Journal of Education and Health Promotion

Abstract BACKGROUND: Menopause is one of the developmental stages of women. One of the most common
problems during this period is sleep disorders. Sleep disorders can affect the quality of life of these
people. To improve sleep disorders, auriculotherapy has received less attention due to its low cost
and effectiveness, and side effects. Therefore, the aim of this study was to determine the effect of
auriculotherapy on improving sleep quality in postmenopausal women aged 45–60 years.
MATERIALS AND METHODS: The present study is a clinical trial study that was performed on
82 postmenopausal women aged 45–60 years under the auspices of health centers in Mahshahr
city, Iran from 2021–2022. Women with inclusion criteria were randomly divided into two groups
(intervention and control). The intervention group underwent auriculotherapy for 4 weeks. The St.
Petersburg Sleep Quality Questionnaire was completed by both groups at the beginning and 4 weeks
after the start of the intervention. Finally, the data were analyzed by SPSS software version 22 and
independent t‑test, paired t‑test and Chi‑square test.
RESULTS: At the beginning of the study, both groups were homogeneous in terms of demographic
variables. The results of data analysis using independent t‑test showed that before the intervention,
mental quality (P = 0.513), length of incubation period (P = 0.285), sleep duration (P = 0.121), sleep
efficiency (P=0.513), sleep disorders (P=0.685), use of sleeping pills (P=0.530), daily functioning(P=0.60),
and overall sleep quality score (P = 0.30) in the control and intervention groups were not statistically
significant.However, comparing the mean scores afterthe interventionin the control and interventiongroups
showed that mental quality (P < 0.001), incubation period (P < 0.001), sleep duration (P < 0.001), sleep
efficiency (P < 0.001), sleep disorders (P < 0.001), use of hypnotics (P=0.002), daily functioning (P=0.001),
overall sleep quality score (P < 0.001), sleep duration (P = 0.822), sleep efficiency (P = 0.889), sleep
disorders (P = 0.889), use of sleeping pills (P = 1.00), daily performance (P = 0.767), overall sleep quality
score (P = 0.69) were statistically significant between the two groups. In‑group comparison using paired
t‑test in the control group showed that mental quality (P = 0128), length of the incubation period (P = 1.00),
and before and afterthe intervention did not differ significantly in the mean scores. However, a within‑group
comparison in the intervention group showed that mental quality (P < 0.001), incubation period (P < 0.001),
sleep duration (P < 0.001), sleep efficiency  (P < 0.001), sleep disorders (P = 0.003), use of sleeping
pills (P = 0.007), daily functioning (P < 0.001), and overall sleep quality score (P < 0.001) before and after
the intervention had a significant difference in the mean scores.
CONCLUSION: The results showed that auriculotherapy has significant effectiveness in improving the
quality of sleep, and its dimensions and can be used as an effective method in this area that can be
implemented at a low cost and easily. According to reports from participants and previous studies in this
field, auriculotherapy did not have any side effects and can be used as a safe way to improve sleep quality.

Abstract BACKGROUND: Multiple sclerosis (MS) is a chronic disease of the central nervous system. Most
women with MS are diagnosed during their reproductive ages. The aim of this study was to evaluate
the interaction between fertility, pregnancy, and MS.
MATERIALS AND METHODS: A retrospective descriptive–analytic study was conducted on 110
women suffering from MS with a history of pregnancy (between 2007 and 2017 years) in Isfahan,
Iran. Samples were selected in a census model. Women completed a researcher-constructed
questionnaire by telephone. The questionnaire consisted of three parts: demographic information, MS
and its symptoms and treatment, and reproductive system and the history of pregnancy associated
with MS. The data were analyzed by SPSS software version 16 using Chi-square, ANOVA, and t-test.
RESULTS: The mean age of women was 32.4 years. In this population, the average number of
pregnancies was 1.61, the number of deliveries was 1.35, the number of abortions was 0.24, the
history of ectopic pregnancy was 0.01, the number of alive children was 1.36, and the number of dead
children was 0.01. The average time of the last MS attack before the pregnancy was 21.36 months.
Fatigue (24.5%) was the most common symptom exacerbated during pregnancy. MS symptoms
improved in 55.0% of women in the second trimester.
CONCLUSIONS: MS had no effect on the pregnancy status, such as the number of abortions,
ectopic pregnancy, alive and dead children, and the duration of pregnancy. Symptoms of the disease
improved during pregnancy. Therefore, pregnancy has a protective role against MS.

Abstract INTRODUCTION: Factors affecting labor pain include physiological, psychological, and social factors,
among which psychological factors refer to attitudes and beliefs about labor pain. Hence, the present
study was conducted to determine the relationship between attitude toward labor pain and length of
the first, second, and third stages in primigravida women.
MATERIALS AND METHODS: This cross‑sectional study was performed on 230 pregnant
women who were referred to hospitals affiliated to Isfahan University of Medical Sciences in a
two‑stage sampling in 2018. In the beginning, the participants completed the questionnaire of
demographic/fertility characteristics and attitude to labor pain (25Q), and at the next stage, the
researcher completed the form of labor information including length of the labor stages. Data were
analyzed by SPSS software version 22 and Pearson correlation coefficient, Student’s t‑test, one‑way
ANOVA, and general linear regression.
RESULTS: The mean (standard deviation) of the attitude to labor pain was 53.96 (1.9), and the
length of the first stage was 10.01 (0.3) (h), the second stage was 1.6 (0.4) (h), and the third stage
was 15.9 (1.7) (min). One hundred and eighty‑three (79.6%) had negative attitude and 47 (20.4%)
had positive attitude toward labor pain. There was a significant positive correlation between attitude
toward labor pain and length of the first (P = 0.001, r = 0.37) and second stages of labor (P = 0.001,
r = 0.24).   There was no significant between length of third stage of labor and attitude toward labor
pain (P = 714).
CONCLUSION: The results showed that the majority of primiparous women had a higher (negative)
attitude toward labor pain, which was associated with  longe the first and second stages of labor.

Abstract INTRODUCTION: Pain is a common phenomenon and an inevitable part of the labor process. Labor
pain is one of the most severe pains. Auriculotherapy is one of the nonpharmacological aspects of
relieving pain, reduces the intensity of pain, and improves its compatibility. The purpose of this study
was to determine the effect of auriculotherapy on labor pain in primiparous women.
MATERIALS AND METHODS: This clinical trial was performed on 84 pregnant women aged between
18 and 35 years, who referred to Isfahan Shahid Beheshti Hospital in 2017. This study was carried
out between two groups: control group (receiving routine hospital care) and interventional group
(20 min for auriculotherapy). We used the McGill Short‑Form Standard questionnaire with Visual
Analog Scale. Data were analyzed by SPSS software using paired t‑test and ANOVA.
RESULTS: The results showed that there was no significant difference between demographic
variables in the two groups. Statistical analysis also showed that the severity of labor pain in the
interventional group (auriculotherapy) was lower than that of the control group (P = 0.001).
CONCLUSION: Auriculotherapy reduces the severity of labor pain in primiparous women. Due to
the easy, inexpensive, and noninvasive nature of this method, its use has been recommended in
these cases.