---

  Background & Aim: Need assessment for promotion reproductive health is important subject and development a questionnaire is essential. Thus the aim of this study was development of questionnaire of intention to use of oral contraception in withdrawal users based on construct of Theory of Planned Behavior (TPB).

  Methods & Materials : In-depth interviews were conducted to elicit the salient beliefs relevant to oral contraception among withdrawal users. Then a cross-sectional study carried out in Tehran, Iran for validate of questionnaire. Participants recruited from attending five family planning clinics of public health services in the Eastern district of Tehran, Iran. Validity and reliability was evaluated using concurrent, content validity and Cronbach's alpha and test- retest respectively. Factor structure of the questionnaire was extracted by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) conducted to assess how well the EFA extracted model fits observed data. The SPSS version 16 and Lisrel programs were used to analyze the data.

  Results: Reliability and validity were confirmed. The principal component analysis revealed a three-factor structure for the questionnaire including attitude, subjective norm and perceive behavior control that explained 50.4 percent of the total of variance.

  Conclusion : In general, the findings suggest that questionnaire of intention to use of oral contraception in withdrawal users based on Theory of Planned Behavior is a reliable and valid measure.

---

  Background & Aim: Several studies have indicated that hospitalizing infants causes disruption on mother-infant attachment. The aim of this study was to assess the effect of infant massage by mothers on maternal attachment behavior in infants hospitalized in the neonatal care units .

  Methods & Materials: In this clinical trial, 42 mothers and their neonates were recruited and randomly allocated to the intervention and control groups. Mothers in the intervention group received training by means of educational movies about practical exercises on how to massage the infants. The trained mothers used massage techniques on their infants for five days. The process lasted 15 minutes. The attachment of the mothers on their infants was assessed before and on the day 5 after the massage. Data were collected using the scale of mother-to-infant attachment. Data were analyzed using the Chi-squared test, Fisher’s exact test and the t-test in the SPSS-19 . 

  Results: There were no differences between the two groups in terms of demographic variables and the mean of maternal attachment at baseline (P>0.05). Five days after the massage, there were statistically significant differences between the two groups in the mean maternal attachment (P<0.001) .

  Conclusion: According to the role of massage in attachment behavior, this traditional care is recommended to be used in neonatal units .

  

---

  Background & Aim: Medication usage is the bases of disease management in patients who undergo hemodialysis. Non-adherence to medication regimen increases the incidence of complications among the patients . The aim of this study was to investigate the effect of a cognitive-behavioral intervention on medication adherence in patients undergoing hemodialysis .

  Methods & Materials: In this clinical trial, 70 patients were selected from Imam Reza and Valiasr hospitals. Patients were assigned into two intervention (n=35) and control (n=35) groups. The intervention group received a cognitive-behavioral intervention including six steps: 1) Identifying the problem 2) Creating confidence and commitment 3) Increasing awareness of behavior 4) Developing and implementing the action plan 5) Evaluating the plan and 6) Maintaining the desired behavior. Adherence to medication regimen was assessed using a self-report questionnaire before and immediately after the intervention. Data were analyzed using the independent t-test . 

  Results: At baseline, there was no significant difference in adherence to medicine regimen between the intervention (20.77 ± 4.56) and control (22.34 ± 3.65) groups (P=0.1). After the intervention, significant difference was observed between the two groups in adherence to medication regimen (P<0.001) .

  Conclusion: Cognitive–behavioral intervention could improve medication adherence in patients undergoing hemodialysis. It is recommended for nurses to use this approach to improve medical care among the patients .

  

---

  Background & Aim: Breast cancer is the most common cancer diagnosed in women in both developed and developing countries. Long-term prognosis of breast cancer strongly depends on the stage of disease at diagnosis. More than three months after detecting breast symptoms by Iranian women, they go to visit a doctor. The understanding of life-threatening symptoms and the subsequent responses are differently affected by social interaction networks as well as cultural and social contexts. This study aimed to explore the role of social interactions on health-seeking behaviors among Iranian women with breast cancer symptoms .

  Methods & Materials: A qualitative study was conducted using purposive sampling method. Twenty Iranian w omen who attended the Cancer Institute in Imam Khomeini hospital at Tehran University of Medical Sciences and complained of symptoms of breast cancer were recruited to the study du ring 2012-2013. Data were collected through semi-structured and in-depth interviews. Interviews were transcribed and analyzed using conventional content analysis in the MAXqda . 

