 0.26) and the highest positive association with socioeconomic status in the indirect path (B = 0.02). The mean duration of using social networks (B ≈ - 0.07) and internet emotional relationships (B ≈ - 0.09) had the highest negative association with quality of life. CONCLUSION: The use of the internet and virtual networks, internet emotional relationships, and unfavorable socioeconomic status were associated with higher DASS-21 scores and reduced quality of life in the students. Since students are the future of countries, it is necessary for policymakers to further address this group and their concerns.

Educational needs on safe motherhood from the perspective of suburban women: A qualitative study.

BACKGROUND: Maternal mortality resulting from pregnancy and delivery complications is a sensitive indicator of women's status in the society, access to care services, and sufficiency and quality of healthcare and is the major indicator of a country's developmental status. The present study aimed at determination of educational needs regarding safe motherhood from suburban women's perspective. METHOD: This qualitative study with conventional content analysis approach was conducted in suburban healthcare centers of Alborz University of medical sciences from 23 October to 22 December 2019. The participants included 15 eligible Iranian suburban women who were selected through purposive sampling. The data were collected via in-depth semi-structured interviews and focus groups. Data were analyzes with MAXQDA10 software. RESULTS: Three main themes emerged from the analysis of the data (barriers against safe pregnancy, accountability multidimensional training, and threats and opportunities of distance learning), six categories, 11 subcategories and 547 codes. DISCUSSION: The results indicated that suburban women were less probable to be present in healthcare centers and receive the required information compared to their peers due to their conditions; provision of accessible training services appropriated to their conditions can greatly contribute to elimination of these problems.

Prediction of Stress Urinary Incontinence Using the Retrovesical (ß) Angle in Transperineal Ultrasound.

OBJECTIVES: The accurate, rapid diagnosis of stress urinary incontinence (SUI) in women can profoundly improve their sexual and psychosocial life. In this study, the diagnostic power of SUI was assessed by transperineal ultrasound. METHODS: In this hospital-based case-control study, married women who were referred to the gynecologic and ultrasound wards with negative urinalysis and culture results were enrolled by random sampling. Patients with positive cough signs based on the urodynamic testing data were considered cases, whereas control women showed no cough symptoms and were recruited from the same ward. RESULTS: There was a significant difference (P < .001) in bladder neck descent (mean ± SD, 10.89 ± 5.51 versus 7.08 ± 2.60 mm, respectively; P = .0001) and the retrovesical (ß) angle with the Valsalva maneuver (144.22° ± 19.63° versus 111.81° ± 24.47°; P < .001) between the case and control groups. Also, the ß angle without the Valsalva maneuver was higher in the case group (112.35° ± 23.10°) than the control group (120.17° ± 25.16°; P = .001). There was no case of a urinary leak, urethral diverticulitis, a bladder stone or mass, and cystourethrocele in the patients of each group. The results of multivariate logistic regression with a backward method showed that bladder neck descent (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.09-1.40), the ß angles with and without the Valsalva maneuver (OR, 1.1; 95% CI, 1.06-1.13; and OR, 1.04; 95% CI, 1.01-1.06) were the predictors of SUI. A ß angle higher than 127° with the Valsalva maneuver, with an area under the curve of 0.89 (95% CI, 0.75-0.96), could very well predict the SUI response. This finding shows that it can be very well used to distinguish between normal and non-normal responses, with 89% sensitivity and 79% specificity. CONCLUSIONS: The ß angle with the Valsalva maneuver could very well predict the SUI response.

Effects of counseling professional ethics principles on midwifery professional codes of ethics compliance and applicability rate among midwives in community health centers: a randomized clinical trial in Iran.

INTRODUCTION: Compliance with ethical principles is regarded as one of the key components in providing services in midwifery profession. This study was to evaluate the effects of counseling professional ethics principles on midwifery professional codes of ethics compliance and applicability rate among midwives working in community health centers in the city of Karaj, Iran. METHODS: This randomized controlled trial (RCT) was conducted in 2018 on a total number of 84 eligible midwives in two intervention and control groups, selected through multistage sampling method. The intervention group took part in six counseling sessions but the control group only received a training manual. Both groups then completed the Self-Reporting Questionnaire of Ethical Codes of Reproductive Health Providers (including 95 items in 14 domains) at three time points (before, immediately, and four weeks after intervention). Finally, the data were analyzed using the IBM SPSS Statistics (version 22) software via descriptive and inferential statistics. RESULTS: The findings showed that level of compliance and applicability rate in all 14 domains of midwifery professional codes of ethics were higher in the intervention group (after intervention) than those in the control group and trend of time changes in mean level of compliance and applicability rate of codes of ethics during the three time points were significantly different between both groups (p < 0.001). CONCLUSION: Given the effectiveness of counseling professional ethics principles on midwifery professional codes of ethics compliance and applicability rate among the midwives working in community health centers, designing and applying this counseling approach was recommended to improve quality of reproductive health care services.

The association between diabetes and age at the onset of menopause: a systematic review protocol.

BACKGROUND: Age at the onset of menopause is the most important determinant of women's future health outcomes. While the basic mechanisms contributing to the onset of menopause are still not fully understood, age at menopause depends on a complex set of various factors. In this regard, the effects of diabetes (DM I/II) on the age at the onset of menopause have received little attention. METHODS AND ANALYSIS: Electronic databases including PubMed/MEDLINE, Web of Science, Scopus, EMBASE, and Google Scholar will be searched for articles published during January 2000 to August 2018 and containing combinations of related MeSH terms, i.e., "age at menopause" and "diabetes." Additional studies will also be extracted from the reference lists of the selected papers, gray literature, and key journals in the field. A set of inclusion criteria will be defined, and all eligible observational studies will be included. Two reviewers will independently conduct the study selection, data extraction, and quality assessment of the selected studies. All cases of disagreement will be resolved through consensus. The methodological assessment of the primary studies will be performed based on the Newcastle-Ottawa Scale (NOS). In case of the availability of sufficient data, fixed or random effects models will be used to combine all data. Heterogeneity will be assessed by I 2 statistic and chi-square test. Stata V.11.1 will be used for data analysis (CRD42017080789). ETHICS AND DISSEMINATION: This systematic review will not raise any ethical issues. Journal publication and conference presentations will facilitate the wide dissemination of the findings to relevant clinicians and researchers.