Healthcare Centers Of Mashhad Research Articles

Effects of Viola odorata syrup on hot flashes and night sweats in menopausal women: A randomized, triple-blind, controlled trial

BackgroundHot flashes and night sweats are among the most common and disruptive symptoms in menopausal women. The present study aimed to assess the effects of Viola odorata syrup on hot flashes and night sweats in menopausal women. V. odorata contain flavonoids, saponins, mucilage, alkaloid, vitamin C, magnesium and melatonin. MethodsThis triple-blind, Randomized Controlled Trial was conducted on 84 menopausal women aged 40–65 years referring to the healthcare centers in Mashhad, Iran. Eligible menopausal women received the V. odorata syrup (5 ml) or placebo twice daily for one month. Data were collected before, during, and after the intervention using valid and reliable daily hot flash checklists. Data analysis was performed in SPSS using independent t-test, Mann-Whitney U test, Friedman test, and Chi-square at the significance level of 0.05. ResultsIn the first week (before the intervention), the intervention group (V. odorata syrup) and placebo group (control) were homogenous in terms of the frequency and intensity of hot flashes and night sweats. The Mann-Whitney U test indicated a significant difference in the duration of hot flashes between the two groups. In addition, significant differences were observed between the V. odorata syrup and placebo groups between the mean duration of hot flashes in the second (P = 0.044), third (P = 0.031), fourth (P < 0.001), and fifth weeks (P<0.001), mean frequency of hot flashes in the third, fourth, and fifth weeks (P < 0.001), and mean intensity of hot flashes in the third (P = 0.003), fourth, and fifth weeks (P < 0.001), as well as night sweats in the second week, the mean values of which were significantly lower in the V. odorata group compared to the control group. ConclusionV. odorata syrup could reduce the frequency, intensity, and duration of hot flashes since the second week of the treatment. Therefore, the use of this plant is recommended for the reduction of hot flashes and night sweats in menopausal women.

Effects of Viola odorata syrup on sleep quality in menopausal women: a randomized, triple-blind, controlled trial.

The present study aimed to assess the effects of Viola odorata syrup on the sleep quality of postmenopausal women. This triple-blinded randomized clinical trial was conducted on menopausal women presenting to the healthcare centers in Mashhad, Iran, in 2019. The participants were selected using simple random sampling. Participants received 5ml syrup V. odorata or placebo twice a day for 1month. Data were collected using the Pittsburgh Sleep Quality Index. The data were analyzed using SPSS version 25. The 118 eligible women enrolled in the study were divided into two groups of V. odorata syrup and placebo (n = 59each). The analysis was conducted on only84 menopausal women (42 in each group)due to exclusions. Exclusions consisted of 12 participants whowithdrew from the study due to unwillingness to cooperate,8 who had irregularconsumption of the therapeutic syrup, 6 withinaccurate completion of the questionnaire, and 8 due to lack of accessibility. The two study groups were homogenous in terms of demographic characteristics. Before the intervention, no significant difference was observed in the mean PSQI scorebetween the two groups (9.2 ± 2.9 vs. 8.4 ± 2.5) (P = 0.18). However, a significant difference was seen in the mean PSQI scorebetween the two groups (4.9 ± 1.9 vs. 8.1 ± 2.1, P < 0.001) after the intervention. The findings of this study suggest that V. odorata syrup may be a useful therapeutic agent to improve the sleep quality of menopausal women. IRCT20180514039660N1.

Investigating the Relationship between Professional Commitment and Resilience of Healthcare Personnel during the COVID-19 Epidemic Crisis in Healthcare Centers in Mashhad

Investigating the Relationship between Professional Commitment and Resilience of Healthcare Personnel during the COVID-19 Epidemic Crisis in Healthcare Centers in Mashhad

Colorectal Cancer Awareness and Related Factors Among Adults Attending Primary Healthcare in North-Eastern of Iran: A Cross-sectional Study.

