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Background & Aim: Menopause has been recognized as a critical stage in women’s life. Menopausal symptoms and problems can affect women’s health and well-being. Health promoting behaviors may be useful in alleviating these symptoms. The purpose of this study was to determine the effect of couple counseling on severity of menopausal symptoms in women.
Methods & Materials: In a quasi-experimental study, 80 women with their husbands were selected by the convenience sampling method from health care centers in Zahedan in 2017, and were assigned to either experimental or control group. The data gathering tool included a demographic questionnaire and Menopuse Rating Scale questionnaire. Couple counseling for the intervention group was conducted in four 60-minute sessions. Data were collected before and 12 weeks after the intervention, and analyzed by independent and paired t-test, analysis of covariance and χ2 using the SPSS software version 21.
Results: There was no significant difference between the two groups in terms of demographic variables, but the mean of score changes for menopausal symptoms in the intervention group was -1.42±1.95 and in the control group was -0.10±1.10. The independent t-test showed a significant difference in the mean of score changes for menopausal symptoms in the two groups (P<0.0001).
Conclusion: Given that couple counseling has a positive effect on severity of menopausal symptoms in women, it is suggested that this counseling strategy be integrated into healthcare programs for menopausal women.
 

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Background & Aim: The experience of domestic violence has negative consequences on the mental health of pregnant women, and interventions must be designed to reduce these negative consequences. Therefore, the aim of this study was to determine the effect of supportive-educational intervention on psychological distress among pregnant women subjected to domestic violence.
Methods & Materials: This clinical trial was conducted on 100 pregnant women subjected to domestic violence, referred to comprehensive health centers of Zahedan for receiving prenatal care in 2018. Eligible women were selected by the convenience sampling method and randomly assigned into two groups of intervention and control. The intervention group received four supportive-educational individual sessions during two weeks. The control group received routine care during this period. Data were collected in two groups by the Kessler Psychological Distress Scale (K10) and Hurts, Insults, Threaten, Screams (HITS), before the intervention and four weeks after the intervention. The data were analyzed by statistical tests using the SPSS software version 21.
Results: The results showed that the mean score of psychological distress of pregnant women dropped from 30.9±4.58 to 22.18±3.81 (mean change score -8.72±3.93) in the intervention group and from 25.22±4.15 to 24.06±4.16 (mean change score -1.16±1.48) in the control group. Analysis of covariance demonstrated that there was a statistically significant difference in the mean score of psychological distress of pregnant women exposed to violence between the two groups after the supportive-educational intervention (P<0.001).
Conclusion: The results of this study showed that the supportive-educational intervention is effective in reducing psychological distress in pregnant women subjected to violence. Therefore, it is recommended to integrate supportive-educational interventions into prenatal care for pregnant women subjected to violence in order to improve fetal and maternal health.
 

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Background & Aim: Due to repeat emergency patients, the high quality obstetrics and gynecology triage is essential in the obstetrics and gynecology department. Given the importance of improving the healthcare quality, clarifying the aspects and features of the concept of obstetric triage quality would be helpful for determining criteria and standardization of obstetric triage quality. Therefore, the aim of the study was to explain the quality index of obstetric triage.
Methods & Materials: This qualitative study was conducted using a directed content analysis method on 15 participants. Participants included obstetric triage service providers and key specialists in obstetric triage. The data were collected through in-depth, semi-structured interviews. Data analysis was performed using the MAXQDA software version 10.
Results: At this stage of the study, conducted with in-depth, semi-structured interviews, 824 initial codes and 97 merged codes were extracted. The quality of obstetric triage was explained by three main themes, including process quality, structure quality and outcome. The concept of process quality included 35 codes in two sub-categories: actions and care, interactions and communications. Structure quality included 51 codes in five sub-categories: routine and process of triage, pattern and standard, equipment, physical space, and manpower. Outcome included eleven codes in five sub-categories: waiting time, satisfaction, physical implication, psychological implication, and cost.
Conclusion: The index of obstetric triage quality is influenced by the quality of the process (actions and care, communications), the quality of the structure (routine and process of triage, pattern and standard, equipment, physical space, manpower), and outcome (waiting time, satisfaction, physical implication, psychological implication and cost).
 

