Comprehensive Health Center Research Articles

Association of social capital with mental health and quality of life among low- and high-risk pregnant women

IntroductionSocial capital means having resources and support in relationships and social ties. It can affect the individual's quality of life and mental health. The present study investigated the association between social capital with psychological status and quality of life among low-risk and high-risk pregnant women. MethodsThe present cross-sectional study was conducted with the participation of 394 pregnant women receiving prenatal care in urban comprehensive health centers in Qazvin, Iran. Two-stage sampling was used to select comprehensive health centers by random cluster sampling and then pregnant women randomly. Social capital, quality of life (QoL), psychological status, and demographic and obstetric characteristics were assessed. Uni-variable and multivariable linear regression models were used to analyze the data. ResultsAmong the participants, 267 had low-risk pregnancies (67.77%) and the remainder were high-risk. The mean age of participants was 27.94 years (SD=5.86), the mean gestational age was 23.63 weeks (SD=7.71). The mean overall quality of life score among low-risk pregnant women was 32.00 (SD=5.27) and among high-risk pregnant women was 29.70 (SD=3.65). High-risk pregnant women experienced significantly higher anxiety and depression and fear of COVID-19. Social capital had a significant and weak relationship with anxiety among low-risk pregnant women (r = 0.22, p < 0.001). Also, a weak and significant relationship between social capital and anxiety (r = 0.24, p = 0.007), depression (r = 0.24, p = 0.007) and fear of COVID-19 (r = 0.27, p = 0.002) was found among high-risk pregnant women. ConclusionWomen with high-risk pregnancies experienced lower quality of life, higher anxiety and depression, and greater fear of COVID-19. There was also a weak relationship between social capital and the aforementioned variables among high-risk pregnant women. Designing and implementing interventions to increase quality of life and reduce anxiety and stress among high-risk pregnant women appears to be warranted.

Predicting cervical cancer screening behavior among women in southern Iran: a cross-sectional study with PEN-3 model

IntroductionDespite the fact that the Pap smear test is a simple, affordable, painless and relatively reliable method to diagnose cervical cancer in women, the majority of women are unaware of the value of this valuable diagnostic method. There are many cultural and social barriers to this diagnostic method. The present study was conducted to predict cervical cancer screening behavior with PEN-3 model among women residents of Bandar Abbas.MethodsThe present descriptive-analytical study was conducted on 260 women aged 18 years and above who visited the comprehensive health centers of Bandar Abbas. The data were collected online using a demographic information questionnaire and a researcher-made questionnaire based on the PEN-3 model constructs and analyzed using Mann-Whitney U test, Pearson correlation test and logistic regression analysis in SPSS-23.ResultsThe participants’ age ranged between 18 and 52 years with an average of 30.95 ± 5.47 years. 27.7% of the participants had done their last pap smear test less than 1 year before the study and 26.2% had not done a pap smear test until the time of study. The results showed that the mean scores of knowledge (11.28 ± 2.87), attitude (64.96 ± 4.96), enablers (44.66 ± 5.8), and nurturers (36.02 ± 8.83) in women who had done the cervical cancer screening behavior was more than those who had not done the behavior. Also, the results of logistic regression analysis showed that knowledge, attitude and nurturers were the major predictors of cervical cancer screening behavior.ConclusionThe present findings showed that knowledge, attitude, enablers and nurturers play a major role in women’s participation in Pap smear test. These findings should be considered in the development and implementation of educational interventions.

Policy and Systems Change in Intimate Partner Violence and Human Trafficking: Evaluation of a Federal Cross-Sector Initiative.

Objectives: This study evaluates Project Catalyst's impact on policies related to Intimate Partner Violence (IV) and Human Trafficking (HT), which contribute to negative health outcomes for survivors. Methods: We utilized continuous evaluation using data from policy assessment tools and interviews with participating state leadership team (SLT) members. Results: Five SLTs reported integration of IPV into state-level initiatives. All implemented clinical practice and organizational policy recommendations. SLTs reported that Project Catalyst increased awareness of IPV/HT and health impacts and established ongoing partnerships between the three organizations. Conclusions: Funding, training, and technical assistance to encourage cross-sector collaboration at the state level can promote policy changes that support comprehensive health center responses to IPV/HT.

