Journal of Education and Health Promotion

The effect of cognitive–behavioral counseling of pregnant women with the presence of a spouse on stress, anxiety, and postpartum depression

. Maryam Dafei; . Shahnaz Mojahed; . Ghasem Dastjerdi; . Ali Dehghani; . Tayebeh Shojaaddini Ardakani

Volume 11, Issue 4 , May 2021, , Pages 1-7

Abstract

  BACKGROUND: Pregnant women are classified as one of the vulnerable groups. Physiological andpsychological changes during pregnancy predispose them to serious psychiatric disorders; ...  Read More BACKGROUND: Pregnant women are classified as one of the vulnerable groups. Physiological andpsychological changes during pregnancy predispose them to serious psychiatric disorders; if notidentified and treated in time, it can have a negative and long‑term impact on mental health. The aimof this study was to determine the effect of cognitive–behavioral counseling of pregnant women withthe 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 pregnantwomen 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 inclusioncriteria. Cognitive–behavioral group counseling in the presence of spouses was performed by themidwife 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 counselingsession. 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 depressionin the two groups in the preintervention stage were not significantly different (P < 0.05), but in thepostintervention 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 controlgroup.CONCLUSION: According to the research findings, cognitive–behavioral group counseling can beeffective as an approach in improving the symptoms of stress, anxiety, and depression in pregnantwomen. Therefore, it is necessary to plan properly to use this counseling approach to manage stress,anxiety, and depression in women during pregnancy.

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Maternal predictive factors for preterm birth: A case–control study in Southern Iran

. Azin Alavi; . Parisa Razmjoue; . Ali Safari‑Moradabadi; . Sakineh Dadipoor; . Saeideh Shahsavari

Volume 11, Issue 4 , May 2021, , Pages 1-6

Abstract

  BACKGROUND: Preterm birth (PTB) is one of the most important factors that increase the risk ofchronic diseases and postpartum death in infants. The aim of this study was to determine ...  Read More BACKGROUND: Preterm birth (PTB) is one of the most important factors that increase the risk ofchronic diseases and postpartum death in infants. The aim of this study was to determine the maternalfactors that affect the birth of preterm infants in the city of Bandar Abbas.MATERIALS AND METHODS: This is a case–control study that was performed on 400 preterminfants. Sampling was done by a simple method, and information was gathered by interviewing themothers and their medical records. Data were collected by SPSS software version 16. To comparerisk factors in the two groups, conditional logistic regression was used, and P < 0.05 was consideredstatistically significant.RESULTS: Results showed that factors such as type of delivery (odds ratio [OR] = 3.584, 95%confidence interval [CI]: 1.981–6.485), preeclampsia (OR = 2.688, 95% CI: 1.164–6.207), historyof PTB (OR = 4.171, 95% CI: 1.483–11.728), premature rupture of membranes (OR = 3.273,95% CI: 1.745–6.137), care during prenatal (OR = 0.334, 95% CI: 0.159–0.701), placentalabruption (OR = 3.209, 95% CI: 1.209–8.519), placenta previa (OR = 9.333, 95% CI: 2.086–41.770),and cervical insufficiency (OR = 11, 95% CI: 1.381–87.641) were independent risk factors of preterminfant birth.CONCLUSIONS: The PTB risk is higher for women with cervical insufficiency, history of placentaprevia, and history of preterm. Early recognition and management of these high‑risk conditions amongpregnant women may lead to a reduction in PTB rates.

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The effect of education on anxiety of pregnant mothers before amniocentesis

. Shahnaz Mojahed; . Razie Sadat Tabatabaei; . Fariba Reihani; . Ali Dehghani; . Faride Khavari

Volume 11, Issue 2 , February 2021, , Pages 1-8

Abstract

  BACKGROUND: Pregnancy alone is associated with many anxieties and worries for many women.Prenatal diagnosis of fetal malformations is one of the most important anxious events for women.Increasing ...  Read More BACKGROUND: Pregnancy alone is associated with many anxieties and worries for many women.Prenatal diagnosis of fetal malformations is one of the most important anxious events for women.Increasing knowledge empowers the person to identify the important issues and by increasingunderstanding, creates a positive attitude in people. Therefore, the aim of this study was to investigatethe effect of education on the level of anxiety of pregnant mothers before invasive screening for fetalabnormalities (amniocentesis).MATERIALS AND METHODS : This is a quasi‑experimental study with two parallel designs in threestages: Pretest (before intervention), posttest (after intervention), and after amniocentesis. This studywas performed on 80 pregnant women candidates for amniocentesis (40 pregnant women in thecontrol group and 40 pregnant women in the intervention group) referred to the perinatology clinic inYazd in 2020. Data collection tools were demographic and midwifery questionnaires and Spiel Bergeranxiety questionnaires. In the experimental group, the intervention was performed as group trainingfor 90 min immediately before amniocentesis. In the control group, only routine procedures (briefdescription by a perinatologist during amniocentesis) were performed. SPSS software version 16was used to analyze the data.RESULTS: The mean age of the research units was 67/5 ± 5/33 years. The results of Mann–Whitneyintergroup test showed that the mean scores of overt anxiety before the intervention between thecontrol and intervention groups were not significant (P < 0.014) but were significant after training andafter amniocenter (P < 0.001). Furthermore, the results of Mann–Whitney group test showed thatthe mean scores of overt anxiety in the intervention group before and after training were significant(P < 0.001). Furthermore, the results of the control group showed significant results (P < 0.001). Theresults of the independent t‑test showed that the mean scores of latent anxiety before the interventionbetween the control and intervention groups were not significant (P < 0.194) but were significantafter the training (P < 0.57) but The results were not significant after amniocentesis (P < 0.216).Furthermore, the results of paired t‑test within the group showed that the mean scores of overtanxiety in the intervention group before and after training was significant (P < 0.001). Furthermore,the results of the control group showed significant results (P < 0.001).CONCLUSION: The findings of the present study indicate the positive effect of education on anxiety ofpregnant women candidates for amniocentesis. The results also show the important role of educationon the psychological dimension of high‑risk pregnant women in relation to the consequences ofpregnancy and childbirth. According to the research results, it seems that education affects thecognitive system and information processing by increasing people’s awareness of the amniocentesisprocess and its consequences.