  Results: The results revealed three themes including: 1) effectiveness of social learning 2) seeking social support and 3) feedback with a supportive approach which included seven categories of informative social learning, reliable social learning, selective disclosure, seeking information, seeking emotional support , giving reassurance and social support for decision making .

  Conclusion: E ffective social learning and supportive interactions have influential role on health seeking behavior. Thus it is necessary to improve public awareness and correct clients' social beliefs about breast cancer to shorten the patients' delay .

  

---

  Background & Aim: Family caregivers play major role in caring for the patients with dementia. Meanwhile, they are at risks of various diseases. Caring for a person with Alzheimer’s disease carries a significant physical, socioeconomic and psychological burden. This study described the impact of cognitive-behavioral management on burden and problems borne by family caregivers of patients with Alzheimer's disease .

  Methods & Materials: This non-randomized controlled clinical trial was conducted on 70 family caregivers of patients with Alzheimer’s disease. The participants were subjected to experimental and control groups. The Zarit Burden Interview was used to assess the burden experienced by family caregivers of the patients. Data were then analyzed using inferential and descriptive statistical parameters (mean and SD) and paired sample t-test on the difference between the scores of pre-test and post-test . 

  Results: The mean level of caregivers’ burden as measured by ZBI was 44.56± 6.77 and 42.57±5.98, in experimental and control groups before intervention respectively. Caregivers’ burden score was 39.54±5.88 and 44.86±5.87, in experimental and control groups after intervention respectively. Results showed a significant decrease in the training group’s score (P<0.001) .

  Conclusion: Given the obtained results indicating the effectiveness of cognitive- behavioral management in reduction of caregivers’ burden, the present study can be helpful in achieving an effective solution to decrease stress among family caregivers of patients who suffer from Alzheimer's disease .

  

---

  Background & Aim: Psychological and social factors such as attachment styles may influence chronic diseases through self-care behaviors. This study was conducted to determine the relationship between attachment styles and self-care behaviors in patients with heart failure .

  Methods & Materials: In this correlational study, 180 patients with heart failure hospitalized in CCUs and Post CCUs of educational hospitals in Zahedan in 2014 were selected through convenience sampling. Data collection tools included the Experiences in Close Relationships-Revised (ECR-R) questionnaire and Self-Care of Heart Failure Index (SCHFIV6.2). Data were analyzed in the SPSS-20 using the descriptive statistics, independent T-Test, Pearson's correlation and regression analysis . 

  Results: The mean and standard deviation of self-care behaviors score of the group with secure attachment style (62.89 ± 12.66) was significantly higher than the group with insecure attachment style (40.43 ± 16.11) (P<0.05). Also, the regression model showed that the score of anxiety, attachment avoidance and age were as predictors of the self care scores in patients .

  Conclusion: Regarding the relationship between attachment styles and self-care behaviors and the low level of self-care in patients with insecure attachment style, psychological interventions should be considered through long-term treatment of chronic heart failure .

  

---

Background & Aim: Caring viewpoint is a requisite of high quality nursing care. It must be operational through the nursing education program. The present study was conducted to compare the viewpoints of undergraduate nursing students at the first, fifth, and eighth semesters about the importance of caring behaviors during their nursing education.

Methods & Materials: The present study is a descriptive-analytical study. In this study, three groups of 40 nursing students (semester one, five and eight) were selected by random sampling from Shahid Beheshti University of Medical Sciences in 2014. Caring Behavior Inventory completed through self-report by the students, was used for collecting data. Data were analyzed by the descriptive and inferential statistics (with the significance level<0.05) using SPSS software (version 20).

Results: The mean scores based on Caring Behaviors Inventory in three groups were: semester 1: 148.2, semester five: 123.6, semester eight: 122.05. ANOVA showed statistically significant differences between the mean scores for three groups of students (P<0.001). Also, the scores of students’ viewpoints were different in all instrument domains included respectful deference to the other (P<0.001), assurance of human presence (P<0.001), positive connectedness (P<0.001), professional skills and knowledge (P=0.004), attentiveness to the other’s experience (P<0.001). Considering the lack of homogeneity in the groups in terms of age and sex, analysis of covariance was used to eliminate their confounding effects on main variable, and despite controlling for the confounding role of age and sex, differences were significant (P<0.001).

