Journal of Education and Health Promotion

Abstract BACKGROUND: Midwifery services help maintain and improve the health of the community. However,
a comprehensive examination reduces students’ psychological well‑being by creating anxiety. For this
purpose, the present study was conducted to determine and compare the effect of two educational
methods based on mindfulness and cognitive emotion strategies on psychological well‑being and
anxiety of eighth‑semester midwifery students before the final clinical trial.
MATERIALS AND METHODS: This study was a quasi‑experimental three‑group study with available
sampling method that was performed on 30 eighth‑semester midwifery students of the School of
Nursing and Midwifery of Isfahan University of Medical Sciences in 2020–2021. Data collection tools
were psychological well‑being and Test Anxiety Questionnaire. Two intervention groups were trained
for eight sessions. The control group did not receive any training program. The data collected by
SPSS version 22 software were analyzed by analytical statistical tests of ANOVA and least significant
difference post hoc test.
RESULTS: The results showed that there was a statistically significant difference between the three
groups in terms of components of test anxiety and psychological well‑being. Furthermore, emotion
regulation training and mindfulness‑based training reduced test anxiety and increased students’
psychological well‑being before the comprehensive test (P = 0.001).
CONCLUSION: It is recommended that educational programs be considered before the comprehensive
examination to promote the mental health and success of these students.

Abstract BACKGROUND: Pregnancy causes a set of complex physiological and psychological changes that 
affect marital relationships. Mindfulness is a form of meditation that can promote person’s performance 
and perception of sexual relationships. The present study aimed to determine the effect of mindfulness 
on sexual desire and sexual satisfaction in primigravida pregnant women.
MATERIALS AND METHODS: The present study is a quasi‑experimental that has investigated 
on 72 primigravida pregnant women. The samples were selected randomly and assigned to 
experimental and control groups. The experimental group received six 90‑min sessions of mindfulness 
intervention, and the control group received the educational pamphlet. The female sexual function 
index (FSFI) was filled by the subjects of the two groups in three stages of before the intervention, a
week, and a month after the intervention. Data analysis was done by SPSS20 (Statistics 20 software;
SPSS Inc., Chicago, IL, USA) at the significance level of 0.05.
RESULTS: According to the statistical tests, there was no significant difference between the two
groups in terms of demographic characteristics and pregnancy information. The findings suggest
no significant difference between the mean pretest and posttest score of sexual desire in the two
groups (P > 0.05). However, the two groups were significantly different in terms of the mean score
of sexual satisfaction before and after the intervention (P<0.05).
CONCLUSION: By increasing the concentration on the present moment and avoiding judgment,
mindfulness can increase sexual satisfaction. However, sexual desire can be affected by various
factors such as the cultural context, the quality of marital relationships, and the pregnancy hormonal 
changes that can influence the sexual response.

Abstract BACKGROUND: Maternal attachment to the fetus is a term used to describe the emotional relationship
between mother and fetus. This emotional connection increases during pregnancy and is reflected
in her feelings, perceptions, and behaviors. Mindfulness is important as one of the factors affecting
the mental health of people during pregnancy. Therefore, the present study was conducted to
determine the relationship between the dimensions of mindfulness and maternal attachment to the
fetus during pregnancy.
MATERIALS AND METHODS: The present study was performed on 500 pregnant mothers referred
to health centers affiliated to Isfahan University of Medical Sciences. The samples were entered into
the study by available sampling method and if they had inclusion criteria and no exclusion criteria.
The research instruments were the Fetal Attachment Questionnaire and the Bauer Mindfulness
Questionnaire. The collected data were analyzed by SPSS software version 22.
RESULTS: The results of the data showed that there was no significant relationship between the
overall score of mindfulness and the overall score of maternal attachment to the fetus (P = 0.62).
While from the dimensions of mindfulness such as “action with awareness” there was a significant
negative relationship (P = 0.03) with maternal attachment to the fetus and a significant positive
relationship “observation” with maternal attachment to the fetus (P = 0.03).
CONCLUSION: According to the results of this study, there is a relationship between maternal
attachment to the fetus during pregnancy and a number of dimensions of mindfulness. For this
purpose, since mindfulness can increase the mother’s interactions with the fetus, and this interaction
begins during pregnancy and with the mother’s attachment to the fetus, it is important to pay attention
to this.

Abstract BACKGROUND: Having a baby admitted to a neonatal intensive care unit (NICU) is so stressful, has
a negative impact on mother well‑being, and also disrupts mother‑infant bonding process because
the infant spend the first several weeks or months in the NICU. Previous studies have shown the
positive association of the mindfulness and various health conditions. This study investigated the
relationship between mothers’ dispositional mindfulness and level of stress and bonding in mothers
with infants in the NICU.
MATERIALS AND METHODS: A cross‑sectional study was performed during 2019 on 140 mothers
with newborns admitted to the NICUs in two hospitals in Qom city in Iran. The self‑report measures of
dispositional mindfulness, Parental Stressor Scale: NICU, and the Postpartum Bonding Questionnaire
were administered to mothers on the 2nd–5th day after birth. The data analysis was carried out by
using a stepwise multiple regression model.
RESULTS: The mean scores of mindfulness, stress, and bonding were 3.32 ± 0.52, 2.32 ± 0.77,
and 0.47 ± 0.37, respectively. There was a statistically significant inverse relationship between total
mindfulness score and stress (P < 0.001). Furthermore, high scores of mindfulness were associated
with better bonding (P = 0.04).
CONCLUSIONS: Improvement in mindfulness helps mothers to reduce stress and make better
bonding with infants. It is recommended that mindfulness interventions use during pregnancy also
after birth, especially for mothers that their infants admitted to in the NICUs.