Colorectal cancer (CRC) is the third most prevalent cancer in Iran. This study aimed to assess the level of awareness regarding CRC warning signs, risk factors, screening program, and related factors among adults in North-Eastern Iran. Study Design: A cross-sectional study. The multi-stage sampling method was used to survey 2614 participants attending primary healthcare centers in Mashhad, Iran. The data collection tools were the demographics section and Bowel/ CRC Awareness Measure (Bowel/Colorectal CAM). The data were analyzed by SPSS, version 25. The significance level of the data analysis was less than 0.05. Mean awareness for CRC warning signs and CRC risk factors were 2.85±2.13 and 3.63±1.85, respectively. Most participants (97.2%) had no awareness of the CRC screening program. There was a significant association between marital status, education, job, income, and family history of CRC with awareness of warning signs (P<0.001); moreover, there was a significant association between age, education, job, income, and family history of CRC with awareness of risk factors (P<0.001). The results of logistic regression indicated that there was a significant association between age (P=0.022, OR=1.794, 95% confidence interval [CI]: 1.087, 2.962), gender (P=0.005, OR=0.488, 95% CI: 0.296, 0.803) and warning sign awareness (P<0.001, OR=1.278, 95% CI: 1.124, 1.454) with awareness of the CRC screening program. In this study, most of the participants had low awareness of CRC. More aimed educational interventions are needed to promote Iranian adults' awareness of CRC.

Evaluating the Agreement between k-median and Latent Class Analysis for Clustering of Psychological Distress Prevalence

Introduction: Psychological distress (PD) is one of the most common mental disorders in the general population. Psychological distress is considered a public health priority due to its adverse effects on quality of life, health, performance, and productivity. It can also predict several serious mental illnesses, such as depressive disorder and anxiety. In this study, we intend to identify the behavioral pattern of PD in the population of 18 to 65 years old in Mashhad using two methods, K-median and Latent Class Analysis (LCA), and evaluate the agreement between the two methods.&#x0D; Methods: This cross-sectional study was performed on 38058 individuals referred to community health care centers in Mashhad of Iran in 2019. The information used in this study was extracted from Sina Electronic Health Record System (SinaEHR) database. A demographic information checklist and a 6-item Kessler psychological distress scale (K-6) were used for data collection. K-median and LCA were used for data analysis.&#x0D; Results: Out of 38058 participants, 49.3% were women, 86.1% were married, and 63.6% had a diploma and under diploma education. The LCA identified three patterns of PD in answering the items of the K-6 questionnaire, including severe PD (19.7%), low PD (36.7%), and no PD (43.5%). Three clusters were identified by the K-Median method: 1) severe PD (22.0%), 2) low PD (31.1%), and 3) and no PD (46.9%). The agreement between K-Median and LCA was kappa = 0.862.&#x0D; Conclusion: About 20% of people were classified as having severe PD. Both LCA and k-median methods can reasonably identify the latent pattern of PD with significant entropy, and there was almost complete agreement between the two methods in data clustering. Considering the advantages of the LCA, this method is recommended to identify the latent pattern of PD based on the k-6 questionnaire.

Pediatric reference intervals for hematology parameters in healthy infants and young children in Iran.

Defining accurate age- and sex-specific reference intervals (RIs) for hematology parameters, especially for the pediatric population, is important for making an appropriate clinical diagnosis. To address gaps, we established age-specific RIs for 11 hematologic parameters in Iranian children younger than 30 months for the first time. Fresh whole blood samples collected from a total of 344 participants (males: 158 and females: 186) ages 3 days to 30 months, with a mean age of 12.91 ± 7.15 months, were recruited from healthcare centers in Mashhad, Iran. Hematologic parameters, including complete blood count (CBC), were analyzed on the Sysmex auto-analyzer system (KX-21 N). RIs were calculated with 90% confidence intervals using the direct method based on CLSI Ep28-A3 and C28-A3 guidelines. None of the CBC parameters required sex partitioning. Of 11 CBC parameters, six required age partitions of 3 days-<4 months, 4-<10, 10-<15, and 4-<30 months. Five parameters (i.e., white blood cell count, mean corpuscular hemoglobin concentration, mean platelet volume, red cell distribution width, and platelet distribution width) did not demonstrate age-specific changes. RIs of red blood cell count and hematocrit, as well as hemoglobin, increased with age, while mean corpuscular volume, mean corpuscular hemoglobin, and platelet count, decreased with age. In this study, we established RIs for 11 hematology parameters in young children. Age partitioning was required for six parameters demonstrating marked changes during the early period of growth and development and necessitating the use of pediatric-specific reference standards.