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Background & Aim: Some women, throughout their life cycle, experience unintended pregnancy and had to decide on continuing or terminating it. Although the decision-making process always recurs, few studies have so far shed light on this complex, and context-based process. The aim of the present study was to explore Iranian women’s decision-making process to abort or continue an unintended pregnancy.
Methods & Materials: This was a qualitative study using grounded theory approach. Data were collected through unstructured, in-depth interviews with 29 participants in Tabriz from March 2016 to May 2017. The participants were selected through the purposeful sampling method and data collection were continued until reaching data saturation. Data analysis was carried out concurrently with the data collection, using the MAXQDA software version 10.
Results: Data analysis gave rise to four axial categories: “perceived threats”, “resistance mixed with indecision”, “values and supportive resources”, as well as “acceptance and confirmation of decision”. This means that the decision-making process among women with unintended pregnancy initially starts with a perceived threat as a main concern leading to their resistance towards accepting such a pregnancy, then exposure to threats arising from abortion can cause indecision and uncertainty in practicing abortion. In this respect, given the social support, women affected by religious values make efforts to choose the procedure with the least harm and threats and maximum acceptability and confirmability. “Confirmation of decision” is as well the outcome of the interactive process of decision-making.
Conclusion: What can differentiate the theory of decision-making on abortion or continuation of an unintended pregnancy from the general theories of decision-making is its sociocultural confirmability. Social acceptance of abortion and childbearing in line with moral evaluation of fetal development directs the confirmability process of decision-making about unintended pregnancy.
 

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Background & Aim: Menopause is a period in women’s lives with complications and consequences that can reduce the quality of life. The most common complications are vasomotor disorders which can affect sleep, life enjoyment, social activities and work. The usual treatment for these effects is hormone therapy but due to its side effects, most people tend to have complication-free treatments. One of these strategies is nutritional measures. The aim of this study was to determine the effect of group counseling about the nutritional measures of Iranian traditional medicine on vasomotor disorders in postmenopausal women.
Methods & Materials: This clinical trial study with multistage sampling was performed in 2018-2019 on 62 postmenopausal women referred to health center number 2 in Mashhad. Two health centers were selected as control or intervention group by Heads or Tails method in order to prevent the dissemination of the material. The intervention group received three sessions of the group counseling about the nutritional measures of Iranian traditional medicine. There was no intervention for the control group. The data collection tool was a questionnaire on the quality of life in menopause that was completed two months before and after the intervention. Data were analyzed on the SPSS software version 24 using independent t-test, Chi-square, Mann-Whitney, and Wilcoxon tests.
Results: There was no significant difference in the mean score of vasomotor between the two groups before the intervention (P>0.05) but after the intervention, the difference between the mean score of vasomotor before and after the intervention was -2.18±4.08 for the intervention group and 0.59±3.30 for the control group. A significant decrease in the vasomotor score was observed in the intervention group compared to the control group (P<0.001).
Conclusion: Group counseling about the nutritional measures of Iranian traditional medicine can help reduce vasomotor disorders.
Clinical trial registry: IRCT20180626040239N1
 

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Background & Aim: Menstrual health is an important aspect of adolescent health. Most girls do not have proper information about menstrual health, and incorrect information from unreliable sources makes problems for them. Aim of this study was to compare small group-based education with maternal participation and routine education on adolescent girls’ menstrual health behaviors.
Methods & Materials: This randomized clinical trial study was performed on 60 high school students with regular menstruation in the groups of intervention and control. Among high schools in Mashhad in 2018, two schools were assigned to one of two groups by lottery. Menstrual health education was provided to the intervention group in four sessions as the groups of 3-4 people. For mothers in this group, two 2-hour sessions with the same content were held and the students in control group received routine education. Data were collected by a questionnaire on menstrual health behaviors, before the intervention, after the end of the first and second menstrual cycle. Data were analyzed by Mann-Whitney, Chi square and independent samples t-test using the SPSS software version 16.
Results: before the intervention, there was a statistically significant difference in the menstrual health behaviors score (P=0.199). After the intervention, mean score of menstrual health behaviors (the end of the first and second menstrual cycles) significantly increased (P<0.001) for the two groups. Also, mean score of menstrual health behaviors for the intervention group was significantly higher than that of for the control group (P<0.001).
Conclusion: The small group-based education with the participation of mothers in comparison to routine education was more effective in promoting menstrual health behaviors in adolescent girls. This method is recommended to health planners for education of health issues, including menstrual health.
Clinical trial registry: IRCT20180904040952N2
 