The Impact of Behavioral Economics-Based Counseling and Mobile Phone Text Educational and Reminder Messages on the Use of Modern Family Planning in Jordan: A Cluster Randomized Controlled Trial.

Favorable attitudes toward modern family planning methods (MFPMs) among Jordanian and Syrian women do not always translate into behavioral changes, and the availability and cost of MFPMs do not appear to be related to either prior stalls in fertility rates in Jordan or to the current and likely temporary decline in fertility rates. This study aimed to determine whether behavioral economics (BE)-based family planning interventions influence the use of any family planning method, MFPMs use, continuation of MFPMs use, and pregnancy rates among women in Jordan. The BE-based family planning interventions included personalized text messaging and augmented counseling based on framing and identity-priming BE principles, with their effects tested over a 9-month period in the postpartum period following the birth of a child. A parallel-group cluster randomized controlled trial was conducted to compare two interventions, augmented counseling based on framing and identity-priming BE principles and personalized mobile phone text messages reminders, aiming to improve the utilization of MFPMs among postpartum women over status quo family planning services in comprehensive health centers in the north of Jordan. In total, 1032 participated in the study: 295 women in the control group; 326 women in Intervention Group 1, which received only augmented counseling; and 411 women in intervention Group 2, which received augmented counseling and monthly text messages. The rates of using MFPMs in the counseling group and the counseling and messages group 3 months (54.7% and 57.1%, respectively), 6 months (50.0% and 51.7%, respectively), and 9 months (49.5% and 52.0%, respectively) were significantly higher than the rates among women in the control group (40.6% at 3 months, 37.6% at 6 months, and 34.3% at 9 months). Overall, 26.8% of women in the control group, 42.1% of women in the counseling-only group, and 45.2% of women in the counseling and messages group used MFPMs continuously for all 9 months. At 9 months, the pregnancy rate was significantly much higher in the control group (13.7%) compared to women in the counseling-only group (7.0%) and to women in the counseling and messages group (7.4%). Simple BE-based interventions can be effective methods for enhancing the use of MFPMs and maintaining the anticipated decline in Jordan's total fertility rate.

Investigating the relationship between socioeconomic status and domestic violence against women in Isfahan, Iran in 2021: A cross-sectional study.

Domestic violence can include controlling or coercive behaviors and acts, as well as physical, sexual, psychological, and financial elements. Given the significance of domestic violence against women and its complications, this study looked into the relationship between socioeconomic status and domestic violence against women in Isfahan in 2019. In 2021, a cross-sectional study of 427 married women referred to comprehensive health centers in Isfahan, Iran, was carried out. The available sampling method was chosen. To collect data, a domestic violence questionnaire and a socioeconomic status index were used. The data were analyzed using SPSS and Latent GOLD software. The average age of the women in this study was 33.21, 37% worked, and 63 were housewives. Based on Latent class analysis method, women were classified into two groups of high or low socioeconomic status class. The findings revealed a significant relationship between socioeconomic status and different types of violence against women, including light physical violence, emotional violence, verbal violence, and sexual violence (p < 0.05). The findings revealed that there is a significant relationship between socioeconomic status and domestic violence against women in Isfahan, with women from lower socioeconomic backgrounds being more vulnerable to violence. Given the prevalence of violence against women in the family and its consequences, policy makers should look for the causes of this type of violence as well as solutions to reduce this health and social problem. Factors such as the expansion of counseling and treatment centers in health care facilities, as well as education and life skills training, are particularly important in reducing this phenomenon in society.