The Effect of Integrated Religious Cognitive Behavioral Therapy (IRCBT) on Psychological Symptoms of Women with Breast Cancer

Breast cancer exacerbates psychological problems and raises existential concerns, and decreases hope and quality of life. The aim of the study was to investigate the efficacy of integrated religious cognitive behavioral therapy (IRCBT) on psychological symptoms among Iranian women with breast cancer. A total sample of 178 patients referred to the community healthcare centers in Mashhad (Iran) was selected. Patients were randomly assigned to experimental and control groups. For the experimental group, eight 120-min sessions of IRCBT were administered. All patients completed the Symptom Checklist-25 (SCL-25). At baseline, there was no significant difference between the two groups on the SCL-25 subscales scores. After the intervention, the mean scores on all subscales of the SCL-25 in the experimental group were significantly lower than the control group, except for the obsessive-compulsive, somatization, and neuroticism subscales. The IRCBT may be useful for improving negative psychological symptoms among Iranian women with breast cancer. Keywords: IRCBT, Psychological symptoms, Breast cancer, Religion, Iran

Interpersonal Cognitive Distortions Among the Community-dwelling Elderly in Tehran, Iran

Background &amp; Aims Interpersonal cognitive distortion (ICD) is one of the psychological problems in old age that causes a person not to have a correct and logical understanding of relations. Its continuation can lead to anxiety and depression. This study aims to determine the ICDs among the community-dwelling elderly in Tehran, Iran. Materials &amp; Methods In this descriptive-correlational study, participants were 200 older people dwelling in the urban parks in Tehran, Iran who were selected using a cluster sampling method from December 2020 to October 2021. Data collection tools included a demographic form, abbreviated mental test score (AMTS), and interpersonal cognitive distortion scale (ICDS). The collected data were analyzed in SPSS software, version 16 software using descriptive statistics (Mean±SD, No. (%)) and inferential statistics (Pearson correlation test, independent t-test, analysis of variance). Results The mean total score of ICD was 52.53±8.29 out of 95, which indicates the moderate level of ICD among the elderly. In terms of the dimensions of ICDS, the unrealistic relationship expectations had the highest mean score (2.91±0.57), while the dimension of interpersonal rejection had the lowest score (2.64±0.52). There was a significant relationship between the age of the elderly and their ICD (P=0.03). Conclusion Considering the existence of a significant relationship between ageing and cognitive distortions, The nurses working in healthcare centers in Mashhad should take it into account in interventions for the elderly.

اعتباریابی و پایایی سنجی نسخه فارسی پرسشنامه نشخوار فکری مشترک

Introduction: Co-rumination refers to excessively frequent discussing personal problems within dyadic relationship. The purpose of present study was to investigate the validity and reliability assessment of the Persian version of the Co-rumination questionnaire. Methods: In a correlational design, 167 adults who were referred to health care centers in Mashhad were selected with multistage cluster sampling. Data were collected by a Co-rumination Questionnaire, Depression, Anxiety, Stress Scale (DASS-21), and Rumination Response Scale (RRS). Exploratory factor analysis, Pearson correlation coefficient and multivariate analysis of variance were used to analyze the data. Results: The results showed that the scale had three factors of rehashing, encouraging problem talk and mulling which explains 66.01% of the variance. Co-rumination had a positive and significant relationship with stress, anxiety, depression and rumination (p < 0.01). Age had no significant relationship with Co-rumination. But differences were significant based on gender, and women had higher mean. Conclusion: It seems that the Persian version of the Co-rumination Questionnaire has a proper validity and reliability in common population and can be used in related research.

