Comprehensive Health Center Research Articles

Improving sexual dysfunction through guided imagery music (GIM): A clinical trial study.

Women with perfect health are strong foundations of a healthy and prosperous family life and suppressing the natural needs of women will have adverse effects on the intimacy and vitality of family members, especially in the field of sexual function. This study aimed to determine the effect of GIM on the level of sexual function in women with sexual dysfunction. In this cluster randomized trial, which was conducted from 2018 to 2019 in the randomly selected comprehensive health centers of Isfahan, Iran, 72 women of reproductive age (two groups of 36 people) with sexual dysfunction were selected by convenience sampling method, and then, music-guided imagination was performed on the intervention group. No special intervention was performed in the control group. Data collection tools were demographic characteristics questionnaire and a standard questionnaire of the female sexual function index. There was no statistically significant difference in sexual function and demographic characteristics before the intervention between the two groups (P = 0/301). The results demonstrated that the overall score of sexual function in the intervention subjects was better than the control group (P = 0/003). Improvement of sexual function dimensions (desire, arousal, orgasm) was also significant in the intervention group compared to the control group (P < 0.05). GIM can be effective in improving women's sexual function. Providing this technique as a low-cost and affordable method is recommended to health experts in private and government clinics. This method can improve the mental health of the family and society.

The Effect of Yoga on Maternal Anxiety in Women with Excessive Gestational Weight Gain: A Randomized Controlled Trial

Background: Excessive gestational weight gain (EGWG) and anxiety are comorbid conditions that increase the risk of adverse maternal and neonatal outcomes. This study was conducted to investigate the effect of yoga on the anxiety of women with EGWG. Materials and Methods: This randomized controlled trial was performed on EGWG pregnant women referring to comprehensive health centers in Qom city, Iran, between October 2021 and August 2022. Eighty-eight participants were assigned to the intervention (N = 44) and control (N = 44) groups. The experimental group participated in six sessions of 90-min yoga classes, and the control group only received routine care. Two questionnaires including a demographic information questionnaire and the State-Trait Anxiety Inventory (STAI) questionnaire were used for data collection. Data were analyzed using SPSS software version 22. Results: The results of this study showed a statistically significant difference between the two groups in terms of trait anxiety (25.84 ± 3.45 vs. 57.38 ± 8.07; p < 0.05) and state anxiety (27.93 ± 3.72 vs. 60.13 ± 8.13; p < 0.05) after intervention. On the other hand, the trait and state anxiety rates were stable in the experimental group before and after intervention, while they increased to the severe form of anxiety in the control group (effect size = −21.84 ± 10.66 vs. −19.43 ± 8.44). Conclusion: The result of this study showed that yoga has a positive effect on the anxiety of pregnant women with EGWG and can be used as a preventive or complementary solution to control the anxiety of these mothers.

Safety analysis of immediate breast reconstruction with a deep inferior epigastric perforator (DIEP) flap in the post-COVID-19 era: a comparison between pre- and post-pandemic cohorts.

The demand for immediate breast reconstruction with a deep inferior epigastric perforator (DIEP) flap is recovering as coronavirus disease 2019 (COVID-19) transitions from a pandemic to an endemic. This study sought to evaluate the safety of resuming DIEP flap reconstruction in the post-COVID-19 era. Consecutive breast cancer patients who underwent immediate breast reconstruction with a DIEP flap at the Comprehensive Breast Health Center, Ruijin Hospital were retrospectively included in the study. The patients were divided into a post-pandemic group (Group A) and a pre-pandemic group (Group B). The clinicopathological factors, surgical procedures, and rates of post-operative complications were compared between the two groups using the Mann-Whitney U test and Chi-squared test. A total of 167 patients were included in the study, of whom 119 (71.3%) were in Group A and 48 (28.7%) were in Group B. The two groups had similar clinicopathological features, including age (P=0.988), body mass index (P=0.504), and tumor, node, metastasis (TNM) stage (P=0.932). The Group A patients were more likely to receive single perforator DIEP flap transplantation than the Group B patients (n=28, 22.8% vs. n=3, 5.8%, P=0.007). There was a numerical decrease in the mean operating time of Group A patients compared to Group B patients (9.82 vs. 10.12 hours, P=0.172). The mean length of stay after the surgery was significantly shorter after the pandemic than before the pandemic (11.2 vs. 14.3 days, P<0.001). The complication rates between the two groups were similar. This study provides evidence that resuming DIEP reconstruction is safe in the post-COVID-19 era.