Sexual-related determinants of life satisfaction among married women: A cross-sectional study

Background and aimLife satisfaction refers to the perceived satisfaction of individuals concerning various aspects of their lives. The present study investigated the predictive role of sexual-related determinants in life satisfaction among married women.MethodsA cross-sectional study was conducted from August to November 2021. A total of 350 married women with at least six months of cohabitation with husbands were included in the study. The study utilized a multi-stage random sampling method from 10 comprehensive health centers in Qazvin, Iran. Scores on the Emotional Intimacy Questionnaire (EIQ), Dyadic Sexual Communication Scale (DSCS), Female Sexual Distress Questionnaire (FSDQ), Female Sexual Quality of Life Scale (FSQLS), Female Sexual Function Index (FSFI), and Life Satisfaction Scale (LSS) were assessed. Data were analyzed using univariable and multivariable linear regression models with a significance level of p < 0.05.ResultsThe mean age of participants was 33.77 years (SD = 9.77) and they had been married for an average of 10.21 years (SD = 9.93). The mean scores on the LSS were 20.16 (out of 35; SD = 6.79). Based on the multivariable linear regression model adjusted for socio-demographic characteristics, the two strongest predictors of life satisfaction among Iranian married women were marital intimacy (β = 0.49, p < 0.001) and sexual functioning (β = 0.17, p = 0.009). Together, these variables explained 45% of variance in life satisfaction.ConclusionGiven that marital intimacy and sexual functioning were the most significant sexual-related determinants of life satisfaction among married women, designing and implementing interventions which increase women’s marital intimacy and sexual functioning might improve married women’s life satisfaction.

Spatial Accessibility to Primary Healthcare Facilities in Iran: A GIS-Based Approach

Background: Primary healthcare facilities are essential to provide healthcare to individuals and the society closer to home. Fast, timely, and affordable access to these centers is important in each society. This is especially crucial to prevent and control the epidemics of non-communicable diseases that are highly affecting populations in urban settings. This study aimed to assess spatial accessibility to primary healthcare facilities in Yazd city (Iran), using a Geographic Information System (GIS).&#x0D; Methods: In this descriptive-analytical study, which was conducted cross-sectionally in 2022, locational information related to primary healthcare centers, population distribution, and urban zoning of Yazd city were collected and recorded in Excel format. Then, distribution maps of each of the studied uses were determined. Then, the existing indicators and standards regarding the uses were determined through documentary studies, and a geographic database was formed through the GIS software collection. Data were analyzed using indicators and models such as hot spot analysis, Thiessen's polygons algorithm, access model based on the two-step floating catchment area, and the average distance model of the nearest neighbor.&#x0D; Results: The results indicated that the comprehensive health centers in Yazd city are located next to each other with a scattered distribution pattern, and are away from each other by an average distance of 1131 meters. Also, the distance of urban health posts from each other is 1045 meters on average, and are randomly located next to each other. The main concentration of the distribution of primary health care facilities is observed in the central and traditional regions of the city, which, according to the hot spot analysis, are among the cold and low population density spots. In addition, the access score of the regions indicates that the distribution of these facilities is not according to the population density, and the highest functional pressure of comprehensive health centers as well as urban health posts is observed in the regions where there is the least access to these facilities.&#x0D; Conclusion: There is a disparity between the distribution of primary healthcare facilities and population density in Yazd city, Iran. This study provides significant evidence to local health policymakers and urban planners to design more efficient actions related to equal development of health infrastructure by using the GIS.

Assessment of Seismic Vulnerability in Urban and Rural Health Service Centers of Hamadan Province Using Geographic Information Systems