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The association between social support and psychological factors with health‑promoting behaviours in pregnant women: A cross‑sectional study

. Nasrin Rashan; . Nasibeh Sharifi; . Azita Fathnezhad‑Kazemi; . Khadijeh Golnazari; . Safoura Taheri

Volume 11, Issue 1 , January 2021, , Pages 1-7

Abstract

  INTRODUCTION: Health promotion is one of the most important aspects in pregnancy, andhealth‑promoting behaviors are one of the major determinants of health under the influence of ...  Read More INTRODUCTION: Health promotion is one of the most important aspects in pregnancy, andhealth‑promoting behaviors are one of the major determinants of health under the influence of variousfactors. This study aimed to determine the association between social support and psychologicalfactors with health‑promoting behaviors in pregnant women.MATERIALS AND METHODS: This cross‑sectional was performed on 375 pregnant women whenthey had 24–28 weeks in Ilam, October 2018 to May 2019. Two‑stage cluster sampling was performedafter checking the inclusion criteria. Data collection tools consisted of four questionnaires that werecompleted in self‑report form. The collected data were analyzed by the descriptive and inferentialtests with the SPSS software version 19.RESULTS: The mean score of health‑promoting behaviors was 139.87 (21.26) and self‑healing andphysical activity had the highest and the lowest mean 27.67 (4.84) and 16.29 (4.84), respectively.Linear regression analysis showed a significant difference between different level of stress, anxiety,depression, and social support with health‑promoting behaviors (P < 0.001). The results showedthat one‑point increase in the score of stress, anxiety, and depression led to the 2.2%, 6.1%, and24.1% reduction of health‑promoting behaviors, respectively, and one‑point score increase in socialsupport resulted in 40% increase in health‑promoting behaviors (P < 0.001).CONCLUSION: A negative association was found between psychological factors and a positiverelationship with health‑promoting behaviors. Although perceived moderate health promotionbehaviors and perceived social support were moderate, they did not have a good status in terms ofpsychological factors. Given awareness of the issues under study in each region is essential andplanning to improve stress, anxiety, and depression, as well as promoting and correcting inappropriatebehaviors through planned interventions are required.

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Assessing the effect of self‑care education on anxiety and depression among pregnant women with a history of spontaneous abortion

. Taharah Boryri; . Ali Navidian; . Fatemeh Hashem Zehi

Volume 10, Issue 12 , December 2020, , Pages 1-8

Abstract

  INTRODUCTION: Abortion is one of the most common complications of early pregnancy, whichemerges as a physically and mentally devastating experience. Due to the prevalence and importanceof ...  Read More INTRODUCTION: Abortion is one of the most common complications of early pregnancy, whichemerges as a physically and mentally devastating experience. Due to the prevalence and importanceof postabortion mental health problems and their adverse effects on subsequent pregnancies, someinterventions should be made to reduce the resultant anxiety and depression. The present studyaimed to determine the effect of self‑care education on anxiety and depression among pregnantwomen with a history of spontaneous abortion.METHODS: This randomized quasi‑experimental study was performed on ninety pregnant womenwith a history of spontaneous abortion who referred to health centers in Zahedan in 2019. Thesamples were selected by convenience sampling method and randomly assigned to two interventionand control groups. Between 6 and 16 weeks of gestation, the participants in the intervention groupreceived four sessions of 60‑min self‑care training over 2 weeks. On the other hand, the controlgroup received routine pregnancy care. Data collection tools included a demographic and fertilityevaluation questionnaire, a 6‑item short‑form of the state scale of the Spielberger State‑Trait AnxietyInventory, and a short form of Beck Depression Inventory. Posttest was performed 4 weeks afterthe end of the intervention. The data were analyzed in SPSS software (version 21) using statisticaltests of independent t‑pair, paired t‑pair, Chi‑square, and Fisher’s exact test.RESULTS: Based on the obtained results, there was no significant difference between the twogroups in terms of anxiety and depression scores before the intervention. Nonetheless, after theintervention, the mean scores of anxiety and depression in the intervention group were calculatedat 7.31 ± 1.31 and 4.71 ± 1.90, respectively. However, these scores were reported as 1.87 ± 13.46and 9.31 ± 1.59 in the control group, respectively (P = 0.0001).CONCLUSION: As evidenced by the obtained results, self‑care education is effective in the reductionof anxiety and depression in pregnant women with a history of spontaneous abortion. Therefore,health professionals and health‑care providers should enrich prenatal care programs with thesetraining sessions and provide women with peace of mind and comfort during pregnancy.

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Investigating the effect of health literacy level on improving the quality of care during pregnancy in pregnant women covered by health centers

. Leila Asadi; . Fatemeh Amiri; . Hadise Safinejad

Volume 10, Issue 10 , October 2020, , Pages 1-6

Abstract

  BACKGROUND: Health literacy is the capacity to acquire, process, and understand basic informationand services necessary for appropriate health decisions. Given the importance of health ...  Read More BACKGROUND: Health literacy is the capacity to acquire, process, and understand basic informationand services necessary for appropriate health decisions. Given the importance of health literacy inwomen, the aim of the present study was to determine the effect of health literacy level on improvingthe quality of care during pregnancy in pregnant women.MATERIALS AND METHODS: The present study was a cross‑sectional analytical study. In thisstudy, 130 women referred to Yazd health centers were examined. Health literacy questionnairesand a researcher‑made checklist of the quality of pregnancy care were used to gather information.The researcher‑made checklist of the quality of pregnancy care was in accordance with the standardprotocol of the Ministry of Health and Medical Education, entitled Integrated Health Care for PregnantMothers, which was validated and reliable. SPSS statistical software version 19 and t‑test and ANOVAstatistical tests were used to analyze the data.RESULTS: According to the findings, the average score of health literacy in pregnant women was74.09, which showed that the level of health literacy was in the marginal or border range. Peoplewith higher health literacy received significantly more prenatal counseling than other women andhad a planned pregnancy (P = 0.04).CONCLUSION: The level of health literacy in pregnant women is unfavorable. Given that the highlevel of health literacy in women in society can lead to an increase in the quality of pregnancy care, soto increase health literacy in women, it is recommended that regular training in society by health‑careproviders be given more attention.