The Social Support Theory as a Predictor of Sleep Hygiene Behaviors Among Older Adults

Background: Aging is associated with several health concerns, including sleep problems. Hence, the current study was conducted to determine the factors related to the performance of sleep hygiene behaviors among the elderly in Malair based on the social support theory. Methods: Data for this cross-sectional study were collected from 298 older adults who referred to comprehensive health centers in Malair, Iran, in 2022. Participants were selected by multi-stage random sampling method. Data collection tools included demographic information, social support theory, and sleep hygiene behaviors questionnaires. Data were then analyzed by SPSS software version 18 using independent t-test, one-way ANOVA, Pearson correlation, and linear regression. Results: According to the findings, among sleep hygiene behaviors, light and sound control behaviors to the minimum possible extent during sleep time (71.1%) and proper bedroom temperature control (68.5%) had the highest frequency. Furthermore, regular exercise behaviors such as walking outside homes in the evenings (16.4%) and examining the effect of drugs on sleep (24.8%) were the least frequent performance by the elderly. The results of linear regression analysis showed that instrumental support (β=0.297), informational support (β=0.224), and emotional support (β=0.15) are the best predictors of performing sleep hygiene behaviors. Moreover, the constructs of social support theory explained a 44.2% variance in sleep hygiene behaviors of the elderly. Conclusion: Considering the unfavorable level of some sleep hygiene behaviors among the elderly, it seems necessary to emphasize the importance of performing sleep hygiene behaviors. It is also suggested to pay attention to instrumental, informational, and emotional support when designing educational programs to increase the amount of the performance of these behaviors.

Providing a Model of Pregnant Women's Quality of Life and Self-care Behaviors Based on Pregnancy Health Literacy and Mindfulness Mediated by a Health-oriented Lifestyle

Introduction: This study was conducted with the aim of creatingp a model of pregnant women's quality of life and self-care behaviors based on health literacy and mindfulness mediated by a health-oriented lifestyle. Method: The present study was a descriptive- correlative study. The study population was pregnant women who were admitted to the comprehensive health centers of the city of Bojnord in the last three months of 2019, of whom 240 pregnant women were voluntarily selected according to the available sampling method. The instruments used for data collection were the Maternal Health Literacy Questionnaire, Mindfulness Scale, Short Quality of Life Scale, World Health Organization Short Scale, Self-care in Pregnancyand Healthy Lifestyle Questionnaire. The data was analyzed and structured using SPSS24 and Lisrel softwares and structural equation method. Results: The age of the participants was between 18-35 years. The independent variables " health literacy during pregnancy” and “mindfulness” and the mediating variable “health-oriented lifestyle” predicted 42% of the changes in self-care and 61% of the changes in quality of life. The indirect effects of health literacy during pregnancy on quality of life (0.52), pregnancy health literacy during pregnancy on self-care (0.50) mindfulness on quality of life (0.49), and mindfulness on self-care (0.47) were also significant due to health-oriented lifestyle (P&lt;0.05). Conclusion: In order to improve the quality of life and self-care behavior of pregnant women, it is suggested that in addition to health literacy and mindfulness during pregnancy, attention should also be paid to a health-oriented lifestyle and its development in pregnant women.

