Journal of Education and Health Promotion

Abstract BACKGROUND: Quality of relationship marital status affects all aspects of family functioning,
including sustainability of cohabit living, supporting children, and happiness of couples. This study
was conducted to examine the effect of group cognitive‑behavioral counseling on optimism and
self‑esteem of women during the 1st month of marriage that referring to marriage counseling center.
MATERIALS AND METHODS: A semi‑experimental study was designed by a test, posttest, and
follow‑up. Participants consisted of 30 women admitted to premarriage counseling center of Farsan
city in 2018 with using purposive sampling by random numbers’ table into experimental and control
groups. The experimental group participated in eight consecutive 2‑h group counseling sessions.
Data collection tools were demographic questionnaire, Rosenberg’s Self‑Esteem Scale, and optimism
designed by Mir Ahmadi (reliability and validity are calculated and was 0.96) and completed in three
rounds. Women’s self‑esteem retested was done after 1 month. Data were analyzed with independent
t‑test and repeated measures ANOVA (significance level <0.005). Quantitative variables were
analyzed using the Kolmogorov–Smirnov test.
RESULTS: There were no significant differences between optimism scores in the
experimental (M = 150.47, standard deviation [SD] = 22.07) and control groups (M = 149.2,
SD = 21.54) prior to intervention (P = 0.875). The mean optimism score was significantly different in
intervention (M = 169.33, SD = 17.01) and control (M = 147.2, SD = 22.22) groups immediately after
counseling (P = 0.005) and 1 month after counseling (P = 0.002, M = 171.08, SD = 17.98). The mean
self‑esteem scores were statistically significant in both groups immediately after counseling (P = 0.023,
I: M = 37.06, SD = 8.69, C: M = 31.4, SD = 4.83) and 1 month after counseling (P = 0.028, I: M =
34.73, SD = 4.93, C: M = 30.06, SD = 4.8).
CONCLUSION: Cognitive‑behavioral counseling enhances women’s optimism by emphasizing
the training of communication and conflict resolution skills, which leads to positive attitude and life
satisfaction. Therefore, using cognitive‑behavioral counseling in marriage counseling sessions can
improve couples’ relationships.

Abstract BACKGROUND: Pregnant women are classified as one of the vulnerable groups. Physiological and
psychological changes during pregnancy predispose them to serious psychiatric disorders; if not
identified and treated in time, it can have a negative and long‑term impact on mental health. The aim
of this study was to determine the effect of cognitive–behavioral counseling of pregnant women with
the presence of a spouse on the level of stress, anxiety, and postpartum depression.
MATERIALS AND METHODS: The present study is a clinical trial that was performed on 40 pregnant
women with a gestational age of 32–28 weeks (20 in the intervention group, 20 in the control group)
who were randomly assigned to the intervention group and the control group according to the inclusion
criteria. Cognitive–behavioral group counseling in the presence of spouses was performed by the
midwife and under the supervision of a psychologist, in eight sessions, each session lasting 90 min,
once a week for the intervention group. The control group received routine care and a counseling
session. Data collection tools were demographic information questionnaire and Depression–Anxiety–
Stress Scale 21, which were completed before the intervention, immediately after the intervention,
and on the 14th day after delivery in both groups. Data analysis was performed using statistical tests,
independent t‑test, repeated measures test, Bonferroni post hoc test, and Kolmogorov–Smirnov test.
RESULTS: The results of this study showed that the mean scores of stress, anxiety, and depression
in the two groups in the preintervention stage were not significantly different (P < 0.05), but in the
postintervention stage and follow‑up, the mean scores of stress (P < 0.001), depression (P = 0.010),
and anxiety (P = 0.029) in the intervention group were significantly reduced compared to the control
group.
CONCLUSION: According to the research findings, cognitive–behavioral group counseling can be
effective as an approach in improving the symptoms of stress, anxiety, and depression in pregnant
women. Therefore, it is necessary to plan properly to use this counseling approach to manage stress,
anxiety, and depression in women during pregnancy.

Abstract INTRODUCTION: Today, the quality of health services is considered to be providing “error‑free”
services, at the right time, by the right person and with the least resources. In recent years, education
through evidence‑based care has been emphasized by health system policymakers as a way to
improve care standards. Therefore, the purpose of this study is to teach clinical error management
to midwifery students in Shahid Sadoughi University of Medical Sciences in Yazd.
METHODS: The present study was performed using consensus‑based methods based on Delphi
technique to identify the most common errors and the best educational solution for its management
with the participation of 21 midwives by purposive sampling method in Shahid Sadoughi University
of Medical Sciences in Yazd in 2018. The rate of agreement was 75% or more. Descriptive statistical
methods and SPSS‑18 software were used for analysis.
RESULTS: The most important errors mentioned were as follows: In the field of hospital care,
it was the scope of care during labor and in clinical care, it was the scope of prenatal care. The
most important error reduction strategies that were considered in the clinical guide in general were
emphasizing the following: active supervision of instructors during the provision of students’ clinical
services, paying attention to the evaluation of service provision with the least incidence of errors in
end‑of‑course evaluation, make changes in clinical teaching methods, attention to the use of active
teaching methods and the use of educational software. The cases were considered separately in
each of the mentioned errors.
DISCUSSION AND CONCLUSION: Incidence of errors in pregnancy and childbirth as the most errors
of midwifery students in the field of hospital and clinical care was agreed on. Therefore, considering
this issue and the importance of preventing errors to provide quality services to mothers and infants,
it seems that it is time to make changes in clinical education in this field by emphasizing the use of
active educational methods.