Journal of Education and Health Promotion

Abstract BACKGROUND: Fertility is always one of the most important functions of the family. Having a
child equals growing up and entering the adult world. Adoption is one of the methods that can be
considered to treat infertility. One of the duties of health professionals, especially midwives, is to
advise and educate infertile people, which helps them in a way beyond medical treatment. Therefore,
this study was conducted to determine the effect of face‑to‑face and telephone counseling on the
desire for adoption in infertile couples.
MATERIALS AND METHODS: The present study was a two‑group counseling intervention study that was
performed on 34 infertile couples referred to Mashhad Infertility Center. Infertile couples were randomly
assigned to face‑to‑face and telephone counseling groups. All participants completed the Adoption
Adoption Questionnaire at the beginning and end of the study. Data were analyzed by spss16 software.
RESULTS: The mean score of propensity to adopt in the face‑to‑face counseling group 2 weeks after
the intervention was significantly higher than before the intervention. Furthermore, the mean score
of desire for adoption in the telephone counseling group increased significantly 2 weeks after the
intervention compared to before (P < 0.001). Adoption scores varied in the face‑to‑face counseling group
at 3.15 and in the telephone counseling group at 3.23. There was no statistically significant difference
between the two groups (P < 0.885). The most common reason for not wanting to adopt was hope
for self‑treatment and having children (70.6% women and 67.6% men). The most common reason for
accepting an adopted child was the strong need to have a child (23.5% in women and 23.5% in men).
CONCLUSION: According to the results of this study, counseling can increase people’s awareness
of the conditions of adoption and thus increase the desire of people to accept the adopted child. For
this reason, considering adoption counseling sessions for infertile couples who have been receiving
infertility treatment for a long time but have not become pregnant can help the couple decide.

Abstract BACKGROUND: Reproductive motivation is a complex issue that has cultural, behavioral, and
ideological roots and changes in the context of population transfer and economic and social
development. Reproductive motivations include positive and negative motivations that can be
influenced by education. Training can be done in different ways. It seems that face‑to‑face training
increases learning. On the other hand, face‑to‑face training increases participants’ cooperation and
desire for educational topics. Therefore, the aim of this study was to compare and determine the
effect of two counseling methods on the fertility motivation of infertile couples.
MATERIALS AND METHODS : This intervention study was performed on 68 men and women
with infertility referring to Milad Infertility Center in Mashhad in 2016–2017. Subjects were randomly
assigned to two methods of counseling. Participants completed written consent to participate in
the study. Infertile couples were included in the study if they met the inclusion criteria. The fertility
motivation questionnaire was completed by the participants at the beginning of the study before
the consultation and 2 weeks after the consultation. The collected data were analyzed by SPSS
Software Version 16.
RESULTS: According to the independent t‑test, there was no statistically significant difference
between the mean scores of positive fertility motivation in the two groups of face‑to‑face and telephone
counseling before the intervention. Independent t‑test showed that 2 weeks after the intervention,
there was no significant difference between the two groups in terms of this variable (P = 0.283). There
was no statistically significant difference between the mean scores of positive fertility motivation in the
face‑to‑face counseling group before and after the intervention. Further, in the telephone counseling
group, there was no significant difference between the mean scores of positive fertility motivation
in the two stages before and after the intervention. According to the independent t‑test, there was a
statistically significant difference between the mean scores of negative fertility motivation in the two
groups of face‑to‑face and telephone counseling before the intervention (P = 0.025). However, this
test showed that there was no significant difference between the two groups in terms of this variable
2 weeks after the intervention.
CONCLUSION: The results of this study showed that face‑to‑face and telephone counseling did not
have a significant effect on fertility motivations of infertile couples. In other words, the mean scores
of positive and negative fertility motivations before and after counseling remained unchanged in both
groups and the two groups did not differ in this regard. In other words, the issue of fertility motivation
in infertile women can be affected by different characteristics such as social, family, cultural, and
economic conditions of individuals. If infertile people do not make having a child a necessity in their
lives and cope with it more easily, no counseling can change their motivation. On the other hand,
if infertile women consider having a child as an essential part of their married life and the health of
their married life, counseling can have the greatest effect on them.