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The effect of educational classes during pregnancy on the level of sexual satisfaction after delivery in nulliparous women

. Farzaneh Rahimi; . Shadi Goli; . Fariba Eslami

Volume 10, Issue 9 , September 2020, , Pages 1-7

Abstract

  BACKGROUND: In the postpartum period, changes in sexual desire and marital satisfaction can beseen. Learning and giving enough information on changes in pregnancy and postpartum can ...  Read More BACKGROUND: In the postpartum period, changes in sexual desire and marital satisfaction can beseen. Learning and giving enough information on changes in pregnancy and postpartum can helpto increase marital satisfaction. The purpose of this study was to determine the effect of prenataltraining on the level of postpartum marital satisfaction in nulliparous women.METHODS: This study is a semi‑experimental two‑group study in which 150 nulliparous women weredivided into two groups: control and intervention groups. The samples into intervention group receivedroutine prenatal care and eight sessions of prenatal education with a training package (educationalpamphlet on sexual health and sexual issues and an educational CD on pregnancy and pelvicexercises), and the control group received only routine prenatal care along with a pregnancy educationpamphlet. Marital satisfaction was measured before intervention during pregnancy and 3 monthsafter delivery (after intervention) using the ENRICH Marital Satisfaction Scale. Data were analyzedusing t‑test, paired t‑test, Mann–Whitney, and Chi‑square test.RESULTS: There was no significant difference in demographic and obstetric variables and pregnancystatus between the two intervention and control groups (P > 0.05). There was no significant differencein marital satisfaction during pregnancy between the two groups (before intervention) (P > 0.05).However, there was a significant difference in the level of postpartum marital satisfaction in theintervention group (P < 0/05). So that, the average marital satisfaction is increased from 52.2 to 64.6.CONCLUSION: The results of this study show that eight sessions of prenatal education class with atraining package (educational pamphlet on sexual health and sexuality and training CD of prenataland pelvic floor exercise) can improve postpartum marital satisfaction in women.

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Comparing the effect of group training and telemedicine on exercise during pregnancy: An application of the health belief model

. Zahra Sheibani Matin; . Samira Khayat; . Ali Navidian; . Hamed Fanaei

Volume 10, Issue 7 , July 2020, , Pages 1-8

Abstract

  INTRODUCTION: Many women refuse to exercise during pregnancy due to lack of awareness andnot receiving training. The aim of this study was to investigate and compare the effect of group ...  Read More INTRODUCTION: Many women refuse to exercise during pregnancy due to lack of awareness andnot receiving training. The aim of this study was to investigate and compare the effect of group andtelemedicine education on exercise during pregnancy by using the health belief model (HBM).MATERIALS AND METHODS: This quasi-experimental study was carried out in 2019 in Zahedan,and a total of 135 pregnant women participated in it. Samples were randomly assigned to the followingthree groups: group training (n = 45), telemedicine (n = 45), and control (n = 45). Group training waspresented in three sessions, and the telemedicine group received the educational content throughmobile applications. The samples completed the HBM questionnaire before and 6 weeks after theintervention. In addition, within 6 weeks after the intervention, they completed the exercise activityschedule. SPSS software Ver. 16 (IBM Corp, Armonk, NY, USA) was used for analysis, and datawere analyzed by ANOVA, Tukey’s post-hoc test, Kruskal–Wallis test, and Mann–Whitney test.RESULTS: After intervention, the scores of HBM constructs and exercise levels in group training,telemedicine group, and control group, respectively, were as follows: perceived susceptibility25.91 ± 3.24, 25.51 ± 1.97, and 22.55 ± 3.78; perceived severity 27.48 ± 2.27, 25.13 ± 2.29, and22.51  ±  3.88; perceived benefits 27.28  ±  2.97, 25.68  ±  3, and 22.8  ±  3.05; perceived barriers10.69 ± 2.69, 10.66 ± 3.19, and 14.17 ± 3.14; cues to action 24.71 ± 4.35, 23.9 ± 2.48, and22.84  ±  3.02; self-efficacy 26.17  ±  3.05, 25.2  ±  2.82, and 22.51  ±  3.38; and exercise levels70.99 ± 20.43, 56.51 ± 21.99, and 37.62 ± 29.66. Group training and telemedicine led to significantimprovement in all HBM constructs and exercise levels (P < 0.05, P < 0.0001, and P = 0.003,respectively). Group training provided more improvement than telemedicine in the scores of perceivedseverity (P < 0.0001), perceived benefits (P = 0.001), cues to action (P = 0.02), and mean exercisetime (P = 0.001).CONCLUSION: The results of this study showed that the HBM is a proper model for exerciseeducation in pregnant women. It is recommended to use HBM as a group training and telehealth inpromoting the rate of exercise in pregnant women.