Background: Maintaining the performance of healthcare centers during an earthquake is essential. Evaluating the seismic vulnerability of these centers is a priority. This study aims to evaluate seismic vulnerability using geographic information systems (GIS) in urban and rural health service centers of Hamadan Province, Iran, in 2021. Materials and Methods: This is a descriptive, analytical cross-sectional study that was conducted in comprehensive health centers. The data of this study were collected in the form of a questionnaire and a map and analyzed using the hierarchical analysis model. In the study, 10 criteria, such as the type of materials, the age of the building, the quality of the building, the number of floors, the area of ​​the centers, as well as the distance from the existing fault lines, and the proximity to the hazardous centers, are defined using a valuation questionnaire, using the chain analysis method, weighting and prioritizing, and using GIS, vulnerability maps of comprehensive urban and rural health centers of Hamadan province were obtained. Results: Among the indices, the distance from the fault index with a weight of 0.328 has the highest and the area distance with a weight of 0.17 has the lowest final weight. The vulnerability distribution of the centers included 46.99% very low vulnerability, 7.23% low vulnerability, 5.42% moderate vulnerability, 20.48% high vulnerability, and 19.88% very high vulnerability. Conclusion: Considering that many urban and rural health service centers are vulnerable to seismic hazards, it is necessary to strengthen vulnerable centers against earthquakes.

A comparative study of depression and its relationship with physical health among families with and without COVID-19 patients in comprehensive health centers

A comparative study of depression and its relationship with physical health among families with and without COVID-19 patients in comprehensive health centers

Care Providers' Perspectives on Quality Prenatal Care in High-risk Pregnancies: A Qualitative Study.

A high-risk pregnancy (HRP) is adversely affects the health of the mother, baby, or both. Most prenatal care research, rather than quality concepts, focuses on the adequacy of prenatal care and describes the emotional-psychological experiences of women with HRP. The main purpose of this study was to explore the perspectives of healthcare professionals regarding the quality of prenatal care for women with HRP. This qualitative study was conducted in three university hospitals and 12 comprehensive health centers in Ahvaz (Iran) from December 2020 to May 2021. In the present study, 10 midwives, 2 executive directors, and 7 specialists were purposefully selected with maximum diversity. In-depth semi-structured individual interviews were used to collect the data. Data were analyzed concurrently using Elo and Kinga's content analysis. The MAXQDA software version 10 was used for data analysis. During data analysis, the 6 main categories "infrastructure for care provision", "optimal clinical care", "organizing referrals", "preconception care", "risk assessment", and "family-centered care" and 14 subcategories were identified. Our findings showed that professional groups focused on the technical aspects of caring. The findings from this study highlight several conditions that can affect the quality of prenatal care for women with HRP. Healthcare providers can use these factors to effectively manage HRPs, thereby improving pregnancy outcomes among women with HRPs.

Explanation of the Structural-functional Challenges of Comprehensive Health Centers in Babol City, Iran, Based on the Guidelines of the World Health Organization’s Elderly-friendly Centers

Objectives Primary care is the first main interface of health services for the elderly to maintain and improve their health. Therefore, it is essential to evaluate the appropriateness of the way to provide services for this population group, which is one of the most vulnerable classes of society. This study was conducted to explain the structural and functional challenges of comprehensive health centers in Babol City, based on the guidelines of the World Health Organization’s elderly-friendly centers to plan aging-friendly. Methods &amp; Materials The current research was a descriptive qualitative study using the content analysis method with a conventional approach. This research was conducted on elderly people who were referred to comprehensive health centers and their families as well as service providers in the form of in-depth semi-structured interviews until reaching the level of data saturation. Each interview was implemented immediately after implementation, and the content analysis of the interviews was conducted by determining conceptual units, accurate coding, and continuous comparison method until the formation of subgroups and main classes. Results In this study, 23 elderly people with an average age of 71.47±7.88, 5 family members, and 14 service providers participated. A total of 72 codes were extracted from all the interviews, which were divided into five main categories of structural factors, behavioral issues, educational characteristics, social support, and functional challenges during the analysis process. A total of twelve subgroups emerged for the five main classes. Conclusion Several underlying factors exist in the path of making comprehensive health centers elderly-friendly, and which will be impossible to achieve this issue without providing the conditions and eliminating the existing challenges. Therefore, the obtained components may help in identifying, and prioritizing needs, and choosing the type of interventions to adapt comprehensive health centers to the needs of the elderly.