The preferences and expectations of married women receiving preconception care in Iran: a qualitative study

ABSTRACT Preconception care (PCC), as an essential strategy in continuity of the care approach for women, could reduce maternal and child mortality. Women’s expectations from healthcare providers regarding PCC are different based on their knowledge, experiences and culture. The purpose of this study was to explore Iranian women’s preferences and expectations regarding PCC. In this qualitative content analysis 22 married women with intention to become pregnant were recruited from 22 healthcare centers in Mashhad, Iran, using purposive sampling. Data were collected through semi-structured in-depth interviews from March to October 2014. Interviews were transcribed verbatim and analyzed using a conventional content analysis approach. The main expectation of women regarding PCC was “being supported and receiving continuing care”. This overarching theme consisted of five categories including continuity of care, couple-centered care, establishing effective communication, accessibility to preconception services and access to competent professionals. Women highlighted their expectations as the need of support and to receive continuing healthcare. They requested PCC for couples and emphasized the importance of the health professional’s competency as well as access to information and services of PCC. Women’s experiences manifested several areas within which changes could be applied to improve the quality of preconception care.

Development and Psychometric Properties of the Women's Recovery of Postnatal Perineal Injuries Questionnaire (WRPPIQ).

ABSTRACTBackground: Recovery of postnatal women with perineal injuries, especially when perineal tear is severe, occurs much later than the healthy women. There is no specific questionnaire to assess the postnatal recovery in these women. The aim of this study was development and psychometric evaluation of a new tool to measure women’s recovery of postnatal perineal injuries questionnaire (WRPPIQ).Methods: In this validation study, which was conducted based on the method developed by DeVellis (2003), 270 women with postnatal perineal injuries who referred to healthcare centers in Mashhad, Iran, were studied between 2018 and 2020. This method consisted of steps: (1) definition of postnatal recovery based on in-depth qualitative interview with 22 women, (2) generation of an item pool, (3) selection of the Likert scale, (4) review of the initial item pool, (5) inclusion of items from relevant instruments, (6) conducting exploratory factor analysis, (7) evaluation of the items, and (8) optimization of the scale length. Results: The initially generated item pool consisted of 144 items on a 5-point Likert scale, which reduced to 85 items following face and content validity measurement. The value of the SCVI/Ave was measured 0.901. The conduction of exploratory factor analysis resulted in 33 items and three factors including evidence of wellness, emotional changes as well as independence and support. The Cronbach’s alpha for the three factors was calculated 0.92, 0.80, and 0.83, respectively.Conclusion: WRPPIQ has validity and reliability to measure the women’s recovery of postnatal perineal injuries in Iran. It is, therefore, recommended that health care providers to assess women’s recovery of postnatal perineal injuries using this newly developed questionnaire.

Comparing the Influence of Integrated and Group Counseling on Childbearing Attitudes in Women on the Verge of Marriage

Background & aim: Premarital counseling is the best opportunity to provide childbirth counseling for young people on the verge of marriage. Given the lack of data on the most effective way to deliver such information during this period, the present study aimed to compare the effects of integrated and group counseling on the attitude towards childbearing in women on the verge of marriage. Methods: This experimental study was carried out on 162 women receiving premarital counseling in the healthcare centers of Mashhad, Iran, during 2015-2016. The subjects were divided into three groups, who received the integrated, group, and routine counseling services. The integrated group received two sessions of group and one session of individual counseling. The group counseling received three sessions of 2-h counseling with one week interval. The control group received only the routine counseling. Data were collected using a demographic and childbirth attitude questionnaire and analyzed using one-way ANOVA, Kruskal-Wallis, paired sample t-test, and Wilcoxon tests. Results: After the intervention, the attitude towards childbearing underwent a significant change in participants of integrated (P<0.001) and group (P=0.03) counseling, compared to that of the control group. However, there was no significant difference between two intervention groups in terms of their attitude. Conclusion: Both integrated and group counseling methods are recommended for providing a favorable attitude towards childbearing in young people. Therefore, enough time must be spent on childbearing counseling for women on the verge of marriage attending premarital counseling clinics.

The effect of individual counseling on attitudes and decisional conflict in the choice of delivery among nulliparous women.