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Novel coronavirus disease 2019 and perinatal outcomes

. Morvarid Irani; . Ali Pakfetrat; . Mahin Kiyani Mask

Volume 10, Issue 4 , April 2020, , Pages 1-5

Abstract

  BACKGROUND AND AIM: Given the prevalence of novel coronavirus disease 2019 (COVID‑19)and the lack of information on coronavirus and pregnancy, the purpose of this study was to evaluatethe ...  Read More BACKGROUND AND AIM: Given the prevalence of novel coronavirus disease 2019 (COVID‑19)and the lack of information on coronavirus and pregnancy, the purpose of this study was to evaluatethe association of COVID‑19 and perinatal outcomes in pregnant women.MATERIALS AND METHODS: In the present review article, the search process was conducted onEnglish and Persian scientific databases of PubMed, Scopus, Google Scholar, Magiran, Irandoc,Iranmedx, and SID as well as the websites of international organizations of World Health Organizationand Centers for Disease Control and Prevention using the main keywords of “Pregnancy,” “Perinataloutcomes,” “Coronavirus,” “COVID‑19,” “MERS‑CoV,” “MERS,” “SARS‑CoV‑2,” and “SARS‑CoV‑1”and their Persian‑equivalent keywords from inception until March 16 2020.RESULTS: The findings of studies on mothers with COVID‑19 were limited, and insufficient informationis available on the adverse pregnancy outcomes in pregnant women with COVID‑19. In cases ofinfection with other coronaviruses such as Middle East respiratory syndrome and severe acuterespiratory syndrome during pregnancy, there have been reports on adverse pregnancy outcomessuch as miscarriage, stillbirth, preterm labor, low birth weight, and congenital malformations followinghigh fever in the first trimester.CONCLUSION: Pregnant women may be more susceptible to viral respiratory infections, includingCOVID‑19, due to immunological and physiological changes. Therefore, pregnant women shouldtake routine preventive measures, such as washing their hands frequently and avoiding contact withinfected people, to prevent infection.

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The relationship between hope and resilience with promoting maternal attachment to the fetus during pregnancy

. Mahnaz Noroozi; . Mahboobe Gholami; . Zahra Mohebbi‑Dehnavi

Volume 10, Issue 3 , March 2020, , Pages 1-7

Abstract

  INTRODUCTION: Maternal attachment to the fetus is an emotional bond and the unique relationshipof the pregnant woman to the fetus. Attachment is an important predictor of mental health. ...  Read More INTRODUCTION: Maternal attachment to the fetus is an emotional bond and the unique relationshipof the pregnant woman to the fetus. Attachment is an important predictor of mental health. One ofthe psychological factors affecting mental health is resilience and hope. The purpose of this studywas to determine the relationship between hope and resilience with promoting maternal attachmentto the fetus during pregnancy.METHODS: This is a descriptive correlational study performed on 386 pregnant women referred tocommunity health centers in Isfahan‑Iran. The research instruments were standard questionnairesof Hope Snyder, Conor and Davidson Resilience, and maternal attachment to the fetus of Cranley.Data were analyzed using descriptive statistics and Pearson’s correlation test.RESULTS: The results showed that there is no significant relationship between the overall scoreof maternal attachment to the fetus and the total score of hope (P = 0.73). The overall score ofmaternal attachment to the fetus was positively and significantly correlated with hope subscales,including thinking (P = 0.004) and path (P = 0.047). The overall score of maternal attachment to thefetus was positively and significantly correlated with the overall score of resilience (P = 0.03). Therewas a correlation between the dimensions of maternal attachment to the fetus, including interactionwith the fetus (P = 0.003) and self‑sacrifice (P = 0.015). Maternal role acceptance (P = 0.001) waspositively and significantly correlated with hope thinking subscale. Self‑sacrifice (P = 0.027) anddifferentiation between self and fetus (P = 0.035) were positively and positively correlated with hopepath subscales. Self‑sacrifice (P = 0.03) and attribution to fetus (P = 0.001) had a significant positiverelationship with resilience.CONCLUSION: The results of this study showed that hope and resiliency are positively andsignificantly associated with maternal attachment to the fetus during pregnancy. Hope and resiliencyare positively and significantly associated with maternal attachment to the fetus, thus increasing theexpectation of pregnant mothers to increase their attachment to their fetus. As a result, they are payingmore attention to prenatal care, which can guarantee the health of their mothers and their babies.

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The relationship between perfectionism and body image with eating disorder in pregnancy

. Maryam Kiani-Sheikhabadi; . Marjan Beigi; . Zahra Mohebbi-Dehnavi

Volume 9, Issue 12 , December 2019, , Pages 1-6

Abstract

  INTRODUCTION: Mental health is very important during pregnancy, and perfectionism, body image,and eating disorder are three important factors in mental health. Given that eating disorders ...  Read More INTRODUCTION: Mental health is very important during pregnancy, and perfectionism, body image,and eating disorder are three important factors in mental health. Given that eating disorders are verydangerous in pregnancy, the aim of this study was to determine the relationship between perfectionismand body image with eating disorder in pregnancy.METHODS: This descriptive study was performed on 200 pregnant women referred to Isfahan HealthCenters in 2017. The research units, if met the inclusion criteria, completed the Eating AttitudesQuestionnaire, Multidimensional Relationships of their Body Questionnaire, and PerfectionismQuestionnaire. Finally, the data were analyzed by SPSS software version 22, with a significancelevel of 0.05.RESULTS: The results showed that there was a significant negative relationship between positiveperfectionism with symptoms of eating disorder, anorexia nervosa, and nervous longing to eat.There was a significant positive correlation between negative perfectionism with symptoms of eatingdisorder, anorexia nervosa, and nervous longing to eat. The results also showed a significant negativerelationship between body image and its dimensions with symptoms of eating disorder, anorexianervosa, and neurasthenia.CONCLUSION: Perfectionism and body image and its dimensions are psychological problems relatedto eating disorder in pregnancy. For this reason, it seems that taking classes for pregnant womenand their spouses can reduce the incidence of this disorder.