Relationship of Health-promoting Behaviors with Demographic and Pregnancy Characteristics in Overweight and Obese Pregnant Women who Refer to Comprehensive Health Centers in Bijar, Iran

Background and Objective: This study aimed to determine the relationship of health-promoting behaviors with demographic and pregnancy characteristics in overweight and obese pregnant women in Bijar, Iran. Materials and Methods: This cross-sectional study was conducted on 194 pregnant women who were selected from five comprehensive health centers in Bijar, Iran, in 2020, using the convenience sampling method. The data were collected via demographic and pregnancy characteristics form and Walker's health promotion lifestyle questionnaire. Following that, the independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple linear regression were used for data analysis. A P-value of 0.05 was considered statistically significant. Results: The health-promoting behaviors of pregnant women were explained under the influence of gestational age and the number of prenatal care. The results showed that obese and overweight pregnant women who had 7 to 8 prenatal cares had a higher and significant mean score of health promoting behaviors, compared to pregnant women who had 1 to 2 cares (β=5.30; Ρ=0.022). Moreover, pregnant women whose gestational age was more than 35 weeks obtained a higher and significant mean score of health-promoting behaviors than pregnant women with a gestational age of less than 25 weeks (β=7.54; Ρ=0.03). Conclusion: Using these findings, in addition to the number of pregnancy cares and age of pregnancy, it seems that there are other factors affecting health-promoting behaviors in pregnant women.

Is Pornography Use Associated with Sexual Desire and Marital Satisfaction Among Heterosexual Iranian Women?

Background: Increasing access to various forms of pornography since the advent of the internet has provided a new context for couples' sexual experiences, but the possibility of adverse effects of pornography on couples' romantic relationships is a concern. Objectives: This study aimed to compare sexual desire and marital satisfaction in 2 groups of married women with and without a history of pornography use in Rafsanjan city, Iran. Materials and Methods: This descriptive study was conducted on 254 women with children covered by comprehensive health centers in Rafsanjan city by convenience sampling in 2020. Data collection tools included a demographic characteristics form, Enrich Marital Satisfaction Questionnaire (EMSQ), Hurlbert Index of Sexual Desire (HISD), and Pornography Questionnaire (SPQ). Data were analyzed by chi-square, 2 independent samples, and multivariate analysis of covariance (MANCOVA) in SPSS version 21. P values less than or equal to 0.05 were considered statistically significant. Results: There was a positive and significant relationship between sexual desire and pornography use (P = 0.043). The mean score of marital satisfaction was lower in the pornography user group than in the nonuser group, but it was not statistically significant. Of the 9 components of marital satisfaction, there was a statistically significant difference only in the component of financial management between the 2 groups (P = 0.037). There was no statistically significant relationship between demographic characteristics and pornography use (P &gt; 0.05). Conclusions: It seems that pornography use in married women is related to sexual desire, but in the present study, no relationship was found between pornography use and marital satisfaction. More studies are needed to reveal the relationship between pornography use and the sexual features of women and their partners.

The Effects of Group Discussion and Multimedia Package Education Interventions on Healthy Lifestyle of Pregnant Women: A Field Trial Study

Background: Healthy lifestyle affects the health of the mother and fetus during pregnancy. This study aimed to compare the effects of group discussion and multimedia package education interventions on healthy lifestyles among pregnant women. Methods: This quasi-experimental study was conducted on 151 pregnant women during their 16-28 weeks of pregnancy who were referred to comprehensive health centers in Bajestan City, Iran. They were randomly allocated to three groups: Group discussion (n=50), multimedia package education (n=52), and control group (n=49). The demographic questionnaire and Walker’s health-promoting lifestyle profile II were used for data collection before and one month after the intervention. The educational intervention in the group discussion was held in 4 sessions. The multimedia package group received software consisting of text, video, animation, and audio materials. Finally, the control group received routine educational support in health centers. The study data were analyzed using descriptive and inferential statistics and at a significance level of 0.05. Results: The result showed no significant difference between the three groups before intervention (P=0.073) regarding their mean lifestyle scores. However, the mean lifestyle score was significantly lower in the control group compared to the other two groups one month after the intervention (P&lt;0.001). However, the mean lifestyle score was significantly higher in group discussion and multimedia groups (P&lt;0.001). Conclusion: The findings showed that multimedia package and group discussion methods improved lifestyle in pregnant women. Therefore, we suggest that health providers use these methods for pregnant women regarding their rationales and facilitations.