Conclusion: The viewpoints of the higher-year students about the importance of caring behaviors not only had not promoted but also it had decreased compared to the lower-year students. Considering the fact that caring viewpoint is the requisite of high quality nursing care that must be operational through nursing education programs, and due to the fading of emotional aspect of care, more emphasis on clinical instructors and nurses and using mentors in clinical practice are needed to practically and concretely show nursing students the emotional aspect of caring.

---

Background & Aim: Pedestrians are the most vulnerable road users. In many cases, pedestrian-vehicle crashes are often the result of their risky road crossing behaviors. So, this qualitative study aimed to explore the reasons for risky road crossing behaviors among young people.

Methods & Materials: The current study was designed as a qualitative content analysis. Twelve males and females who had a car-accident were purposefully selected with maximum variation sampling. Data were collected and analyzed by semi-structured individual interviews.

Results: Conformity with the masses including “conformity with peers and conformity with the public space of society”, and anomie emerged as the most important social reasons for young pedestrian’s risky road crossing behaviors.

Conclusion: According to the results of this study, young pedestrian’s risky road crossing behaviors are affected by conformity with the masses and peers and as well as anomie so that risky behaviors have been commonplace and inevitable and a part of their lifestyle.

---

Background & Aim: The delay in childbearing is associated with a reduction in the total fertility rate and increase in the risk of pregnancy at an older age. Social learning theory has mostly been used to clarify the interaction between personal and environmental factors and behavior. In order to understand the factors underlying delayed childbearing, the present study aimed to predict the factors affecting the delay in first childbearing among young married women using the Bandura’s social learning theory.
Methods & Materials: This cross-sectional correlational study was conducted on 284 married women referred to the health centers and OB/GYN clinics of teaching hospitals in Mashhad in 2015-2016. The data collecting tool was comprised of five questionnaires regarding to personal and social factors. Data were analyzed by descriptive statistics, Pearson and Spearman correlation co-efficient, linear regression and multivariate regression using the SPSS software version 16.
Results: The mean age of participants was 27.99±4.2, and the mean interval between marriage and the first child was 3.22±1.96, which was 1.25 years more than that of ideal spacing between marriage and childbirth. Multiple linear regressions showed negative and positive fertility motivations, perceived maternal self-efficacy, martial relationship, the number of sisters and childbearing-related religious beliefs had a significant effect on the interval between marriage and first childbirth (P<0.01).
Conclusion: The individual and environmental factors predicting delay in the first reproductive behavior were identified using the Bandura's social learning theory. The both factors should be considered in designing intervention programs for increasing fertility rate.
 

---

Background & Aim: Falling is a serious problem in the elderly population, with many physical, psychological, social and economic consequences. The fear of falling has been considered an activity limiting condition, which can lead to a reduction in the quality of life of the elderly people. The study aimed to determine effect of fall care behaviors training on fear of falling among the elderly people referred to health centers.
Methods & Materials: This double-blind randomized clinical trial was carried out on 110 elderly people referred to health centers in Ardabil in 2017. Participants were selected by the multi-stage random sampling and divided into intervention and control groups by random allocation. The data collection tools were consisted of demographic questionnaire, Mini-Mental State Examination: MMSE, Abbreviated Mental Test Score: AMTS and Fall efficacy scale international: FES-I. Data were analyzed using statistical tests on the SPSS software version 22.
Results: The mean and standard deviation of fear of falling in the intervention and control groups before the intervention were 33.91±12.03 and 31.22±14.76, respectively (P=0.29). Three months after the intervention, the mean and standard deviation of fear of falling were 22.32±4.45 and 30.85±15.03 (P<0.001). Also, ANCOVA was used for controlling pre-test scores and level of education compared to the post-test scores in the two groups (P<0.001).
Conclusion: The results showed that education on fall care behaviors reduces the fear of falling in the elderly people. Therefore, this education is suggested to be considered in the self-care program for elderly people.
Clinical trial registry: IRCT20180205038618N1
 