Attitude and Factors Affecting Intention of Childbearing in COVID 19 Pandemic in Married Women of Reproductive Age Referred to Comprehensive Health Centers in Yazd City in Year 2022

Introduction: One of the serious challenges that societies all over the world are facing is the tendency of couples to have fewer children and to delay it. It is possible thatcovid-19 pandemic, in addition to the previous reasons, attitudes and factors affecting childbearing, may make couples physically and psychologically hesitant to accept the role of parents. This study was conducted with the aim of investigating the attitude and intention to childbearing age during Covid-19 pandemic in married women of reproductive age in Yazd City in year 2022.&#x0D; Methods: This descriptive-cross-sectional study was conducted from March 2022 to June 2022 on 225 married women aged 15-40 covered by comprehensive health centers in Yazd-Iran.&#x0D; The data were collected by completing the demographic information questionnaire, the Persian Version of Attitudes toward Fertility and Childbearing Scale that was approved in 2014 by Baezt et al.; obtaining a higher score indicated a more favorable attitude By answering to the open-ended questions, by self-reporting and electronically, the information related to the factors affecting the intention to have children was collected. The data were analyzed with SPSS16 software.&#x0D; Results: The results showed that the attitude towards having children in the research community was not favorable (66.96 ± 10.55). Economic problems (n=184, 81.1%), Covid 19 pandemic (n=129, 56.4%) and the importance to comfort and convenience of parents (n=70, 30.8%) was considered as one of the most important factors affecting couples intention to childbearing.&#x0D; Conclusion: Although the spread of communicable diseases and epidemics can affect the desire of couples to childbearing, but the economic problems and the economic consequences of the pandemic, had undeniable and greater effects on the desire of families childbearing.

The effect of midwife-oriented breastfeeding counseling on self-efficacy and performance of adolescent mothers: a clinical trial study

BackgroundBreastfeeding behaviors are strongly influenced by self-efficacy. This research aimed to determine the effect of breastfeeding counseling based on the Ready Set Baby (RSB) education program on self-efficacy and breastfeeding performance in adolescent mothers.MethodsIn 2022, a parallel randomized clinical trial was carried out in Hamadan city's comprehensive health centers, involving 64 pregnant teenagers. The block randomization method was employed to divide the participants into two groups. The data collection instruments were a demographic characteristics questionnaire, a breastfeeding self-efficacy questionnaire, and the Bristol breastfeeding checklist. Three individual counseling sessions during pregnancy were conducted based on the "RSB" program. The ANCOVA was used for comparing groups. The statistical analyst was blinded to the group assignment.ResultsThe study included 64 participants with a mean age of 16.97(1.30) years, data from 60 participants were analyzed. The demographic and clinical characteristics of the two groups were relatively similar (P > 0.05). Following the intervention, self-efficacy and breastfeeding performance scores were measured and adjusted for confounding factors. The mean scores for self-efficacy were 116.03(20.64) and 100.02(20.64) (P < 0.005), with effect size 0.77 [MD = 16.01 (95% CI: 5.34,26.67)], and the mean scores for breastfeeding performance were 6.30(2.07) and 4.12(2.07) (P < 0.002), with effect size 1.05 [MD = 2.18 (95% CI: 1.11,3.24)] in the intervention and control groups, respectively.ConclusionsThe Ready Set Baby education program's breastfeeding counseling for primiparous adolescent pregnant women significantly boosted their self-efficacy and performance in breastfeeding. Given the crucial role of breastfeeding in ensuring the well-being of both mother and child, further research is imperative to identify suitable and impactful interventions that can encourage breastfeeding practices among adolescents.Trial registrationThe trial protocol of this study has been registered in Iranian Registry of Clinical Trials at 08/09/2021. The registration reference is IRCT20200530047596N3.