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The investigation of effects of static immersion and calming in water on pregnant women’s stress participating in preparation classes for childbirth

. Leila Ebad Sichani; . Parvin Bahadoran; . Fariba Fahami; . Parivash Shekarchizadeh Esfahani

Volume 9, Issue 11 , November 2019, , Pages 1-6

Abstract

  INTRODUCTION: Stress in pregnancy can have a negative effect on mother and fetus and at laston childhood. The use of stress reduction techniques in pregnant women has an effective role ...  Read More INTRODUCTION: Stress in pregnancy can have a negative effect on mother and fetus and at laston childhood. The use of stress reduction techniques in pregnant women has an effective role inthe reduction of the mother and child’s mental problems. This study aimed at determining the effectof static immersion and relaxing the pregnant women in water on stress, participating in preparationclasses for childbirth in Isfahan, Iran, 2017.METHODS: The present study was a semi‑experimental and had pre‑ and post‑testone on 55 pregnant women aged 20–30 weeks (20 test group and 35 control group)participating in the preparation classes for delivery by available sampling method selected in2017 and their stress level was assessed by depression, anxiety, and stress scale questionnaire.Then, they were divided into test and control groups. In the control group, no intervention wasperformed, and in the test group, static immersion and calming in water was done in IsfahanUniversity’s 9‑Dey Pool. To analyze the data, paired t‑test, Chi‑square t‑test, and independentt‑test were used.RESULTS: In this study, stress in the test group decreased after the intervention, so that the meanstress score decreased from 20.20 to 16.67 (P < 0.05). Of course, the stress level declined in thecontrol group, but in the control group, it decreased significantly.CONCLUSION: Based on the findings of the present study, static immersion and calming in waterare considered as reducing women’s stress intervention in improving pregnancy period and aretherefore recommended to be included in the sanitary system.

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Influence of maternal periodontal health as a risk factor for low‑birth‑weight infants in Terai population of Nepal

. Sartaj Singh Wazir; . Pallak Arora; . Snehashish Ghosh; . Vasuda Bhagat; . Suchi Khurana; . Swagat Mahanta

Volume 9, Issue 11 , November 2019, , Pages 1-6

Abstract

  BACKGROUND: Preterm low birth weight (PLBW) is a leading perinatal problem in developingcountries. PLBW is considered as a leading cause of neonatal death in the 1st year of life, with ...  Read More BACKGROUND: Preterm low birth weight (PLBW) is a leading perinatal problem in developingcountries. PLBW is considered as a leading cause of neonatal death in the 1st year of life, with problemsin childhood and adulthood. Several studies have suggested a possible relationship between PLBWand periodontal status of the expectant mothers. The present study was conducted to determine theassociation between the maternal periodontitis and the low birth weight (BW) of the babies.MATERIALS AND METHODS: This study consisted of 200 primipara mothers ranging between18 and 35 years old, with a mean age of 23.96 years. The mothers were categorized based on theweight of the infants as cases (BW <2500 g) and as controls (BW ≥2500 g). Age, mean weight,height, body mass index, and periodontal status of the mothers as well as weight of the babies wererecorded. Periodontal parameters were assessed using the community periodontal index (CPI). Thedata were recorded, analyzed, and statistically compared using the Chi‑square test (χ2).RESULTS: BW of the babies was regressed against CPI. Periodontitis was significantly associatedwith decrease in BW of the babies (P < 0.0001).CONCLUSION: Our findings showed an association of maternal periodontal disease with PLBW thatemphasizes to promote good oral hygiene of the expectant mothers during routine prenatal visits.

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Investigating the service provision challenges by healthcare providers in selected comprehensive health centers

. Foruzandeh Sabaghpoor; . Shahnaz Kohan; . Pejman Aghdak; . Marjan Beigi

Volume 9, Issue 9 , September 2019, , Pages 1-6

Abstract

  INTRODUCTION: The healthcare program has opponents and supporters with its multiple policiesand also its difficult implementation, which requires that its barriers and problems be addressedcomprehensively ...  Read More INTRODUCTION: The healthcare program has opponents and supporters with its multiple policiesand also its difficult implementation, which requires that its barriers and problems be addressedcomprehensively and extensively. This study was conducted aimed to determine the serviceprovision challenges by healthcare providers, from their point of view, in selected comprehensivehealth centers of Isfahan.MATERIALS AND METHODS: The present study is a descriptive‑analytic one. One‑hundredand ninety‑seven healthcare providers were selected by census sampling method from thepopulation of female healthcare providers in Isfahan comprehensive health centers in 2017. Thedata collection tool was a researcher‑made questionnaire in the field of individual–professional,managerial–organizational, and executive challenges. Data analysis was done by repeated measuresANOVA and post hoc test.RESULTS: The findings indicated that there was a significant difference between the mean scoreof individual–professional, managerial–organizational, and executive challenges (P < 0.001) fromthe point of view of healthcare providers. According to least significant difference post hoc test, themean score of individual challenges was significantly lower than that of managerial and executivechallenges (P < 0.001). However, there was no significant difference between the mean score ofmanagerial–organizational and executive challenges (P = 0.46).CONCLUSION: Based on the results, healthcare providers have put forward several challenges duringthe implementation of the healthcare program. Meanwhile, executive and managerial challengeshave been considered more than individual challenges. Considering that this could lead to improperservice provision to the clients, the role of policymakers in this program to remove obstacles and toprovide satisfaction to healthcare providers is emphasized.

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Investigating the relationship between cognitive emotion regulation and the health of pregnant women

. Fatemeh Ghorbani-Marghmaleki; . Zahra Mohebbi-Dehnavi; . Marjan Beigi

Volume 9, Issue 9 , September 2019, , Pages 1-6

Abstract

  INTRODUCTION: Mental health is one of the focuses of the health assessment of differentcommunities and plays an important role in ensuring the dynamism and efficiency of each community.Pregnancy ...  Read More INTRODUCTION: Mental health is one of the focuses of the health assessment of differentcommunities and plays an important role in ensuring the dynamism and efficiency of each community.Pregnancy is one of the most sensitive periods, in which mental health is effective. The mental healthof individuals is the result of the interaction of cognitive‑emotional ordering strategies and properevaluation of stressful situations. The aim of this study was to determine the relationship betweencognitive emotion regulation and the health of pregnant women.MATERIALS AND METHODS: This is a descriptive and cross‑sectional study that was carried out on200 pregnant women who were covered by Navab, Amir Hamzeh and Motahari centers in Isfahan in2017 by available sampling method. The instrument was the Beck Depression Inventory, GoldenbergHealth, and Emotional Cognitive Order. Finally, the data were analyzed using the SPSS software.RESULTS: The mean age of pregnant mothers participating in the study was 26.66 ±6.09 years. The resultsof data analysis showed a significant positive correlation in relation to blaming others and disaster withphysical health, blaming others and rumination and catastrophes with anxiety, disaster with social health,blaming others and rumination and catastrophes with depression, and also blaming others and rumination,catastrophizing, and positive re‑focusing have a significant positive correlation with total health score.CONCLUSION: Regarding the relationship between mental health and cognitive dysmenorrheaduring pregnancy, pregnant women carers can help with pregnant women by conducting educationalprograms on health promotion and strive to maintain mental health and improve their quality of life.Consequently, they will ensure the mental health of their future children.