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Background & Aim: Gestational diabetes mellitus is the most common medical disorder during pregnancy that has many negative psychosomatic effects on the pregnant women and their fetus. According to existing studies, the role of counseling and husband’s support in gestational diabetes has been less studied, so the present study aimed to determine the effect of couples' supportive counseling on self-care behavior in women with insulin-treated gestational diabetes.
Methods & Materials: In this randomized clinical trial, 64 pregnant women (26-30 weeks of gestation) with gestational diabetes referred to the diabetes clinic of Umm al-Banin Hospital in Mashhad in 2018-2019 were divided into the intervention or control groups using the 4-way blocking method. For the women and their husbands in the intervention group, couples' supportive counseling was conducted by the researcher in the form of three one-hour sessions with one week interval. A diabetes self-care questionnaire was completed in two stages, before and four weeks after the intervention for both groups, and data were analyzed by independent t-test and paired t test using the SPSS software version 16.
Results: There were no statistically significant differences between the two groups in pre-intervention self-care scores (P>0.05). After the intervention, the difference between the mean of self-care scores before and after the intervention in the intervention group was 12.09±7.56 and in the control group was 0.00±3.60, which a significant increase was observed in the self-care score for the intervention group compared to the control group (P<0.001).
Conclusion: Couples' supportive counseling helps to promote self-care behavior in patients with gestational diabetes and can be used as an effective method to reduce the adverse consequences of gestational diabetes.
Clinical trial registry: IRCT20181002041202N1
 

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Background & Aim: Hysterectomy is one of the most common surgeries in women, which causes many physical and psychological complications including anxiety. The aim of this study was to compare the effect of diaphragmatic breathing and pursed lip breathing on anxiety in women undergoing hysterectomy.
Methods & Materials: In this double-blind randomized controlled clinical trial, 126 patients referred to Taleghani hospital of Arak during 2017-2019 were selected by convenience sampling, and then assigned into three groups of diaphragmatic breathing, pursed lip breathing and control using the random number table. Anxiety was measured the evening before the operation (before the intervention), one hour before entering the operating room (after the intervention) and two hours after the operation, using the Spielberger Anxiety Questionnaire. Data were analyzed using descriptive and analytic statistics using the SPSS software version 16.
Results: The mean and standard deviation of anxiety scores for the diaphragmatic breathing, pursed lip breathing, and control groups were 55.33±10.49, 55.4±9.84, and 55.07±11.31 respectively, and there was no significant difference between the groups (P=0.983). One hour before going to the operating room (after the intervention), the mean and standard deviation of the anxiety score was 41.98±8.5, 42.43±7.88, and 52.86±11.5, respectively, and after the operation, the scores decreased to 37.79±8.13, 38.07±8.33 and 50.62±11.35 respectively. There was a significant difference between the three groups (P<0.0001). There was no statistically significant difference in the anxiety scores between the diaphragmatic breathing group and the pursed-lip breathing group after the intervention (P=0.999).
Conclusion: The results of this study showed the diaphragmatic breathing and pursed-lip breathing techniques are effective in reducing hysterectomy anxiety in women. Therefore, using this non-pharmacological approach is recommended to reduce anxiety before and after hysterectomy surgery.
Clinical trial registry: IRCT20180103038211N4
 