Inequities in referrals to a breast cancer risk assessment and prevention clinic: a mixed methods study

BackgroundInequitable access to personalized breast cancer screening and prevention may compound racial and ethnic disparities in outcomes. The Breast Cancer Personalized Risk Assessment, Education and Prevention (B-PREP) program, located within the Brigham and Women’s Hospital (BWH) Comprehensive Breast Health Center (BHC), provides care to patients at high risk for developing breast cancer. We sought to characterize the differences between BWH primary care patients referred specifically to B-PREP for risk evaluation and those referred to the BHC for benign breast conditions. Through interviews with primary care clinicians, we sought to explore contributors to potentially inequitable B-PREP referral patterns.MethodsWe used electronic health record data and the B-PREP clinical database to identify patients referred by primary care clinicians to the BHC or B-PREP between 2017 and 2020. We examined associations with likelihood of referral to B-PREP for risk assessment. Semi-structured interviews were conducted with nine primary care clinicians from six clinics to explore referral patterns.ResultsOf 1789 patients, 78.0% were referred for benign breast conditions, and 21.5% for risk assessment. In multivariable analyses, Black individuals were less likely to be referred for risk than for benign conditions (OR 0.38, 95% CI:0.23–0.63) as were those with Medicaid/Medicare (OR 0.72, 95% CI:0.53–0.98; OR 0.52, 95% CI:0.27–0.99) and those whose preferred language was not English (OR 0.26, 95% CI:0.12–0.57). Interviewed clinicians described inconsistent approaches to risk assessment and variable B-PREP awareness.ConclusionsIn this single-site evaluation, among individuals referred by primary care clinicians for specialized breast care, Black, publicly-insured patients, and those whose preferred language was not English were less likely to be referred for risk assessment. Larger studies are needed to confirm these findings. Interventions to standardize breast cancer risk assessment in primary care may improve equity.

Predictors of Preconception Care Reception in a Sample of Iranian Pregnant Women Referred to Qazvin Health Centers

Background: Preconception care (PCC) is one of the most important components of healthcare services for women of reproductive age. Focus on improving preconception health; it can lead to improved reproductive outcomes, healthier pregnancies, and healthier babies. Aim: Determine the predictive factors of receiving PCC in pregnant women of Qazvin. Methods: The present cross-sectional study was conducted from March 2018 to September 2019. Participants were 350 pregnant women in their 6-14 weeks of gestation, who had been referred to a selected comprehensive health center (CHC) for their initial prenatal visits. A two-stage cluster sampling was used to access the samples with maximum socioeconomic and cultural diversity. Data was collected using a questionnaire about demographics, fertility, and factors that affect access to PCC; a questionnaire about perceived social support; and a general self-efficacy questionnaire. Data was analyzed using univariate and multivariate logistic regression methods with SPSS software version 25. Results: In the present study, 57.5% of the participants had received PCC. More than 75% of them received this care less than a year ago at a CHC. In the final model, wanted pregnancy (OR= 11.68), awareness of PCC (OR= 8.86) and history of ART for current pregnancy (OR= 7.18) were the strongest predictors in the model. Conclusion: Women of reproductive age appear to benefit strongly from PCC services, when they have planned their pregnancy and were aware of PCC service. Therefore, information related to the opportunities and potential outcomes of PCC should be made publically available. In addition, healthcare providers should focus more on providing patients with information about preconception counseling.

The effect of training intervention based on the theory of planned behavior on oral and dental health behaviors in pregnant women