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The relationship between mode of delivery and postpartum depression

. Leyla Kaya; . Zerrin Çiğdem

Volume 9, Issue 1 , January 2019, , Pages 1-6

Abstract

  PURPOSE: Postpartum period is a critical interval in which the woman is under risk for psychiatricdisorders including postpartum depression (PD). This study was performed to investigate ...  Read More PURPOSE: Postpartum period is a critical interval in which the woman is under risk for psychiatricdisorders including postpartum depression (PD). This study was performed to investigate the impactof the mode of delivery on the occurrence of PD in primiparous mothers.MATERIALS AND METHODS: This correlational study was performed on 244 primiparouswomen (aged 15–49 years) in 17 primary health‑care centers. Sociodemographic, obstetric, andPD‑related data were gathered using questionnaires and the Edinburgh Postnatal DepressionScale (EPDS) on the 1st and 3rd months after delivery. The questionnaires were administered to allprimiparous mothers who were registered to the relevant health-care center. Questionnaires wereadministered by the researcher for 25–30 min with face-to-face interview technique.RESULTS: Comparison of EPDS scores on the 1st and 3rd months indicated that there was aremarkable decline over time (Z = 11.112, P = 0.001). There was an inverse association betweeneducational level and EPDS scores on the 3rd month (P = 0.037). On the other hand, no significantrelationship was detected between age groups, occupation, income, place of accommodation, andEPDS scores. Evaluation of the relationship between obstetric features and EPDS scores revealedthat desired and performed modes of delivery, induction, episiotomy, and spinal anesthesia werenot linked with EPDS scores. The postpartum behavior (2=10.315; P = 0.035) and feeding methodof infants (2 = 6.109; P = 0.013) were associated with EPDS scores on the 1st month, but not withEPDS scores on the 3rd month.CONCLUSION: Effective measures must be established for early recognition of factors affecting theoccurrence of PD. Health planners and policymakers must spend their efforts for promotion of theknowledge and attitudes of mothers during pregnancy. Identification of factors for PD necessitatesimplementation of multicentric, controlled trials on larger series.

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Psychological profiles of risk for antenatal depression and anxiety in Iranian sociocultural context

. Zahra Alipour; . Gholam Reza Kheirabadi; . Ahmad Ali Eslami; . Ashraf Kazemi

Volume 8, Issue 12 , December 2018, , Pages 1-7

Abstract

  BACKGROUND AND AIM: Mental health issues including depression and anxiety are commonin pregnancy worldwide. This study aimed to identify factors associated with mental disorders in ...  Read More BACKGROUND AND AIM: Mental health issues including depression and anxiety are commonin pregnancy worldwide. This study aimed to identify factors associated with mental disorders in asample of Iranian pregnant women.MATERIALS AND METHODS: A cross‑sectional study was conducted among pregnant womenreferred to a prenatal‑care clinic in an urban area, Isfahan, Iran. The questionnaires in this studyincluded the General Health Questionnaire and additional structured questionnaires exploringsociodemographic, obstetric, and economic risk factors and empowerment for decision‑makingregarding pregnancy, parenting, financial authority, trust, and confidence in health‑care staff.Regression analysis was performed to assess the impact of the number of variables on the likelihoodof the presence of mental health problems.RESULTS: Overall, 54.2% and 11.7% of the women had anxiety and depression, respectively. Nostatistically significant associations were reported between anxiety and depression and obstetriccharacteristics such as gestational age, parity, abortion, previous infertility, unwanted pregnancy,and the screening test results . According to the logistic regression analysis, the predictors ofdepression and anxiety were acknowledging psychological changes in pregnancy and empowermentfor decision‑making regarding pregnancy and parenting and financial authority (P < 0.05).CONCLUSIONS: probably, women’s empowerment on becoming aware of psychological changesduring pregnancy and making decisions on pregnancy, parenting, and financial authority is the factoraffecting the mental health of pregnant women.

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The comparison of fear of childbirth and sense of coherence among low‑risk and high‑risk pregnancy women

. Shahla Mohamamdirizi; . Marjan Mohamadirizi; . Soheila Mohamadirizi

Volume 8, Issue 11 , November 2018, , Pages 1-5

Abstract

  INTRODUCTION: Childbirth fear is one of the major problems during pregnancy and postpartum,and it assesses the sense of management coherence in stress. Therefore, the present study ...  Read More INTRODUCTION: Childbirth fear is one of the major problems during pregnancy and postpartum,and it assesses the sense of management coherence in stress. Therefore, the present study wasconducted to compare the association between the sense of coherence and childbirth fear in high‑riskand low‑risk pregnant women.MATERIALS AND METHODS: This was a cross‑sectional correlation study performed on 440low‑risk and high‑risk pregnant women referred to health centers in Isfahan in 2016. Sampling wascarried out in several stages and clustered and accessible. The data gathering tool was Sense ofCoherence and Fear of Childbirth Questionnaires.RESULTS: The results showed that in high‑risk pregnant women, the mean score of the sense ofcoherence was 108.23 and the fear of delivery was 41.7, and in low‑risk pregnant women, the senseof integrity and fear of delivery were 19.109 and 42.25, respectively. In addition, the results of t‑testshowed that there is no significant relationship between the fear of delivery in high‑risk and low‑riskpregnant women (P = 0.056), while there is a significant relationship between sense of coherencescore in high‑risk and low‑risk pregnant women (P = 0.02).CONCLUSION: Having the desired level of success, happiness, well‑being, ability to cope with stressand overcoming psychological crisis, and pleasant social relationships can increase the sense ofcoherence in pregnant mothers.