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Background & Aim: Tokophobia was introduced as a psychiatric disorder for the first time in 2000. The purpose of this study is to answer four questions: What is tokophobia and how does it occur? What is the global prevalence of tokophobia? What are the symptoms of tokophobia? and what are the strategies for the control and treatment of tokophobia?
Methods & Materials: This systematic review was conducted by searching articles in English and Persian published between January 2000 and January 2018 on international databases; PubMed, Scopus, Web of Science, Google Scholar, Science Direct, and domestic databases; Magiran and SID, along with a manual search in resources.
Results: After reviewing 151 articles, finally 16 were included in the study. The results indicate that tokophobia is a severe and pathological fear of childbirth. In the categorization of psychiatric disorders, it is classified as a specific phobia based on the Diagnostic and Statistical Manual of Mental Disorders, 4^th edition (DSM-IV). The etiology of tokophobia is multifactorial, and its prevalence in pregnant women was reported around 14 percent among 18 countries. The signs and symptoms of the disorder are insomnia, crying, restlessness, depression, anxiety and severe worry about childbirth. Psychological strategies, cognitive behavior therapy and medication have been proposed to reduce the fear of childbirth in women in different studies.
Conclusion: As a guide, these results can assist the healthcare team members to recognize and screen at-risk women as well as to perform nursing interventions and psychotherapy in the prenatal and delivery stages.
 

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Background & Aim: Physical activity is a health behavior that helps one's mental and general health, improves the health of women during preconception period and reduces pregnancy and birth complications. The aim of this study was to predict physical activity based on the BASNEF model constructs during preconception period among women referred to Uremia health centers.
Methods & Materials: This cross-sectional study was conducted on 230 women during preconception period, who were selected using the multistage sampling method in 2018. The data collection tool was a researcher-made questionnaire containing sociodemographic information, the BASNEF model constructs, and a short form of the international physical activity questionnaire. Data were analyzed using logistic and linear regression and t-test through the SPSS software version 16.
Results: The results showed that 61.3% of women had low levels of physical activity. Knowledge (β=0.2, P<0.003), attitude (β=0.15, P<0.017), and enabling factors (β=0.18, P<0.004) significantly explained their intention to do physical activity. Also, among the predictive variables, knowledge (P<0.001) significantly explained physical activity.
Conclusion: Low rate of women's physical activity during preconception period calls for designing an intervention based on BASNEF model in order to influence knowledge, attitude and enabling factors.
 

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Background & Aim: Pregnancy and childbirth is one of the most important events in the life of every woman that can be a memorable experience with positive consequences for the mother and the baby, under support of others, especially the spouse. Numerous interventions to promote men's participation have been conducted during this period. Therefore, this study was conducted with the aim of a systematic review of men's participation in prenatal care.
Methods & Materials: This study is a systematic review of published articles on strategies to promote male participation, during pregnancy, childbirth and after childbirth (from 2000 to 2019), based on PRISMA guidelines, and the search was conducted by two scholars on the valid databases. Experimental and quasi-experimental studies, published on strategies for increasing male participation during perinatal period, published in national and international journals, were included in the study. Qualitative assessment of the articles was done using the Jadad and CONSORT checklist and the data extraction was based on the researcher's checklist.
Results: In this systematic review, 4808 articles were identified. After reviewing the titles, and considering the inclusion and exclusion criteria, 15 articles were included in the study. The promotion strategies were categorized into four groups: female-centered, couple-centered, community-centered, and facility-centered.
Conclusion: According to the results of the study, in order to promote the participation of men in perinatal care, it should be planned on four areas of female-centered, couple-centered, community-centered and facility-centered.
 

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Background & Aim: Optimal weight gain during pregnancy, as an important indicator of maternal and fetal health, is affected by many adjustable variables. The present study was conducted to evaluate the gestational age-specific weight gain based on the indices of the American Institute of Medicine and to determine its related factors.
Methods & Materials: In this descriptive study, 250 pregnant women referred to the health centers of Torbat Heydarieh were assessed in 2018. The gestational age-specific weight gain was calculated for each woman, and based on the amount of deviation from the IOM indices, the subjects were divided into three groups including weight gain less than optimal, optimal and over than optimal. Data collection tools were demographic questionnaire and Multidimensional Body Relationship Questionnaire. Data were analyzed by chi-square, ANOVA, Kruskal-Wallis tests and ordinal regression using the SPSS software version 16.
Results: In this study, 22% of the subjects gained weight less than optimal, 46.4% gained weight normally and 31.6% had excessive weight gain. Weight gain in most women with normal and low body mass index was in a normal range (55.4%) and in most overweight and obese women was higher than an optimal range (43.2% and 35.7%, respectively). Weight gain was related to age, education, parity, abortion history, feelings of women and their partners toward pregnancy and wanting the pregnancy from the viewpoint of the partner (P<0.05). After entering the significant variables into the ordinal regression model, only nulliparity was able to predict pregnancy weight gain status (P=0.017).
Conclusion: Optimal weight gain in most pregnant women of this study may reflect the proper nutrition and effectiveness of prenatal care in this city. Identifying factors related to weight gain out-of-range increases the effectiveness of interventions on weight gain.
 