BackgroundPregnancy is a transient physiological condition that causes adverse oral and dental consequences. The present study aimed to determine the effect of a training intervention based on the theory of planned behavior on oral and dental behaviors in pregnant women.MethodsThis quasi-experimental study was conducted on 140 pregnant women (70 in the intervention group and 70 in the control group) supported by comprehensive health centers on the outskirts of Shiraz, Iran, in 2019–2020. The sampling was performed in each center by a simple random method. The tool included a demographic characteristics questionnaire, a questionnaire based on the theory of planned behavior, a self-care behavior questionnaire, and checklists for recording DMFT(Decayed, Missing due to caries, and Filled Teeth(DMFT)) and dental plaque indices. The questionnaires were completed before and 3 months after the intervention by both groups. The intervention group received six 50-min training sessions. The data were analyzed using SPSS 22, the chi-squared test, independent t-test, paired t-test, and descriptive statistics (p < 0.05).ResultsThe mean ages of the intervention and control groups were 32.28 ± 6.14 and 31.84 ± 6.71, respectively. The results showed that the average scores of all constructs of the theory of planned behavior, dental plaque indices (PI), and MDFT in the intervention group significantly changed after the intervention (p < 0.001).ConclusionAccording to the results, training based on the theory of planned behavior was effective on dental and oral health behaviors in pregnant women and improved the clinical results of their self-care behaviors. Therefore, training sessions will increase the knowledge of pregnant women, and providing timely consultations and examinations can be helpful and effective in developing oral and dental health behaviors in pregnant women.

Medication Use Status and Its Related Factors among Older Adults in Kerman, Iran

Introduction: Older adults are the largest group of medication users in each society. Since medications act differently in seniors compared with younger patients, great considerations are required regarding the effects and side effects of medications in the older adults. The present study aimed to determine the status of medication use and its related factors among older adults in Kerman city, Iran.&#x0D; &#x0D; Methods: In the cross-sectional study, 388 seniors were selected using multistage cluster sampling from the population covered by comprehensive health centers in Kerman in 2021. Demographic information questions (age, gender, education level, marital status, life status, substance abuse, income, and health insurance status), a question regarding medication usage status and a question regarding disease that the elderly are currently suffering from, Montreal Cognitive Assessment Questionnaire, Geriatric Depression Scale, and Sleep Disorder Questionnaire were used for data collection. The data were analyzed using SPSS software by running Chi-square and multiple logistic regression tests.&#x0D; &#x0D; Results: The average number of medications used per day was 4.59 and 53.5% of the participants used five or more medications concomitantly. Antihypertensive medications had the highest prevalence (64.3%) followed by anti-hyperlipidemic (43.6%) and Supplements (41.3%). A significant correlation was found between the participants' frequency of medication use and their gender, income, primary insomnia, and cognitive impairment (p &lt; 0.001). However, medication use had no significant association with the senior's age, marital status, education level, living status, substance abuse, and health insurance (p &lt; 0.05). The risk of polypharmacy was 2.15 times higher in the elderly women than men (p = 0.001) and 0.45 times higher in participants with depression than non-depressed seniors (p = 0.011).&#x0D; &#x0D; Conclusion: The high prevalence of polypharmacy indicates an unfavorable status of medication use among older adults in Kerman. So, authorities are required to provide educational information about polypharmacy to aged groups.

Fear of Falling and its Relationship With Frailty in Older Adults

Objectives Fear of falling affects the daily performance of older adults, exacerbates the frailty syndrome, and ultimately reduces their independence. This study aims to investigate the relationship between fear of falling and frailty in older adults in Bushehr, Iran. Methods &amp; Materials This descriptive-analytical study with a cross-sectional design was conducted on 215 older adults aged ≥60 years referred to urban comprehensive health centers in Bushehr, Iran in 2021 who were selected by a cluster sampling method. A demographic/clinical form, falls efficacy scale international (FES-I), and Fried’s frailty scale were used for collecting data. Data were analyzed using chi-square test, and logistic regression analysis in SPSS software, version 24. Results The mean age of the participants was 68.81±8.31 years. They included 56.7% female (n=122) and 43.3% male (n=93). The chance of developing frailty syndrome in people with high level of fear of falling was 6 times that of people with low fear of falling (OR=6.37, 95% CI, 1.44%-28.08%). The fear of falling was significantly higher in those with younger age, low education level, low income, those who were widower/widow, housekeeper or retired, and those with a history of falling in the last year, and frailty (P&lt;0.001). Conclusion Fear of falling can cause frailty and thus increase the dependence of older adults; therefore, timely screening and intervention are recommended to reduce its negative effects