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The effect of progressive muscle relaxation and guided imagery on stress, anxiety, and depression of pregnant women referred to health centers

. Saeideh Nasiri; . Hossein Akbari; . Leila Tagharrobi; . Akram Sadat Tabatabaee

Volume 8, Issue 3 , March 2018, , Pages 1-6

Abstract

  BACKGROUND: If anxiety and depression do not detect in pregnant women, they may causecomplications for the mother, child, and family, including postpartum depression. With regard to ...  Read More BACKGROUND: If anxiety and depression do not detect in pregnant women, they may causecomplications for the mother, child, and family, including postpartum depression. With regard to theadministrative capability of relaxation in health centers, this study was conducted to determine theeffect of progressive muscle relaxation and guided imagery on stress, anxiety, and depression inpregnant women.MATERIALS AND METHODS: This randomized clinical trial was conducted on pregnant women inthe city of Kashan at 28–36 weeks. At the onset of the study, demographic questionnaire, EdinburghDepression Scale, and Depression, Anxiety, and Stress Scale‑21 (DASS‑21) were completed.Providing obtaining score of mild‑to‑moderate in the stress, anxiety, and depression scale and scoreof 10 or higher in Edinburgh Depression Scale, individuals were divided randomized to the interventiongroup (n = 33) and control group (n = 33). DASS‑21 was again completed in the 4th–7th weeks ofbeginning of the study by all women.RESULTS: Analysis of variance with repeated measures indicated significant differences in meanof scores of stress, anxiety, and depression at three different times in relaxation group (P < 0.05)whereas found no significant differences in the mean of scores of stress, anxiety, and depressionin the control group.CONCLUSIONS: In this study, relaxation could reduce stress, anxiety, and depression in pregnantwomen during six sessions. Due to the simplicity and low cost of this technique, it can be used toreduce stress and anxiety in pregnant women and improve pregnancy outcomes.

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Oral health of pregnant females in central India: Knowledge, awareness, and present status

. Saxena Payal; . Gupta Saurabh Kumar; . Yadav Sumitra; . Jain Sandhya; . Jain Deshraj; . Kamthan Shivam; . Saxena Parul

Volume 7, Issue 6 , December 2017, , Pages 1-6

Abstract

  BACKGROUND: The oral health of pregnant females needs attention, especially in developing countrieslike India where oral checkup and care is not considered to be a part of mandatory ...  Read More BACKGROUND: The oral health of pregnant females needs attention, especially in developing countrieslike India where oral checkup and care is not considered to be a part of mandatory antenatal protocols.OBJECTIVE: This study aimed to evaluate the oral health status of pregnant females in Central Indiaincluding the assessment of their knowledge, attitude, and awareness about oral health.MATERIALS AND METHODS: The study population comprised of 320 pregnant females, and acontrol group consisted of 103 age‑matched nonpregnant females. A cross‑sectional self‑reportedquestionnaire‑based survey and clinical examination was conducted.RESULTS: Out of 320, 192 (60%) pregnant females had some dental problem during pregnancy.Community periodontal index (CPI) score for total pregnant females (2.16) was significantly higherin comparison to control group (1.29). Nearly 72.81% of pregnant females had never attended thedentist. Trimester‑wise comparison showed time‑dependent increase in CPI score. Low educationalstatus, older age, earlier issues, poor hygiene habits, and tobacco use showed a direct effect oncompromised oral health.CONCLUSION: The study highlights the need of interaction between dental practitioners andgynecologists including routine dental checkup during antenatal visits of pregnant females as essential.

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Awareness about rational use of medicines among fresh Bachelor of Medicine and Bachelor of Surgery graduates

. Vijaya Laxman Chaudhari; . Smita N. Mali; . Amruta V. Dawari; . Tushar B. Nishandar

Volume 7, Issue 5 , September and October 2017, , Pages 1-6

Abstract

  CONTEXT: Fresh Bachelor of Medicine and Bachelor of Surgery graduates (FMGs) are responsiblefor the majority of prescription errors and irrational use of medicines. Little research ...  Read More CONTEXT: Fresh Bachelor of Medicine and Bachelor of Surgery graduates (FMGs) are responsiblefor the majority of prescription errors and irrational use of medicines. Little research has exploredtheir knowledge on rational prescribing practices.AIMS: The present study aimed to evaluate the awareness of rational use of medicines (RUMs)among the FMGs.SETTINGS AND DESIGN: A multicentric, cross‑sectional, and questionnaire‑based study wasconducted among 308 FMGs during the internship orientation program.SUBJECTS AND METHODS: The structured and prevalidated questionnaire consisted of35 statements on important aspects of RUM.STATISTICAL ANALYSIS USED: Data were analyzed using SPSS version 24.0 at 95% level ofsignificance with Fisher’s exact test.RESULTS: Nearly 31% of FMGs did not know that the generic drugs are equally efficacious as brandeddrugs whereas 53% were in support of pregnant female should not consume any drug. Nearly 58% ofFMGs were confused about deciding the dose in children and 18% were in favor of using antibioticsin common cold. Almost 55% of FMGs were disagree for adjusting the dose of antidiabetic drugs bypatient depending on the meal taken whereas 12% were not aware of the importance of complianceof antihypertensive drugs and 40% were supporting the safety of fruits in chronic renal disease. TheFMG from government colleges answered more correctly than that of the private colleges.CONCLUSIONS: The awareness of RUM among FMG is not satisfactory, and also there is a gap inits implementation. Thus, they should be supervised during the initial phase of their medical practice.