---

Background & Aim: Health promoting behaviors have been recognized as an important strategy for maintaining and improving the independence, health and quality of life of people with chronic diseases. The aim of the present study was to compare the health promoting behaviors of patients with MS with those of healthy people.
Methods & Materials: This cross-sectional, comparative study was conducted on MS patients and healthy people in Guilan province in 2018. For this purpose, 120 MS patients (from the MS association of Guilan province and other health centers) and 120 healthy people were selected by the convenience sampling method. The Health-Promoting Lifestyle Profile (HPLP-II) was used to collect the data. The data were analyzed using the SPSS software version 22.
Results: The results showed that health promoting behaviors of MS patients were significantly lower than those of healthy people (t=-3.127, df=238, P<0.001). The results of the components analysis indicated that the mean ranks of self-actualization (U=4948.500, Z=-4.191, P<0.001), interpersonal relationships (U=12874.000, Z=-2.957, P<0.003), stress management (U=5787.000, Z=-2.644, P<0.008) and physical activity (U=5506.500, Z=-3.156, P<0.002) in MS patients were significantly lower than those in healthy people. However, there was no significant difference between MS patients and healthy people in the components of health responsibility and nutrition.
Conclusion: In general, it can be concluded that chronic conditions are associated with a decrease in health promoting behaviors in MS patients, and the patients should be educated in this area using appropriate nursing and psychological interventions.
 

---

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
 

---

Background & Aim: Osteoporosis is a silent and progressive disease that causes disability in people particularly women, with age and has irreversible consequences in their lives. This study aimed to determine the effect of an educational intervention program based on BASNEF model on prevention of osteoporosis among women referred to health centers in the south of Tehran.
Methods & Materials: This is a quasi-experimental study with two groups of intervention and control, performed on 162 women (81 in the intervention group and 81 in the control group) aged 30-49 years, referred to health centers in the south of Tehran in 2018. The data collection tool included demographic information, a researcher-made questionnaire based on BASNEF model constructs and another part of the questionnaire was Health Promotion Standards Questionnaire (HPLP II). Questionnaires were completed for both the intervention and control groups before and six months after the intervention. Data were analyzed by the SPSS software using chi-square, t-test, and paired t-test at a significance level of 0.05.
Results: The mean of women’s age in this study was 37.79±5.47 years old. There was no significant difference in demographic variables and BASNEF model constructs before the intervention (P>0.05). After the intervention, the mean score of BASNEF model constructs and the dimensions of health promoting behaviors significantly increased in the intervention group (P<0.001).
Conclusion: The study results revealed a positive effect of the BASNEF model-based educational program on health promoting behaviors regarding osteoporosis prevention among women. It is suggested to use this model as a successful model in educational interventions to prevent osteoporosis in women.
Clinical trial registry: IRCT20130213012460N15
 

---

Background & Aim: Considering the importance of COVID-19 vaccine acceptance to end the corona disease pandemic, the study was conducted to determine the factors affecting the vaccine acceptance based on the behavioral change wheel mode and its components (capability, opportunity, and motivation).
Methods & Materials: In this cross-sectional study, 1102 adults aged 18 years and older living in Bushehr province were selected by multi-stage sampling method from February 16 to 28, 2021. To collect the data, a questionnaire including demographic characteristics, questions on the constructs related to the behavioral change wheel model components and questions on the COVID-19 vaccine acceptance was completed on WhatsApp platform. Data was analyzed using the SPSS software version 22.
Results: The results of the study showed that most participants tended to receive the Iranian vaccine (726 people or 65.9%). Among the demographic factors, only gender was associated with vaccination, and men were more likely to accept to be vaccinated (P=0.022). Among the model constructs, the most predictive construct was related to social support in the opportunity component (P<0.001, β=0.55 and B=0.183). In the motivation component, social role (P<0.001 and β=0.118 and B=0.162) and in the capability component, behavioral regulation (P<0.001 and β=0.152 and B=0.155) had the highest predictor of vaccine acceptance. In general, constructs of opportunity component had the greatest impact on vaccine acceptance.
Conclusion: In order to increase the acceptance of COVID-19 vaccination, opportunities should be provided through social support, vaccination should be introduced as a social role, and behavioral regulation, in other words, understanding of the ability to vaccinate to prevent the disease and break the disease transmission chain should be promoted.
 