Childbearing Tendency and Related Factors Among Married Women in Rasht City, north of Iran

Introduction: Reducing childbirth rates is a serious problem in some countries. Iran is one of the countries experiencing a decrease in the fertility rate, with a more than 50% decrease in avery’s child statistics. Objective: This study aimed to determine childbearing desire and its related factors among married women. Materials and Methods: In this cross-sectional study, 550 women aged 15 to 49 referring to comprehensive health centers in Rasht City were selected by multi-stage random sampling. Information was collected using a questionnaire consisting of three parts. The audience was asked about their willingness to have children in the personal and social profile section, the fertility information section, and the third section that to detect degree of desire to have children. Descriptive statistics and the chi-square and logistic regression were used to investigate the factors affecting the reluctance to have children. Results: The results of the research showed that the mean age of the women, the spouse, the age at marriage, and the duration of their marriage were 31.57±6.2, 35.69±6.6, 22.42±4.52, and 9.05±6.5 years, respectively and 54.9% of women were currently willing to have children. The relationship between unwillingness to have children was significant regarding the husband’s age (OR=1.112, 95% CI, 1.050%-1.177%, P=0.001). Also, the relationship between reluctance to have children and the age at marriage was not significant; however, it became significant with the length of marriage (OR=1.090, 95% CI, 1.019%-1.167%, P=0.013). The relationship between unwillingness to have children and the women’s opinion about the desired number of children was significant (OR=8.101, 95% CI, 3.518%-18.654%, P=0.001). The relationship between unwillingness to have children and the number of current children was significant (OR=16.515,95% CI, 8.293%-32.888%, P=0.001). Conclusion: Our analysis showed that the inability to accept the responsibility of being a parent is one of the reasons why people postpone childbearing to the fourth decade of life and even beyond. Detailed studies are needed to correct the current trend of population decline.

Drug prescription pattern in primary healthcare centers in southwest Nigeria. A cohort analysis of primary health workers prescription records

Introduction: Rational use of Drugs is the prescription and dispensation of drugs to the appropriate patients in appropriate doses, for required period and at lowest cost to them and their community. Irrational use refers to inappropriate use of drugs which include prescription and dispensation of too many drugs (polypharmacy), unnecessary and overuse of antibiotics and use of injection where oral drug suffices. A step towards preventing irrational drug use is to document it in a study such as this, so that appropriate corrective steps can be taken. Methods: This was a cross sectional cohort analysis of the prescribing records of primary health care workers from eight primary health care facilities. Result &amp; Discussion: There were 513 prescriptions of 2, 590 drugs from the eight facilities;206 (40%) from a cohort of two comprehensive health centres and 307(60%) from a cohort of six basic health clinics. 206(40%) was diagnosis-based prescriptions, while 307(60%) was not based on diagnosis. About 426(83%) contain antibiotics prescriptions, while 87(17%) had no antibiotic prescriptions. About 395(77%) prescriptions contained injectable drugs while 118(23%) did not contain any injectable drug. Conclusion: The average of number drugs per prescription and the proportions of antibiotics and injectables prescriptions in this study were higher than the WHO recommendations. These values were equally higher than values in many studies. Healthcare workers at the basic health clinics did more diagnosis-based prescriptions, prescribed more antibiotics and more injectable than their counterparts at the comprehensive health centers.