Abstract CONTEXT: One of the most important issues in patients with coronary artery disease is their mental
health indices such as perceived stress and perception of disease.
AIMS: The aim of this study was to evaluate the effectiveness of mindfulness‑based intervention on
the perceived stress and disease perception of patients with acute coronary syndrome.
MATERIALS AND METHODS: This is a clinical trial, two‑group, and three‑stage study on 76 patients
with acute coronary syndrome who were randomly divided into intervention and control groups. Nine
weekly sessions of mindfulness‑based training program were administered to the intervention group.
The control group received routine services during this period. Data collection was done before,
immediately, and 1 month after the intervention, using the Perceived Stress Scale and the Illness
Perception Questionnaire. Data were analyzed using descriptive and inferential statistics.
RESULTS: There was no significant difference between the mean scores of perceived stress and
illness perception before intervention. After the intervention and 1 month after it, the mean score
of perceived stress in the intervention group was statistically significantly lower than the control
group (P < 0.001), and the perception of disease in the intervention group was statistically significantly
higher than that of the control group (P < 0.001).
CONCLUSIONS: It is worthwhile to suggest the mindfulness‑based training program to reduce the
perceived stress and correct the perception of disease for patients with acute coronary syndrome.
Keywords:

Abstract INTRODUCTION: Patients undergoing hemodialysis have a low level of health and mindfulness
technique in mind‑body medicine is used to help patients with chronic illness. Therefore, this clinical
trial was conducted to determine the effect of the mindfulness program on the general health of
patients undergoing treatment with hemodialysis.
METHODS: Sixty hemodialysis patients were selected through the convenient method and randomly
divided into experimental and control groups. Both groups completed demographic information
questionnaire and general health questionnaire. Then, the experimental group received 8 sessions of
mindfulness training and the control group received 8 sessions of education in relation to end‑stage renal
disease and hemodialysis. Educational sessions were performed for both groups in the second 30 min
after hemodialysis for 1 h in six individual sessions and two 1.5 h group sessions. Immediately after
and 1 month after the intervention, the General Health Questionnaire was completed by both groups.
RESULTS: Analysis of the findings showed no significant differences between the mean score
of general health disorder and its subscales before the intervention in to two groups (P > 0.05).
Nevertheless, after intervention in the experimental group, the mean of general health disorder score
decreased from 44.17 ± 12.32 to 21.9 ± 6.4 and 1 month after the intervention, the mean score
of this score was 23.6 ± 6.2. The mean score of physical symptoms, anxiety and sleep disorder,
social functioning deficiency, and depression were also significantly lower in the experimental group
immediately after intervention and 1 month after the intervention; however, there were no significant
differences between the mean of this score immediately and 1 month after the intervention. In addition,
the mean score of general health disorder changes immediately and 1 month after the intervention
in the experimental group was significantly more than the control group. In the control group, there
was no significant difference between the mean score of general health disorder and its subscales
before, immediately, and 1 month after the intervention (P > 0.05).
CONCLUSIONS: The results of this research showed that mindfulness has been effective in reducing
physical and anxiety symptoms, sleep disorder, social dysfunction, and depression symptoms.
Therefore, the use of mindfulness as a complementary treatment can improve the general health
level in these patients.

Abstract Background: Mindfulness may be conceptualized as a dispositional trait which differs
across individuals, so this study was, therefore, designed to determine the survey of
mindfulness in multiple sclerosis (MS) patients and its association with attachment style.
Materials and Methods: This was a cross‑sectional study which was conducted in Kashani
Hospital affiliated to Isfahan University of Medical Sciences, Iran, in 2013. Samples were 210
adult patients who suffered from MS completed demographic and disease characteristics
questionnaire, Five Factor Mindfulness Questionnaire and adult attachment style. The SPSS
version 16 software was used to conduct statistical tests including t‑test, NOVA, and Pearson
correlation. Results: The means of age and duration of illness were (33/96 ± 9/5) years
and (24/3 ± 6/3) month, respectively. Most patients were married (66/1%), without university
education (62/8%) and with incomes suffice (63%). The majority of the patients had received
beta‑interferon (55/4%) as their main treatment. The mean ± standard deviation attachment
style and mindfulness were 25/6 ± 11/6 and 79/8 ± 25/6, respectively. Furthermore, there
was a significant negative correlation between the attachment style score and mindfulness
score (P = 0.001, r = −0.32). Conclusion: The result shows that stronger association between
mindfulness and attachment can reflect the beneficial effects of mindfulness interventions
on both mindfulness and attachment and it can provide some evidence that mindfulness
interventions may enhance secure attachment.