Effect of an Educational Intervention for Mothers Based on the Health Belief Model on Timely Vaccination of Their Children in Qom, Iran

Background and Objectives: One of the effective methods for preventing infectious diseases, especially in children, is vaccination; if children are not fully, correctly and timely immunized, infectious diseases will threaten their lives. The present study aims to evaluate the effect of an educational intervention based on the health belief model (HBM) on timely vaccination of children in Qom, Iran Methods: This is an interventional study that was conducted on 100 mothers referred to comprehensive health centers in Qom, Iran for the 2-month and 4-month vaccination of their children with a delay of more than 10 days. After dividing them into two groups of intervention and control by the block randomization method (4 blocks), questionnaires were completed by both groups. Then, the intervention group received the online educational materials for two months. Two months later, the questionnaires were completed by both groups again and the time of their visit was checked. Results: The mean score of practice in both groups increased after two months, which was higher in the intervention group and this difference was significant (P&lt;0.001). Conclusion: HBM-based educational programs can be used to increase immunization coverage of children in Qom, Iran.

Support and control during childbirth and attachment after birth in mothers referring to comprehensive health centers in Bijar, 2019

Childbirth is one of the most important experiences in the life of mothers, which can bring tensions and worries due to physical and psychological changes. Therefore, the present study was conducted to determine the amount of support and control during childbirth and attachment after birth in mothers who were referred to comprehensive health centers in Bijar County, in 2019. In this descriptive-analytical study, the studied population consisted of all the mothers who were referred to the comprehensive health centers of Bijar, who had passed 28 days after giving birth. The participants in the study were available to choose and completed the questionnaires for support and control during childbirth and attachment after birth. The collected data were analyzed using SPSS statistical software version 22 and multiple regression statistical tests, and a significance level of p<0.05 was considered. The results of the study showed that the level of support and control during childbirth was 83.32±17.038 and the level of attachment after birth was 47.70±4.688. Also, the results of the study showed that none of the investigated demographic variables were related to support and control during childbirth. The type of delivery (vaginal delivery with episiotomy r=-2.226, p=0.012) and the baby's gender (r=9.927, p=0.047) were related to support and control during delivery. Also, the results showed that among the demographic variables examined with attachment after birth, the variable of income (equal to monthly expenses r=6.307, p=0.01) had a positive and significant relationship with attachment after birth. The findings showed that support and control are at a moderate level and attachment after birth is at an average level, so it seems that with the necessary training on the importance of mother and child attachment to medical personnel, an effective step can be taken to improve these two factors and their consequences.

Evaluating the Health Belief Model Constructs in Adopting the HPV Preventive Behavior.

Genital warts are a highly contagious sexually transmitted disease. It is caused by the human papillomavirus (HPV), which is transmitted through sexual contact. HPV is the most important cause of cervical cancer. This study aimed to evaluate the health belief model (HBM) constructs in adopting HPV preventive behavior in women referred to comprehensive health centers in Southwestern Iran. This descriptive-analytical study was performed on 1000 women referring to health centers in Ahvaz during 2019-2020 who were selected via a two-stage stratified random sampling technique. Data were collected using a valid and reliable researcher-made questionnaire based on the HBM. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and regression analysis in SPSS v.18, at a significance level lower than 0.05. Total scale reliability of the tool was very good (α=0.828), as the Intra-cluster correlation coefficient (ICC) was to be 0.86. The mean of preventive behavior using an ANOVA test was significantly different at different levels of education (P <0.05). The mean and standard deviation of knowledge about HPV and preventive behavior was moderate (11.45±3.4). Pearson correlation coefficient showed a significant direct relationship between preventive behavior with awareness, perceived sensitivity, and self-efficacy and inversely related to perceived barriers. Perceived sensitivity (0.01) and self-efficacy (<0.001) were identified as the final predictors of behavior in regression analysis. As the results showed, designing programs to prevent HPV, considering the perceived role of perceived sensitivity and self-efficacy, increases the likelihood of effective interventions.