Evaluating the Effect of Telenursing and Multimedia Self-Care Educational Program on the Level of Existential Anxiety in Patients with COVID-19: A Quasi-Experimental Study

Background &amp; Objective: For patients, COVID-19 disease is a reminder of non-existence and death. For this reason, these patients experience existential anxiety. One of the effective factors in the control and treatment of this disease is to educate patients on self-care to reduce the burden of these psychological problems on them. The present study was designed and conducted with the aim of evaluating the effect of self-care educational program using telemedicine and multimedia methods on the level of existential anxiety in COVID-19 patients.Materials &amp; Methods: This study was a quasi-experimental research conducted on 88 COVID-19 patients referred to the comprehensive health service centers of Bandar Abbas, Iran from 2020 to 2021. Th0ey were selected using a convenience sampling method. The samples were randomly assigned to the multimedia (44 patients) and telenursing (44 patients) groups. Patients in both groups received education on self-care during COVID-19 disease for 21 days. The Existence Anxiety Scale was completed before and immediately after the intervention. Data were analyzed with SPSS software version 26. Descriptive statistics, normality test, independent t-test, homogeneity of variance and covariance, univariate and multivariate analysis of covariance were used.Results: The mean score of existential anxiety at the beginning of the study was 90.50± 12.57 and 85.25 ±16.12, respectively, in the telenursing and multimedia groups, and after the intervention, it was 46.88 ± 6.38 and 65.40 ± 9.59, respectively, in the telenursing and multimedia groups. After the intervention, the existential anxiety score was significantly reduced in the telenursing group compared to the multimedia group (p &lt;0.001).Conclusions: Based on the findings of this study, self-care education programs and knowledge about necessary care during COVID-19 illness should be considered for patients in comprehensive health centers, and telenursing should be used for more effective self-care education.

Evaluating the Compliance of Saveh Primary Healthcare Centers with World Health Organization's Age-Friendly Standards

Background: Since primary healthcare is a significant link in promoting and maintaining the health of the elderly, evaluating age-friendliness of service provision system is of great importance in ensuring the health of the elderly. The purpose of this study is to evaluate the state of primary healthcare centers’ compliance with the standards of age-friendliness in Saveh city.&#x0D; Methods: This was a cross-sectional and descriptive study conducted on May and June 2022, in Saveh city, Markazi Province in Iran. The statistical population of the research included 33 primary healthcare centers selected by the census method and based on World Health Organization’s checklist regarding age-friendly primary healthcare centers (2008); they were examined by observation. After translating the checklist, its face validity, content validity, and reliability were reviewed and approved by 13 experts in the fields of health policy, health education and promotion, the elderly's health, occupational health engineering, and healthcare. Data analysis was done using descriptive statistical tests, one-way analysis of variance, Kolmogorov-Smirnov test, Tukey's post hoc test, and SPSS 16 software.&#x0D; Results: Regarding the psychometric analysis of checklist, based on the experts' opinions, the content validity ratio and content validity index were calculated and except for 8 items, all items scored higher than 0.54 and 0.79. In order to check the reliability, the research tool was provided to 2 observers. By calculating the Kappa coefficient, the agreement between the 2 observers was above 0.6, which indicates the validity of the checklist. This study showed that comprehensive health centers and their affiliated units had a 57.6% access to public transportation and 72.7% access to stairs at the front entrance. The entry was 100% free from obstacles, access to parking was 42.4%, access to public telephones, 18.2%, to a reception counter near the entrance restrooms, 42.4%, to waiting room, 78.8%, to a dining area, 42.4%, to stairs, 9.1%, to corridor, 87.9%, compliance with guiding signs, 66/7%, visibility of the signs, 72.7%, and personnel identification was 42.4%. Also, based on the analysis of variance, a statistically significant difference was obtained between the type of centers (urban and rural) and friendliness towards the elderly (p &lt; 0.05).&#x0D; Conclusion: Primary healthcare centers of Saveh city did not have an acceptable compliance with the standards of age-friendly centers. The main issues are the number of stairs and the lack of alternatives (ramps and elevators) for people with mobility problems, the lack of facilities such as public telephones, and the inadequacy of guiding signs and personnel identification to identify employees. The government should strengthen and improve primary healthcare centers for the elderly and facilitate geographical access to these centers, considering the important role of these centers in the health of the elderly.