BACKGROUND:The most important reasons for choosing cesarean include negative attitude of pregnant women toward natural childbirth, and it is not easy for many women to make a decision about the choice of delivery, Midwives as responsible individuals, play an important role in providing maternal counseling and care during pregnancy and childbirth and the postpartum period. This study was carried out to determine the effect of individual counseling on attitudes and decisional conflict in the choice of delivery among nulliparous women.MATERIALS AND METHODS:This clinical trial was performed on 90 nulliparous women with 28–30 weeks of gestational age, who were referred to health-care centers in Mashhad. They were divided randomly into intervention and control groups. The intervention group received the counseling program individually during three sessions, while the control group received routine care, childbirth attitudes, and decisional conflict on choice of delivery were compared on women of 34–36 weeks of pregnancy. Data collection tools included demographic details form, Childbirth Attitudes Scale and Decisional Conflict Scale; data were analyzed using Chi-square tests, Fisher's exact test, Mann–Whitney test, t-test, parried t-test, and ANCOVA in SPSS v. 16, and P < 0.05 was considered statistically significant.RESULTS:After consultation, there was a significant difference in attitude score between the intervention group (86.577 ± 13.531) and the control group (69.955 ± 19.858) (P < 0.001), And there was a significant difference in decisional conflict score between the intervention group (0.614 ± 0.626) and the control group (1.216 ± 0.949) (P < 0.001), and there were significant differences between the two groups in terms of preferred delivery (P < 0.001).CONCLUSION:According to the results of this randomized control trial, individual counseling in nulliparous women during pregnancy leads to a positive attitude toward natural childbirth, informed decision-making, and increase in the selection of natural childbirth.

Effect of Positive Psychology Interventions on the Quality of Prenatal Care Offered by Midwives: A Field Trial.

Background:The quality of prenatal care has been recognized as critical to the effectiveness of care in optimizing maternal and child health outcomes. This study examined the effect of positive psychology interventions on the quality of prenatal care offered by midwives.Materials and Methods:This field trial was conducted on 60 midwives working in community health centers in Mashhad, Iran, from September 23, 2015 to March 20, 2016. Initially, centers No. 1 and No. 3 were selected via cluster sampling from among the five healthcare centers of Mashhad. Then, all subsidiaries of these centers were listed and assigned to intervention and control groups through simple random sampling. Thus, 60 midwives were randomly assigned to two equal intervention and control groups. The intervention, based on Seligman's Well-Being Theory, was presented weekly with homework in eight 2-h sessions. Before the interventions and immediately after the intervention, the Oxford Happiness Questionnaire (OHQ) and Ryff's Scales of Psychological Well-Being (SPWB) were completed by the midwives, and the Quality of Prenatal Care Questionnaire (QPCQ) was completed by two pregnant women for each midwife.Results:After the intervention, the mean [Standard Deviation (SD)] score of the overall quality of prenatal care in the intervention group was significantly higher than that of the control group [mean (SD) = 1.51 (0.49) vs. 0.05 (0.21); t43,12= 18.7, p < 0.001].Conclusions:It seems that improving the well-being of midwives through positive psychology interventions is effective on the quality of prenatal care provided by them.

The Effectiveness of Counseling using PLISSIT Model on Depression, Anxiety and Stress, among Postpartum Women with Sexual Dysfunction: A Randomized Trial

Background & aim: Sexual dysfunction is common among women after childbirth, which could be associated with depression, anxiety and stress. The majority of these problems can be treated in early stages with different counseling approaches. The aim of this study was to assess the effect of counselling based on the PLISSIT model on depression, anxiety and stress among postpartum women with sexual dysfunction. Methods: This clinical trial was carried out on 80 women referred to urban healthcare centers of Mashhad, Iran in 2017, who had a score ≤ 28 based on the female sexual function index, with no history of sexual dysfunction before and during the pregnancy. They were randomly assigned to two groups of PLISSIT and control group. The subjects in the PLISSIT group attended two counseling sessions in two consecutive weeks and those in the control group received routine care. A demographic questionnaire, FSFI, as well as DASS-21 were used to measure female sexual function as well as depression, anxiety and stress before and 4 weeks after the last session in both groups. Data was analyzed using independent t-test, analysis of covariance, and Mann-Whitney U test. Results: The mean scores of DASS-21 total score were 9.6±7.5 and 3.3±2.9 in the PLISSIT group and 9.2±9.5 and 8.7±4.3 in the control group at the baseline and 4 weeks after the last session, respectively. The difference between means in two groups was significant (P=0.026). By controlling the intervening variables, the DASS-21 score in the intervention group decreased, compared to that in the control group. Conclusion: The PLISSIT model decreases the DASS-21 total score in women with sexual dysfunction after childbirth.