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Background & Aim: Cesarean section (CS) rate was 56% in 2012 in Iran, which was considerably higher than the WHO recommended rate (10-15%). Thus, the Normal Delivery Promotion (NDP) program as a part of Iran’s Health Transformation Plan (HTP) was implemented in 2014 to reduce unnecessary cesarean deliveries and promote maternal and neonatal health. The aim of the study was to evaluate the effect of the NDP plan on the CS rates.
Methods & Materials: This quasi-experimental and longitudinal study analyzed the immediate and long- term effects of the NDP program on the CS trend in Iran using an interrupted time series analysis. Monthly CS rates in the hospitals of the country were extracted from April 2013 to September 2018.
Results: Overall CS rate in Iran decreased by 6% immediately after the implementation of the NDP program and then remained at the same level. The NDP program reduced the CS rate in teaching (9.5%), non-teaching (11.7%), private (18.1%), and charity (27.1%) hospitals. But the CS rate increased in social security (7%) and other hospitals (15.7%). The CS rate would have reached 58.5% by September 2018 if the NDP program had not been implemented.
Conclusion: The NDP program was somewhat effective in reducing the CS rate in Iran. Promoting this program by formulating a strategic plan and comprehensive action plans addressing various underlying causes of CS at meta (ministry of health), macro (universities of medical sciences), meso (hospitals) and micro (obstetricians, midwives, and mothers) levels and considering effective solutions in the areas of governance and leadership, financing, human resources, equipment, information and service delivery is critical to achieve the determined national goals.
 

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Background & Aim: Clinical competence is the ability to perform professional tasks and coordinate cognitive, communication and psycho-motion skills in patient care, and empathy is one of the factors influencing clinical competence. Given the role of clinical competence in the quality of midwifery care, this study aimed to determine the effect of empathy skill training on clinical competence in midwifery students.
Methods & Materials: This randomized clinical trial study was conducted on 73 midwifery students and 438 pregnant women in 2015. A clinical competence questionnaire was used to assess the clinical competence of the students, which was completed in two ways by self-assessment and researcher assessment (after reviewing the student's performance for 3 times). Data were analyzed by chi-square test, independent t-test and paired t-test using the SPSS software version 16.
Results: There was no significant difference between the two groups in the mean score of clinical competence in the ways of self-assessment and assessment by the researcher before the intervention (P>0.05). Results from the post-intervention showed that there was significant difference between the two groups. However, the clinical competence score by the researcher assessment in the intervention group was significantly higher than in the control group (P<0.05). Also, the difference in the mean scores of the self-assessment of clinical competence before and after the intervention between the two groups was not significant (P>0.05), but the difference in the mean scores of the researcher assessment of clinical competence before and after the intervention between the two groups was significant (P<0.05).
Conclusion: Empathy skill training is an effective way to increase the clinical competence of students.
Clinical trial registry: IRCT 2016051127855N1
 