Knowledge of the effects of regular pelvic floor exercises on maternal health among women in a comprehensive health centre in Ado-Ekiti, Nigeria.

Regular pelvic floor exercise is essential for maternal health among women because it is a proven conservative treatment and prevention for pelvic organ prolapse. This study aimed at investigating the knowledge of women on the effects of regular pelvic floor exercise on the maternal health among women attending a primary health centre in Ado - Ekiti. It also assessed the women's attitude towards and the practice of pelvic floor exercises. The study was predicated on reasoned action theory, while a descriptive cross-sectional design was adopted using total enumerative sampling technique. Data was collected from 248 respondents using researcher-administered questionnaires. Data were analyzed using descriptive and inferential statistics. Findings from the study showed that the majority (72.20%) of the respondents had a low level of awareness of pelvic floor exercises, 74.2% perceived pelvic floor exercises as very necessary to maternal health, 75.4% showed a negative attitude to pelvic floor exercises, less than half (48.7) claimed to be practicing pelvic floor exercises. No significant association was found between women's attitude and the practice of pelvic floor exercises (P > 0.05). More education should be given to women seeking primary health care on the benefits of pelvic floor exercises.

Childbirth expectations and coping strategies of first-time mothers attending a comprehensive health centre in Ekiti State, Nigeria.

Childbirth is a complex life event for every woman. Women will have positive experiences if their expectations are met during childbirth, unmet expectations can result in negative experience. This study assessed the knowledge, expectations and coping strategies used by first time mothers attending a Comprehensive Health Center in Ekiti State. The study adopted a qualitative research design and twenty individual semi-structured interviews were conducted. Purposive sampling technique was used and the sample size was determined by saturation of data. Interviews were analyzed using qualitative thematic content analysis. Findings revealed limited knowledge about labour as majority of the participants had no knowledge of labour signs and process. Also, almost all the women were not familiar with the various methods for relief from discomfort during labour and first-time mothers expect midwives to care for them throughout the labour process. This study emphasized the need for healthcare professionals to provide suitable comprehensive education on the process and signs of labor as well as the various methods of pain relief. Supportive networks should also be provided for women during prenatal clinics. Also, health care professionals should consider the needs of mothers and try as much as possible to provide holistic support.

Utilization obstacles to hypertension services provided at comprehensive health centers: a content analysis study

IntroductionHypertensive patients' failure to refer to health centers for the management of their disease is the most fundamental public health challenge in most societies. The aim of this study was to identify the utilization obstacles to hypertension services provided at comprehensive health centers (CHCs) from the perspective of patients and the staff of health centers.MethodsThis was a qualitative study using conventional content analysis which was conducted in 2022. Participants included 15 hypertensive patients referring to CHCs and 10 staff (including personnel of CHCs and expert staff) of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, southwest of Iran. Data were collected using semi-structured interviews. Interviews were analyzed using content analysis method, and coding was done manually.ResultsIn total, 15 codes and 8 categories were extracted from the interviews which were organized in two main themes of "individual problems" and "systemic problems". More particularly, the main theme of “individual problems” involved attitudinal obstacles, occupational obstacles, and economic obstacles. The main theme of "systemic problems" included educational obstacles, motivational obstacles, procedural obstacles, structural obstacles, and managerial obstacles.ConclusionIn order to address individual problems associated with the patients' failure to refer to CHCs, we need to take appropriate measures. These include using motivational interviewing techniques and utilizing the effective activity of healthcare liaisons and volunteers in CHCs to increase patients' awareness and change their negative attitudes and misconceptions. To solve systemic problems, it is imperative that effective training courses be held for health center staff.

Evaluation of mental health status and some related factors in nurses, midwives, and healthcare providers in hospitals and comprehensive health centers of Hormozgan province of Iran during the COVID-19

Evaluation of mental health status and some related factors in nurses, midwives, and healthcare providers in hospitals and comprehensive health centers of Hormozgan province of Iran during the COVID-19