Depression, anxiety, stress, and dysmenorrhea: a protocol for a systematic review

Background: Dysmenorrhea is one of the most common menstrual disorders and is influenced by various factors. Psychological disorders including anxiety, depression, and stress have been suggested as influencing dysmenorrhea, but previous findings are inconsistent. This study will investigate the relationship between depression/anxiety/stress and dysmenorrhea using a systematic review and meta-analysis. Methods: Online databases including PsycINFO, Scopus, PubMed, Science Direct, ProQuest, ISI Web of Knowledge, and Embase will be searched. Appropriate keywords and MeSH terms will be used to retrieve the journal papers published from 1990 until the end of December 2019. To improve search coverage, the reference lists of all included studies will be reviewed to find eligible papers. Inclusion criteria include the following: descriptive, cohort, case-control, and cross-sectional studies; the relationship between depression/anxiety/stress and dysmenorrhea being an objective of the study; and published in peer-reviewed journals. The paper selection, data extraction, and quality assessment of selected studies will be performed independently by two researchers, and disagreements will be resolved through discussions. The Newcastle-Ottawa Quality Assessment Scale will be used to assess the quality of selected studies. A quantitative synthesis will be performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) via the STATA software, if retrieving enough number of studies with no severe methodological heterogeneities. Otherwise, qualitative synthesis will be used to report the findings. Discussion: To the best of our knowledge, this will be the first systematic review on this topic. Performing an inclusive search in major databases over a wide timescale is one key strength of the proposed study and will maximize the coverage of the original research studies on this topic. Results of present study are expected to lead to deeper understanding the relationship between common mental health conditions and dysmenorrhea

Investigating the effect of vitamin D vaginal suppository on sexual function among postmenopausal women: study protocol for a randomized controlled trial

Background: Menopause is associated with changes in sexual function which are partly due to vaginal atrophy in response to estrogen reduction. Estrogen administration temporarily reduces the symptoms of vaginal dryness, but long-term exposure to this drug is likely to be associated with serious complications. Considering the promising results of previous studies concerning the effect of vitamin D on vaginal dryness, the proposed study will investigate the effect of vitamin D vaginal suppository on the sexual function of postmenopausal women. Methods: In a randomized, controlled clinical trial, 105 postmenopausal women will be randomly assigned to three groups receiving vitamin D vaginal suppository, placebo vaginal suppository, or control (no intervention). Vitamin D vaginal suppositories contain 1000 units of vitamin D3. The timing of the use of vitamin D vaginal suppositories and placebo suppositories will be every night in the first 2 weeks, and every other night in the following 6 weeks (8 weeks in total). The primary outcome will be the sexual function of participants which will be assessed using the Female Sexual Function Index (FSFI) before and immediately after the intervention, and at 1 and 2 months after the end of the intervention. The side effects of these suppositories will be examined as a secondary consequence of the study. Data will be analyzed using SPSS software version 25. In the case of normal distribution of data, the mean score of sexual function will be compared between the groups using a repeated measurements ANOVA. If statistical analysis leads to significant results, the post-hoc test will be used to determine the differences between the groups. Comparison of demographic and fertility characteristics of the women will be carried out using statistical tests such as chi-squares and t-tests. A significance level of p [less than] .05 will be used for statistical analyses. Discussion: If vitamin D vaginal suppositories improve sexual function among premenopausal women with long-term effects and minimum side effects, the suppositories will be considered a safe complementary and alternative choice for alleviating sexual dysfunction among this group

The effect of nutritional education based on the health action process approach (HAPA) on the pregnancy outcomes among malnourished pregnant mothers

Objective: To examine the effectiveness of nutritional education based on the health action process approach (HAPA) on pregnancy outcomes among malnourished pregnant mothers utilizing nutritional support. Methods: In a randomized controlled trial, 234 malnourished pregnant women under nutritional support from the fourth month of pregnancy participated. Participants were randomly allocated in study groups by the balance block randomization method. Data were collected using a socio-demographic and pregnancy outcomes checklist as well as self-devised questionnaire assessing the constructs of the HAPA model before and three months after the educational intervention. The framework of the educational intervention was based on the constructs of the HAPA and included three one-hour training sessions through lectures, group discussions, ‘question and answer’ sessions, and the use of educational tools. Data were analyzed using analysis of covariance (ANCOVA) and SPSS software. Results: Pregnancy outcomes including optimal weight gain during pregnancy (p = 0.47), neonate’s birth weight (p = 0.58), gestational age at delivery (p = 0.83), type of delivery (p = 0.48) gestational anemia (p = 0.22), diabetes (p = 0.59) and hypertension (p = 0.29) were not significantly different in the intervention and control groups. The results showed that the educational intervention produced a significant increase in the total score (24 points) in the intervention group. Improvement of scores in the intervention group compared to the control was observed in all of the model constructs except outcome expectation (0.68 decrease). The educational intervention in the present study had a large measure of effect in total (SMD: 2.69, partial eta2: 0.664). Conclusion: A nutritional education intervention based on the HAPA model for malnourished pregnant women increased behavioral intention and planning for action to have better nutritional behavior. However, the intervention did not change the pregnancy outcomes significantly. Practice implications: Nutritional education based on the HAPA model can be used to improve nutritional behaviors of malnourished pregnant women

Psychometric properties of the Maslach Burnout Inventory for Medical Personnel (MBI-HSS-MP)