---

Background & Aim: Nurses' organizational loyalty to health systems plays an important role in expanding organizational performance. Investigating the role of factors such as citizenship behaviors and adaptive performance can be helpful in this regard. The aim of the present study was to investigate the relationship between citizenship behavior and adaptive performance with organizational loyalty in nurses.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2019 on 200 nurses working in Valiasr hospital affiliated to Shahrekord University of Medical Sciences in Borujen, and were selected by the random sampling method. A demographic information form, the Lee & Allen’s citizenship behavior questionnaire, the Charbonnier-Voirin and Roussel’s adaptive performance scale, and the Kumar and Shekhar’s organizational loyalty questionnaire were used to collect the data. The data was analyzed by descriptive and inferential statistical tests using the SPSS software version 16.
Results: The Pearson's correlation coefficient indicated a significant positive correlation between citizenship behavior and adaptive performance with organizational loyalty (P<0.05). Regression tests showed that citizenship behavior (ADJ.R²=0.199) and adaptive performance (ADJ.R²=0.131) significantly predicted organizational loyalty. All dimensions of citizenship behavior and some dimensions of adaptive performance such as creativity, learning efforts and job stress management can predict organizational loyalty in nurses. The average scores for citizenship behavior (66.85±18.26), adaptive performance (68.76±16.98) and organizational loyalty (120.67±24.09) were reported to be moderate.
Conclusion: Managers and planners should pay attention to factors such as creativity, stress management, and continuing education along with improving healthy working relationships and nurses’ participation, which can play an important role in expanding organizational loyalty through the development of citizenship behavior and adaptive performance.
 

---

Background & Aim: Feelings of loneliness can affect the mental health of the elderly and lead to cognitive problems. As a potentially effective treatment approach, cognitive-behavioral therapy (CBT) has emerged as an intervention to alleviate loneliness among the elderly. This study aims to determine the effect of CBT on alleviating loneliness among elderly women referred to health centers in Khomeini Shahr.
Methods & Materials: This quasi-experimental study was conducted in 2020 on a sample of 60 elderly women who had been referred to health centers in Khomeini Shahr. The participants were conveniently selected and then randomly assigned to either the intervention or control groups. Data were collected using a demographic information form and the Deshiri et al’s loneliness questionnaire, which were administered before, immediately after, and one month after the intervention. The intervention group received eight counseling sessions of CBT that lasted for 60 minutes each, while the control group did not receive any counseling. Data analysis was carried out using the SPSS software version 23, employing descriptive and inferential statistics.
Results: The results obtained from conducting a two-way repeated measures analysis of variance (ANOVA) showed a significant statistical difference in the mean score of loneliness resulting from communication with family, the score of emotional symptoms of loneliness and the total score of loneliness in the intervention group before and after the intervention (P<0.001). However, no statistically significant difference was observed in the control group (P>0.05). Furthermore, when comparing the mean score of loneliness resulting from communication with friends in the intervention group, no statistically significant difference was observed before and after the intervention (P=0.094). Similarly, no statistically significant difference was observed in the control group (P=0.338).
Conclusion: The results of the current study indicate that CBT is an effective approach to alleviate loneliness in elderly women. Therefore, it is suggested that this method be implemented as a means to reduce feelings of loneliness among elderly women.

 

---

Background & Aim: Eating disorders manifest numerous psychological and social consequences for both individuals and society. The present study was conducted to investigate the effectiveness of cognitive-behavioral therapy in alleviating COVID-19-related anxiety, fear of negative evaluation, and depression among women diagnosed with Anorexia Nervosa.
Methods & Materials: This study employed a quasi-experimental pre-test-post-test design with a control group. The research population consisted of women diagnosed with anorexia nervosa in Tehran in 2022. Thirty participants were selected through convenience sampling from psychological clinics in the 6th and 8th districts of Tehran, and were randomly assigned to either the intervention group (n=15) or the control group (n=15). Questionnaires assessing eating attitudes, COVID-19-related anxiety, fear of negative evaluation, and depression were administered to both groups. The intervention group received a total of eight 90-minute sessions of cognitive-behavioral therapy, while the control group did not receive any intervention. The collected data were subsequently analyzed using multivariate analysis of covariance through the SPSS software version 24.
Results: The results of the study showed that cognitive-behavioral therapy led to a significant reduction in mental anxiety related to COVID-19 (P<0.001, F=36.41), physical anxiety related to COVID-19 (P<0.001, F=39.15), fear of negative evaluation (P<0.001, F=41.92), and depression (P<0.001, F=47.48) in women diagnosed with anorexia nervosa (P<0.001).
Conclusion: Cognitive-behavioral therapy demonstrated efficacy in alleviating psychological disorders among women diagnosed with anorexia nervosa. Given the potentially severe impairment of mental health experienced by numerous individuals with anorexia nervosa, it is imperative to implement measures for identifying and providing psychological interventions to vulnerable groups.