Behavioral brain systems activation with postpartum blue: According revised reinforcement sensivity theory

Context: Mood disorders such as postpartum blue are very prevalent in the postnatal period, while the underlying mechanism of postpartum blue is not well known. Aim: This research aimed to investigates the role of brain-behavioral systems activation in postpartum blue according to revised reinforcement sensitivity theory in mothers referring to Mashhad health-care centers. Settings and Design: This correlational study has been conducted during February–March 2018, on 172 cases who diagnosed with postpartum blue were chosen through the purposive sampling method. Materials and Methods: Participants completed demographic questionnaire, Jackson five-factor questionnaire, and the Edinburgh depression scale. Statistical Analysis Used: The normality of data distribution examined using the Kolmogorov–Smirnov test. After, data were analyzed using descriptive methods (mean and standard deviation), Pearson confiscation, and stepwise regression method. Results: The results showed that brain-behavioral systems, including behavioral inhibition system (BIS) (P Conclusion: The findings suggest that behavioral-brain systems play a role in mothers' “postpartum psychological disorders such as postpartum blue and in the conception of mothers” distress after maternal delivery, the effects of these systems can be used in short-term interventions.

The Relationship between Frequency of Breastfeeding and Sexual Distress in Postpartum Women

Background & aim: Due to frequent waking at night for breastfeeding, nursing mothers are likely to suffer from sleep deprivation, which may lead to sexual dysfunction. To the best of our knowledge, few studies have been conducted on sexual distress in nursing mothers. Thus, we sought to examine the relationship between the frequency of breastfeeding and female sexual distress during postpartum period. Methods: This descriptive correlational study was conducted on 80 women aged 18-35 years, visiting healthcare centers in Mashhad, Iran, during 2016. To select the participants, multi-stage sampling method was used. The data collection tools included demographic and fertility-related questionnaire, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Female Sexual Distress Scale-Revised (FSDS-R). To analyze the data, Kruskal-Wallis H test, Spearman’s rank-order correlation, and linear regression model were run in SPSS, version 16. Results: The mean score of postpartum sexual distress in mothers was 20.43±8.00. According to the results of the Spearman’s rank-order correlation, the frequency of nighttime breastfeeding was directly correlated with maternal sexual distress (P=0.010, r=0.26). However, there was no correlation between the frequency of daytime breastfeeding sessions and sexual distress (P=0.976, r=0.003). Conclusion: Considering the correlation between the frequency of breastfeeding at night and postpartum sexual distress in mothers, it seems necessary to adopt effective counselling approaches to overcome female sexual distress during this period.

Effects of Yakson Therapeutic Touch and Heel Warming on Pain Caused by Heel Stick Procedure, Vital Signs, and Cry Duration in Full-term Neonates