Providing sexual health services by midwives in comprehensive health centers: A qualitative study from Iran

Providing sexual health services by midwives in comprehensive health centers: A qualitative study from Iran

The Relationship Sexual Satisfaction and the Marital burnout in Married Women of Yasouj City

Background &amp; Aims Sexual dissatisfaction in women has several consequences. Due to the cultural factors and the traditional context of Iranian cities, there are limitations for women to talk about sexual issues and do not express their sexual satisfaction during the necessary care in reproductive age. This study aims to determine the relationship between sexual satisfaction and marital burnout of women living in Yasuj, Iran. Materials &amp; Methods This cross-sectional study was conducted on 300 married women referred to four comprehensive health centers in Yasuj. Data was collected using a demographic form, the Married Women’s Sexual Satisfaction Questionnaire (MWSSQ), and the Couple Burnout Measure (CBM). The data was analyzed using the Pearson correlation test in SPSS software, version 22. Results The component of mental and physical barriers to sexual satisfaction had a significant positive correlation with the total score of CBM (r=0.488, P&lt;0.001). Other three components of MWSSQ, including antecedents (r=-0.624, P&lt;0.001), husband-related factors (r=-0.662, P&lt;0.001), and dominant cultural values (r=-0.447, P&lt;0.001) had a significant negative correlation with the total score of CBM. Conclusion Higher mental and physical barriers to sexual satisfaction can cause higher marital burnout in women, while lower antecedents, husband-related factors, and cultural values related to sexual performance can reduce marital burnout. Healthcare workers working in health centers should check women's sexual satisfaction status and, if necessary, remove their mental and physical barriers to sexual satisfaction and improve their physical, mental, and emotional conditions and relationships with husbands by providing training and counseling to them.

РАЗРАБОТКА КОНЦЕПЦИИ ЦИФРОВОГО ДВОЙНИКА РАБОТНИКА РАДИАЦИОННО- И ЯДЕРНО-ОПАСНОГО ПРЕДПРИЯТИЯ И ПРОИЗВОДСТВА

Purpose: Analysis of the possibilities of a predictive model for assessing the risks of pathology of the cardiovascular, cerebrovascular systems and psychophysiological state in workers of radiation and nuclear hazardous enterprises and industries as part of the development of the concept of a digital twin. Material and methods: The study involved employees of one of the leading radiation and nuclear hazardous enterprises, who underwent periodic medical examinations at comprehensive medical health center of the A.I. Burnazyan Federal Medical and Biological Center in September–October 2022. In total 154 patients (115 men and 39 women) were questioned, examined, and analyzed medical records. Diagnostic criteria for risk factors and other pathological conditions and diseases that increase the likelihood of developing chronic non-communicable diseases were evaluated both in accordance with the orders of the Ministry of Health and using the AI-HIPPOCRAT digital prognostic model developed by the Computer Science and Management Federal Research Center. Results: In accordance with the criteria specified in the orders of the Ministry of Health, it was revealed that high or very high risks of developing diseases such as heart attack, stroke, hypertension and depression are observed in 120 people (77.9 %), and according to the analysis in the AI-HIPPOCRAT system, these risks occur in 131 people (85.1 %). Conclusion: As a result of the study, the capabilities of the AI-HIPPOCRATE system were analyzed and the following recommendations were given for its use by workers of radiation and nuclear hazardous enterprises and industries: to integrate the AI-HIPPOCRAT system into the medical information system used at the enterprise; to divide the presented risk factors into three groups: manageable (on which the doctor or patient can influence), conditionally manageable (which can be influenced by the use of drugs) and uncontrollable, which the doctor and the patient cannot manage (for example, gender, age, etc.); to raise the threshold for setting the risk of a particular disease to “high and above”.