Abstract INTRODUCTION: Many infertile people have heard about adoption, but little is known about the true
meaning of adoption and how it is accepted. Giving the right information about adoption is effective
in making the right decision for couples. As a result, there is a need to intervene and provide training
to improve community attitudes and increase adoption among infertile people. Therefore, the present
study aimed to determine the effect of two counseling methods (face‑to‑face and telephone) on
awareness and attitude toward adoption in infertile couples.
MATERIALS AND METHODS: The present study is a randomized quasi‑experimental study of two
groups in the Milad Infertility Center of Mashhad on 34 (each group of 17 couples) infertile couples
with the criteria to enter the study. Couples were randomly assigned to two telephone and face‑to‑face
counseling groups, and each individual’s awareness and attitudes toward adoption were completed
separately before and after counseling. The average number of face‑to‑face sessions for face‑to‑face
counseling was three 60‑min sessions and six 30‑min sessions for telephone counseling.
RESULTS: Based on the results of t‑test, there was a statistically significant difference between
the average score of awareness of adoption before and after the intervention (2 weeks after the
last counseling session), in infertile couples in face‑to‑face training group and in telephone training
group (P < 0.0001). The score of the attitude toward adoption before counseling in the face‑to‑face
counseling group was 60.55 ± 5.5, which reached 66.76 ± 4.7 after counseling. Based on the results
of the T‑pair test, this difference was significant (P < 0.0001). In addition, in the telephone counseling
group, the score of attitude toward adoption increased from 59.53. 7.4 to 67.73 ± 7.5, which was a
significant difference in terms of t‑pair test. The mean score of attitudes toward adoption was not
statistically significant in the two groups (P = 0.653).
CONCLUSION: The results of this study showed that both counseling methods (face to face and
telephone) increase the level of awareness and attitude of couples about adoption, but neither
method was superior to the other.

Abstract BACKGROUND: The most important reasons for choosing cesarean include negative attitude of
pregnant women toward natural childbirth, and it is not easy for many women to make a decision
about the choice of delivery, Midwives as responsible individuals, play an important role in providing
maternal counseling and care during pregnancy and childbirth and the postpartum period. This study
was carried out to determine the effect of individual counseling on attitudes and decisional conflict
in the choice of delivery among nulliparous women.
MATERIALS AND METHODS: This clinical trial was performed on 90 nulliparous women with
28–30 weeks of gestational age, who were referred to health‑care centers in Mashhad. They were
divided randomly into intervention and control groups. The intervention group received the counseling
program individually during three sessions, while the control group received routine care, childbirth
attitudes, and decisional conflict on choice of delivery were compared on women of 34–36 weeks
of pregnancy. Data collection tools included demographic details form, Childbirth Attitudes Scale
and Decisional Conflict Scale; data were analyzed using Chi‑square tests, Fisher’s exact test,
Mann–Whitney test, t‑test, parried t‑test, and ANCOVA in SPSS v. 16, and P < 0.05 was considered
statistically significant.
RESULTS: After consultation, there was a significant difference in attitude score between the
intervention group (86.577 ± 13.531) and the control group (69.955 ± 19.858) (P < 0.001), And there
was a significant difference in decisional conflict score between the intervention group (0.614 ± 0.626)
and the control group (1.216 ± 0.949) (P < 0.001), and there were significant differences between
the two groups in terms of preferred delivery (P < 0.001).
CONCLUSION: According to the results of this randomized control trial, individual counseling in
nulliparous women during pregnancy leads to a positive attitude toward natural childbirth, informed
decision‑making, and increase in the selection of natural childbirth.

Abstract INTRODUCTION: Using fertility treatment will cause high levels of anxiety and depression. The study
was carried out with the objective of determining the effect of problem‑solving skills (PSS) training on
mental health and the success of treatment of infertile women under intrauterine insemination (IUI)
treatment.
MATERIALS AND METHODS: this randomized clinical trial was carried out on 72 women
referring to Milad Infertility Center in Mashhad. Individuals were randomly assigned into control and
intervention groups. PSS were taught in three sessions in the intervention group, and the control
group received usual care. The success rate of therapy and the mean of anxiety and depression
on the day of IUI operation were compared using the Beck Depression Inventory and Spielberger
Anxiety Inventory in both groups. t‑test, Mann–Whitney, paired t‑test, Wilcoxon, and Chi‑square
tests were used to analyze the data.
RESULTS: on the day of IUI operation, the mean score of state anxiety in the control
group (5 0 . 11 ± 8.51) and PSS (68.12 ± 11.49) was significant (P < 0.001), trait anxiety in the
control group (46.41 ± 8.70) and PSS (44.00 ± 9.92) was significant (P < 0.001), and depression in the
control group (17.44 ± 11.70) and PSS (12.99 ± 8.99) was significant (P < 0.001); however, the success
of treatment in both groups (14.7% and PSS (26.5%) was not significantly different (P = 0.230).
CONCLUSION: Considering the effect of problem‑solving on reducing anxiety and depression, it is
suggested that infertility center of this intervention should be used.