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Background & Aim: Perimenopause is associated with severe changes in reproduction and hormones. The aim of this study was to determine the effect of group counseling on the severity of menopausal symptoms in the transition to menopause.
Methods & Materials: This clinical trial study was performed on ninety perimenopausal women in Javanrood city in 2019. Women were randomly assigned into the intervention or control groups using the block randomization method. Counseling was conducted for the intervention group in groups of 11 to 12 people in four 60-minute sessions for four consecutive weeks. After 8 weeks, the severity of menopausal symptoms was measured using the Menopause Symptoms Scale. Data were analyzed using the SPSS software version 21.
Results: There was no statistically significant difference between the two groups in terms of menopausal symptoms scores before the intervention (P=0.86). After the group counseling, the median (Q1, Q3) of menopausal symptoms, physical, mental and genitourinary symptoms in the intervention and control groups were 17.0 (15.0, 21.5) and 21.0 (17.0, 30.5) (P<0.001), 6.0 (5.0, 8.0) and 9.0 (6.5, 11.0) (P<0.001), 6.0 (5.0, 8.0) and 8.0 (5.0, 10.0) (P=0.004), and 5.0 (4.0, 6.0) and 6.0 (5.0, 8.5) (P<0.001), respectively. These values for the intervention group were significantly lower than those in the control group.
Conclusion: Providing group counseling for four sessions was effective in reducing the severity of menopausal symptoms in perimenopausal women. Therefore, it is suggested that this strategy be used to promote women's health in the premenopausal period.
Clinical trial registry: IRCT20120215009014N320
 

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Background & Aim: Midwives experience high levels of stress due to the nature of their work. Some factors can play a significant role in the occupational stress experience. The aim of the study was to investigate the predictive role of emotional intelligence and individual-occupational factors on occupational stress among the midwives working in Rasht.
Methods & Materials: In this descriptive, correlational study, 250 midwives working in health centers and hospitals in Rasht, from May to September 2018 were included using stratified random sampling. Questionnaires on demographic characteristics, emotional intelligence and occupational stress were used to collect the data. Data were analyzed through the SPSS software version 23 using descriptive and inferential statistics including independent t-test, one-way ANOVA, Pearson correlation, multiple linear regression at the significant level of 0.05.
Results: The mean and standard deviation of emotional intelligence and occupational stress were 114.20±12.55, 119.66±15.48 respectively. Predictors of occupational stress (P<0.05) included workplace variables (private hospital: β=-0.19, P=0.012), overtime hours (β=-0.33, P<0.001), sleeping hours (β=0.13, P=0.011), social activity (β=0.11, P=0.029), age (β=0.25, P=0.045) and the overall score of emotional intelligence (β=0.55, P<0.001). These variables explained 54% of variance of occupational stress.
Conclusion: Overall, in the adjusted model of the workplace variables, overtime hours, sleeping hours, level of social activity, midwife’s age and the overall score of emotional intelligence were significant predictors of occupational stress. Accordingly, designing effective programs can improve the performance of midwives.
 

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Background & Aim: Anxiety is one of the most important psychological problems during the menopausal period. Anxiety can affect the health and quality of life of postmenopausal women. The purpose of this study was to investigate the effect of viola odorata syrup on anxiety among postmenopausal women.
Methods & Materials: This study is a triple blind clinical trial that was performed on 84 postmenopausal women referred to health centers in Mashhad in 2019. In both groups, postmenopausal women received 5 ml of viola odorata or placebo syrup twice a day for one month. Before and after the intervention, anxiety was assessed using the Depression, Anxiety and Stress scale-21. Data was analyzed using the SPSS software version 25 and Mann-Whitney, Chi-square and Fisher's exact tests.
Results: Before the intervention, there was no significant difference in women’s anxiety levels between viola odorata group and placebo group, and the two groups were homogeneous (P=0.084). After the intervention, there was a significant difference between the two groups (P=0.004). The corrected average was 3.61±3.02 (2.9-4.2, CI95%) for the violet group and 7.63±3.60 (6.9-8.3, CI95%) for the placebo group. Also, after the intervention the anxiety score decreased in the viola odorata group, and increased in the placebo group. The Mann-Whitney U test showed a significant difference (P<0.001).
Conclusion: According to the results of the present study, viola odorata syrup decreased anxiety in postmenopausal women. Therefore, it can be used as a complementary treatment along with chemical therapies to reduce anxiety in postmenopausal women.
Clinical trial registry: IRCT20180514039660N1
 