Background: Neonates are more sensitive to pain and likely to suffer from its long-term complications. Therefore, various methods including non-nutritive sucking, sensory stimulations, and various supportive interventions are employed to relieve pain in newborns. Aim: This study aimed to compare the effects of Yakson therapeutic touch and heel warming on pain caused by heel stick procedure, vital signs, and cry duration in full-term neonates. Method: This randomized clinical trial was conducted among 78 full-term newborns referred to healthcare centers in Mashhad, Iran, 2017. They were assigned into three groups of Yakson theraputic touch, heel warming using a hot-water bottle with the temperature of 40°C, and control receiving routine care, through randomized block method. Then, vital signs before and after and pain intensity after heel-stick procedure were measured using Neonatal Infant Pain Scale (NIPS). Data analysis was performed using Kruskal-Wallis and Wilcoxon tests in SPSS software, version 16. Results: The study groups were homogeneous considering demographic characteristics. The results of Kruskal-Wallis test showed a significant difference between the groups regarding the mean scores of the NIPS at the post-intervention phase (P=0.02). However, no significant difference was observed between pre- and post-intervention phases in the groups considering respiratory and heart rates. Additionally, cry duration significantly reduced in the group that received Yakson therapeutic touch (P=0.03). Implications for Practice: The use of Yakson therapeutic touch could relieve pain, soothe the neonates, and shorten cry duration in newborns after heel stick procedure. Nevertheless, heel warming only increased up blood flow for easier blood sampling.

Effect of Training Based on Choice Theory on Health-Promoting Lifestyle Behaviors among Menopausal Women

Background & aim: Menopause is considered as a stage of life that is often encountered by all women with symptoms as hot flashes, sweating, palpitations, sleep disorders, and urinary tract problems. The improvement of health-promoting lifestyle behaviors is one of the effective measures to moderate these symptoms by facilitating the women to enhance their lifestyle behaviors through making proper choices. The aim of this study was to measure the effect of training based on choice theory on health-promoting lifestyle behaviors in menopausal women. Methods: This two-group pretest-posttest design was conducted on 40 menopausal women within the age range of 45-55 years, referring to healthcare centers in Mashhad, Iran, in 2016. The subjects were randomly assigned into intervention and control groups using simple random sampling method. The data collection instruments included a demographic questionnaire, a menopause knowledge/attitude questionnaire, as well as Health-Promoting Lifestyle Profile II (HPLPII), which consisted of six dimensions of nutrition, physical activity, responsibility for health, stress management, interpersonal relationships, and spiritual growth. The intervention group received training in seven 90-minute sessions based on choice theory. The data were analyzed in SPSS software using descriptive statistics, Mann-Whitney U test, independent t-test, paired sample t-test, and Friedman test. Results: According to the results, after the intervention, the mean scores of total health-promoting lifestyle behaviors (p <0.03) and responsibility for health (P=0.005) showed a significant increase in the intervention group, compared to those in the control group. Conclusion: As the findings of this study indicated, the midwives could play an effective role in the moderation of menopausal side effects using choice theory. In this regard, the needs of the menopausal women in terms of boosting their awareness and practicing health-promoting lifestyle behaviors should be identified to deal with menopausal problems.

Childbearing Motivation in Iranian Engaged Couples: A Structural Equation Model

Background: Childbearing is considered to be one of the main purposes of marriage in Iranian culture. The aim of this study was to assess relationships among age of marriage, religious and educational levels, participation of couples in childbearing and finical status with childbearing motivation using structural equation model. Materials and Methods: This study is a secondary analysis of previous data; 450 young couples attending four healthcare centers of Mashhad, Iran, included in this study. Sampling method was convenience sampling. Structural equation modeling was performed using AMOS version 19.0. Model was tested using maximum likelihood. Goodness of fit of the model was evaluated based on the Chi-square to degree of freedom ratio (χ2/df), goodness-of-fit index (GFI), comparative fit index (CFI), and root mean square error of approximation (RMSEA). Results: Mean age for women and men were 22.16±4.84 and 26.02±4.6 year-old, respectively. The result of our study showed that suggested childbearing motivation model was well fit with data (GFI=0.96; CFI=0.96; RMSEA=0.063, and χ2/df=4.51). Marriage age and educational level significantly negatively associated with childbearing motivation, respectively (standardized β =-0.082, p=0.018), and (standardized β= -0.222 and p<0.001). Religious level was positively significantly associated with positive motivation (standardized β =0.226 and p<0.001). Participation of couples in childbearing had a significantly strong positive motivation (standardized β=0.56 and p<0.001). The R-squared value for childbearing motivation model was 0.34. Conclusion: The findings indicated that the couple’s childbearing motivations were influenced by educational level, participation of couples in childbearing, marriage age and religious level.