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Determinants of the self‑efficacy of physical activity for maintaining weight during pregnancy: The application of the health belief model

. Nafise Abdolaliyan; . Hossein Shahnazi; . Ashraf Kzemi; . Akbar Hasanzadeh

Volume 7, Issue 5 , September and October 2017, , Pages 1-6

Abstract

  INTRODUCTION: Pregnancy is one of the high‑risk periods for women’s health that the lack ofattention to healthy behaviors such as weight control behaviors can lead to adverse ...  Read More INTRODUCTION: Pregnancy is one of the high‑risk periods for women’s health that the lack ofattention to healthy behaviors such as weight control behaviors can lead to adverse consequenceson the health of women and also the fetus. Therefore, the aim of this paper was to explore thedeterminants of weight control self‑efficacy among pregnant women using Health Belief Model (HBM).MATERIALS AND METHODS: In this cross‑sectional study were enrolled 202 pregnant womenreferring to Health Care Center in Isfahan city, Iran. Sampling method was multistage random.A researcher‑made instrument based on HBM structures was used after confirming the valid andreliable. Data were analyzed by software SPSS 21 and descriptive statistics were representedwith (frequency, mean and standard deviation) and analytical (Pearson correlation, independent tand liner regression) at the significant level of <0.05.RESULTS: The average age of participants was 27.80 ± 5.08. HBM structures were able explained31% of variance of weight control self‑efficacy. Also, of the studied structures, perceived benefits,perceived barriers were statistically significant predictors of weight control self‑efficacy, within whichperceived barriers (β = 0.391) was the most significant predictor.CONCLUSION: The findings of current study showed that the HBM model could be as a suitableframework to identify effective factors for designing educational intervention to improve weight controlbehaviors among pregnant women.

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A randomized trial to promote physical activity during pregnancy based on health belief model

. Mahnaz Shafieian; . Ashraf Kazemi

Volume 7, Issue 2 , May and June 2017, , Pages 1-6

Abstract

  BACKGROUND: The positive effects of physical activities during pregnancy are totally recognizedbut due to lack of knowledge and negative aspect toward it, physical activities decrease ...  Read More BACKGROUND: The positive effects of physical activities during pregnancy are totally recognizedbut due to lack of knowledge and negative aspect toward it, physical activities decrease throughoutthe pregnancy period. To find the appropriate model to enhance physical activity during pregnancy,the education that are focused on health belief constructs about physical activity during pregnancy,were assessed.MATERIALS AND METHODS: This was a semi‑experimental study conducted on 90 pregnantwomen in their first trimester that were divided into two groups of control and intervention.After assessing health belief model (HBM) constructs and measuring the duration of severe/moderate‑intensity) physical activity through a questionnaire, participants were divided intotwo groups of 45. The intervention group received education about physical activity based onHBM and the control group received dental health education. In the second trimester again, theconstructs of HBM and the duration of physical activities were evaluated. Significant level wasset at P < 0.05.RESULTS: Data analysis showed that level of perceived susceptibility/severity and perceivedbenefits and also the level of appealing physical activity (P < 0.05), had a significant increase inthe intervention group after the education, but the mean of the severe/moderate‑intensity physicalactivity with did not rise to 150 min/week.CONCLUSION: Study results showed that education based on HBM could lead to an increase inphysical activity during pregnancy by increasing the level of health beliefs in pregnant women, butthis increase does not reach the adequate level.

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Pregnant women’s preferences for mode of delivery questionnaire: Psychometric properties

. Fereshteh Zamani‑Alavijeh; . Parvin Shahry; . Maryam Kalhori; . Marzieh Araban

Volume 7, Issue 1 , March and April 2017, , Pages 1-7

Abstract

  Introduction: The rate of caesarean delivery is increasing worldwide. Maternal beliefs may beinfluential on the mode of delivery. This study aimed to validate pregnant women’s ...  Read More Introduction: The rate of caesarean delivery is increasing worldwide. Maternal beliefs may beinfluential on the mode of delivery. This study aimed to validate pregnant women’s preferencesfor mode of delivery questionnaire among pregnant women. Materials and Methods: This wasa cross‑sectional study which was done in Ahvaz Public and Private Health Care Centers. A totalof 342 low‑risk pregnant women were included in a study conducted in spring 2011 in Ahvaz,Iran. After careful consideration and performing content and face validity, a 62‑item measurewas developed and subjects completed the questionnaire. Reliability was estimated usinginternal consistency and validity was assessed by performing face, content and structure anddiscriminate validity. Data were analyzed using explanatory factor analysis, t‑test, and correlationsin SPSS 16. Results: The findings of content and face validity showed almost perfect results forboth content validity ratio = 1 and content validity index = 1. The explanatory factor analysisindicated a 7‑subscale measure (Eigenvalue >1, factor loading >0.4), and discriminate validityrevealed satisfying results P < 0.05 for 6 out of 7 subscales. Internal consistency as measuredby the Cronbach’s alpha coefficient was acceptable for subscales. Conclusions: In general,the findings suggest that this newly generated scale is a reliable and valid specific questionnairefor assessing pregnant women’s preferences for mode of delivery. However, further studies areneeded to establish stronger psychometric properties for the questionnaire.

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The study of physical activity and some relative factors in referred pregnant women to Isfahan Health‑Care Centers and Shahid Beheshti Hospital

. Parvin Bahadoran; . Soheila Mohamadirizi

Volume 5, Issue 5 , December 2015, , Pages 1-4

Abstract

  Background: Physical activity generally declines during pregnancy, but activity barriers duringthis period are not well understood. The objective was to determine physical activity ...  Read More Background: Physical activity generally declines during pregnancy, but activity barriers duringthis period are not well understood. The objective was to determine physical activity and somerelative factors in referred pregnant women. Materials and Methods: This cross‑sectionalstudy was carried on 384 in referred pregnant women to Isfahan Health Care Centers andShahid Beheshti Hospital in second stage sampling method in 2013. Demographic/prenatalcharacteristics, physical activity (36Q) and prenatal life quality questionnaire (26Q) werecompleted by participants. The statistical analysis was performed with various statistical testssuch as the t‑test, one‑way ANOVA, individual correlation coefficient, and linear regressionusing SPSS statistical software (version 16). Results: Based on the findings, 98.7% (n = 378)of pregnant women had low physical activity. Also, there were a correlation among physicalactivity and parity, age, gestational age (P ≤ 0.005). Conclusion: Since physical activity isrecommended for the most of pregnant women, it is imperative to promote physical activitybetween pregnant women and some intervention suggestions.

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