 

---

Background & Aim: Infectious diseases represent a significant health concern within human communities. Considering the importance of pregnancy, the present study was conducted with the aim of exploring the health behaviors exhibited by pregnant women during the COVID-19 pandemic.
Methods & Materials: This qualitative study employed the conventional content analysis approach to examine a cohort of 16 pregnant women in 2021. The research was conducted within the health centers of Ilam, employing the purposeful sampling technique and unstructured interviews to collect the data. Simultaneous to the data collection, conventional content analysis was employed to analyze the data. MAXQDA version 10 software was utilized for data management purposes.
Results: The participants had a mean age of 30 years, while the average gestational age was 30.38 weeks. Through analysis, three main themes and eight categories were derived from the collected data. The main themes identified were as follows: 1- self-care practices for disease prevention, 2-  the adverse effects of the pandemic on pregnancy, and 3- changes in the healthcare system.
Conclusion: The results of the present study highlight the emergence of a novel form of self-care among pregnant women as a consequence of the COVID-19 pandemic. The adverse effects of the pandemic, such as quarantine measures, were associated with the development of negative ruminations within pregnant women. Following the quarantine restrictions, significant modifications were observed in the ways through which women sought health-related information and engaged in daily activities. Moreover, alterations were made to care policies. Paying attention to the comprehensive health needs of pregnant women, including both physical and mental health, is imperative within the context of pandemic-related health services.

 

---

Background & Aim: A large number of drug users make attempts to cease drug use; however, a relapse tendency often emerges subsequent to the cessation period. The present study aimed to examine the effect of emotion regulation skill training on self-control and psychological distress among opioid-dependent people hospitalized at Zahedan Psychiatric Hospital.
Methods & Materials: This quasi-experimental study was conducted over the fourth quarter of the year 2022, focusing on 80 drug users who underwent treatment at Baharan Psychiatric Hospital in Zahedan. The participants were selected using convenience sampling and subsequently assigned to either the intervention group or the control group. The intervention group received a total of 10 sessions of training in emotion regulation skills. The self-control and psychological distress questionnaires were used to collect the data. The data were analyzed using both descriptive and inferential statistical tests through SPSS software version 22.
Results: The mean and standard deviation of the psychological distress score among opioid addicts in both the intervention group (P<0.001) and the control group significantly decreased (P<0.005). To account for the significant effect of pre-test scores, an analysis of covariance test was conducted, indicating a statistically significant difference in the average psychological distress scores between the two groups after the intervention (P<0.001). Similarly, the self-control score in both the intervention and control groups showed a significant increase in mean and standard deviation (P<0.001). The analysis of covariance test, considering the significant effect of the pre-test scores, also showed a statistically significant difference in the average self-control score between the two groups after the intervention (P<0.001).
Conclusion: The findings showed that emotion regulation skills training among individuals with opioid dependency is associated with a significant decrease in psychological distress and a significant increase in self-control. Consequently, these findings suggest that such regulation may exert positive and inhibitory influences on behaviors contributing to the recurrence of substance use. In light of these findings, it is recommended to implement training programs focused on developing emotion regulation skills as a means to improve psychological distress and self-control among individuals undergoing addiction recovery.

 

---

Background & Aim: The high prevalence of cesarean section in most developed countries, exceeding 50%, has led to detrimental effects on maternal and child health. Vaginal birth after cesarean (VBAC) is a beneficial way to reduce cesarean rates. This study aimed to determine the effect of theory of planned behavior-based training on the intention and behavior of VBAC in pregnant women with previous cesarean section.
Methods & Materials: In this randomized controlled trial study, a convenience sample of 70 pregnant women with a history of cesarean section, referred to comprehensive health centers in Ardabil in 2020, were randomly assigned to either the intervention or control group. The intervention group received four weekly education sessions based on the theory of planned behavior structures, while the control group received standard care. Data were collected using a researcher-developed questionnaire at three time points: before, immediately after, and four weeks after the intervention. Data analysis was conducted using SPSS software version 16, employing independent t-test, Fisher’s exact test, chi-square test, and repeated measures ANOVA at a 95% confidence level.
Results: Repeated measures ANOVA revealed significant differences in mean scores of attitude, subjective norm, perceived behavior control, intention, and awareness over time between the intervention and control groups (P<0.001). However, the educational intervention did not lead to a behavior change.
Conclusion: Based on the findings, it is imperative for health planners to focus on providing organizational support and fostering a positive attitude among obstetricians and midwives to prioritize the implementation of VBAC.
Clinical trial registry: IRCT20200519047509N1