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Background & Aim: Sexual function is an important part of the health of women, and the satisfaction of basic psychological needs is among the variables related to sexual dysfunction. The self-determination theory is one of the most important motivational theories, which considers one’s internal motive the main cause of behavior, and also views three psychological needs (autonomy, relatedness, and competence) as the basis of human behavior. This study was to determine the effect of sexual consulting based on the self-determination theory on women’s sexual function.
Methods & Materials: This clinical trial was conducted on 104 married women aged 18 to 49 years referred to Mashhad health centers in two groups of intervention and control in 2019. The intervention group received five sessions of two-hour group counseling based on the constructs of self-determination theory, with intervals of one week. The data was collected using the sexual performance questionnaire and the constructs of self-determination theory (basic psychological needs) before and after the intervention. Data was analyzed using the SPSS software version 16 through independent t-test, paired t-test, Mann-Whitney and Wilcoxon tests.
Results: There was no statistically significant difference between the two groups in the average score of sexual function before the intervention. However, after the intervention, the difference in the average score of sexual function between before and after the intervention was 2.76±3.02 for the intervention group and -0.25±0.73 for the control group, which showed a significant increase in the sexual function score of the intervention group compared to the control (P<0.001). Moreover, after the intervention between the intervention and control groups, a statistically significant difference was observed in the average scores of autonomy, competence and relatedness (P<0.001).
Conclusion: Providing group sexual counseling based on the self-determination theory can satisfy the basic needs relating to sexuality and improve women's sexual performance.
Clinical trial registry: IRCT20180726040602N1
 

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Background & Aim: In recent years, women's experience of disrespect and misconduct during childbirth has been raised as a significant problem around the world. This study aimed to determine the prevalence of disrespectful maternity care and its associated factors.
Methods & Materials: This is a cross-sectional study conducted in 2019 on 357 mothers who gave birth at hospitals affiliated to TUMS. The data collection tool included socio-demographic characteristics form, and the disrespectful maternity care questionnaire, measuring various domains of abuse. The questionnaire was completed by interviewing mothers. Data was analyzed using descriptive tests, Chi-square test and multivariate logistic regression through the SPSS software version 24.
Results: All participants reported at least one form of disrespect, of which “not allowing for mobility, fluid and companion” was the most prevalent (99.7%) and “stigma and discrimination” was the least prevalent (4.5%). Statistical analysis showed a significant relationship between older age, ethnic minority, primiparity, higher socioeconomic status, delivery time (night, day) and a history of illness with more experience of different forms of disrespect.
Conclusion: This study confirmed a relatively high prevalence of disrespectful maternity care in hospitals based on international standards, which requires serious and prompt attention of top-level managers to take action to eliminate or limit this type of behavior.
 

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Background & Aim: The health of newborns and infants as the future makers of the country is of special importance. Today, the main benefits of breastfeeding for children, mothers and society have widely been recognized. Given the importance of self-efficacy in initiating and continuing breastfeeding, the present study was conducted to determine the effect of breastfeeding counseling with a spiritual approach on breastfeeding self-efficacy in primiparous women.
Methods & Materials: In this randomized controlled trial study, 60 primiparous women referring to the childbirth preparation classes at Alavi Hospital, Azadegan Comprehensive Health Service Centers, Sina and Dr. Hazrati in Ardabil in 2019 were selected through the convenience sampling method and assigned to intervention or control groups using quadruple block method. The control group received routine care and the intervention group received eight sessions of breastfeeding counseling with a spiritual approach. Data was collected using the Dennis Lactation Self-efficacy Questionnaire and analyzed through the SPSS software version 16 using descriptive statistics, chi-square test and independent t-test at 95% confidence level.
Results: The mean scores of breastfeeding self-efficacy for the intervention and control groups were 27.48±5.83 and 28.23±4.44 (P=0.575) before the intervention, 39.83±10.14 and 25.33±3.62 (P<0.001) immediately after the intervention, 42.45±13.00 and 23.43±6.23 (P<0.001) one month after the intervention. There was a significant difference between the two groups after the intervention.
Conclusion: Employing spiritual approach in breastfeeding counseling was effective in improving the breastfeeding self-efficacy of primiparous women. The integration of spiritual content into the package of postpartum services with a focus on breastfeeding appears to be an appropriate measure that can be considered by planners in this area.
Clinical trial registry: IRCT20150731023423N14