Background: This study aimed to validate the Persian version of Maslach Burnout Inventory for Medical Personnel (MBI-HSS-MP), an instrument developed to capture burnout for health professionals. The specific aims were to psychometrically assess the Persian MBI-HSS-MP in relation to its structure, test-retest reliability, and item properties. Methods: The study setting was all eight hospitals in Qazvin province, Iran (study period from 10 September to 16 November 2020). Health professionals of physicians (n = 106) and nurses (n = 200) participated in the study. The psychometric properties of the 22-item MBI-HSS-MP was then examined for its factor structure via confirmatory factor analysis (CFA) and Rasch models, test-retest reliability, item fit, and differential item functioning (DIF). Results: The MBI-HSS-MP was verified as having a three-factor structure and each item was embedded well in its belonging construct (comparative fit index = 0.941, Tucker-Lewis index = 0.929 derived from CFA results; infit and outfit MnSq = 0.71 to 1.38 derived from Rasch models). Test-retest reliability of each MBI-HSS-MP item was satisfactory and no substantial DIF items were displayed across gender or across health professionals. Conclusion: The MBI-HSS-MP has good psychometric properties to assess burnout accurately among healthcare professionals in the three dimensions of emotional exhaustion, personal accomplishment, and depersonalization

Prevalence of household food insecurity and its predictive role on the health of mothers with children aged under 60 months

Background: Food insecurity can have poor physical and mental health consequences for all family members. The present study investigated the prevalence of household food insecurity and its predictive role on the health of mothers of children aged under 60 months in Qazvin (Iran). Methods: A cross-sectional study was carried out between January 2019 and December 2020. Participants included all mothers with children aged under 60 months who referred themselves to comprehensive health centers in Qazvin (N = 1750; mean age 30.61 years). Convenience sampling was performed. Data were collected using a demographic information checklist, the General Health Questionnaire (GHQ) and the Household Food Insecurity Access Scale (HFIAS). Data analysis was performed using independent t-tests, one-way analyses of variance, uni-variable and multivariable linear regression with a significance level of p < 0.05. Results: Two-thirds of the participants had a secure food status (68.4%). Household food security status showed a significant, and inverse relationship with general health subscales. General health subscales of depression (standardized mean difference or SMD: −1.24 [95% CI: −1.36; −1.13]), somatic symptoms (SMD: −0.92 [95% CI: −1.03; −0.81]) and anxiety and insomnia (SMD: −0.72 [95% CI: −0.83; −0.61]) were significantly lower among food secure participants vs. food insecure participants. Social dysfunction was not significantly associated with household food security. The regression models demonstrated that household food security was a significant predictor for the health of mothers with children aged under 60 months: uni-variable (β = −0.38) and multivariable (β = −0.41). Conclusion: Household food security is associated with various aspects of mothers’ health. Since the growth and development of a healthy child depends on having a healthy mother, the food security situation of the family and the general health of mother can be assessed as part of providing health service regarding monitoring growth and development of children. This will help in targeting appropriate interventions if needed

Mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life among women of reproductive age: an Iranian cross-sectional study

Objectives: This study aimed to determine the mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life (QoL) among Iranian women of reproductive age. Methods: A cross-sectional study comprising 324 married women was conducted. Online convenience sampling was used to collect data. SPSS PROCESS macro was used for the mediation analysis. The direct and indirect effects of the fear of COVID-19 on sexual QoL and marital satisfaction were estimated comprising a 95% CI using 5000 bootstrap samples. Pairwise comparisons between the mediators were calculated by Hayes’ macros. Results: A positive/negative or suspected history of COVID-19 infection had marginally significant relationship with marital satisfaction (p=0.049). The total effect of fear of COVID-19 on sexual QoL was significant (b=−1.31, SE=0.20, p<0.001). Fear of COVID-19 had no significant direct effect on sexual QoL (b=−0.22, SE=0.19, p=0.24) but it had an indirect effect on sexual QoL via mediation of psychological distress (b=−0.34, SE=0.09, 95% CI: −0.53 to −0.19) and domestic violence (b=−0.75, SE=0.18, 95% CI: −1.12 to −0.40). The total effect of fear of COVID-19 on marital satisfaction was significant (b=−1.91, SE=0.32, p<0.001). Fear of COVID-19 had no significant direct effect (b=0.20, SE=0.25, p=0.42) on marital satisfaction but it had an indirect effect on marital satisfaction via mediation of psychological distress (b=−0.59, SE=0.13, 95% CI: −0.86 to −0.36) and domestic violence (b=−1.51, SE=0.29, 95% CI: −2.08 to −0.92). Conclusion: The fear of COVID-19 during the pandemic indirectly decreased women’s marital satisfaction and sexual QoL via increased psychological distress and domestic violence. Consequently, in critical situations such as the COVID-19 pandemic, improving couples’ psychological health and reducing domestic violence are likely to improve women’s sexual QoL and marital satisfaction

Psychometric properties of Postpartum Partner Support Scale-Persian version

Aim: The aim of the present study was to translate the Postpartum Partner Support Scale (PPSS) into Persian and evaluate its psychometric properties among postpar-tum women. Design: A total of 248 women aged 18-39 years participated in this psychometric study. The PPSS was translated into Persian using a forward-backward method. Confirmatory factor analysis (CFA) and Rasch model analysis were used to assess the psychometric properties of the PPSS. In addition, the Edinburgh Postpartum Depression Scale (EPDS) was completed simultaneously to assess the construct validity. Internal consistency of the questionnaire was assessed by calculating the Cronbach's alpha coefficient and corrected item-total correlation. Results: The unidimensionality of the PPSS was supported in both CFA and Rasch analysis. The PPSS had a significant negative association with EPDS (r = −0.39 p < .001). The scale had excellent internal consistency (Cronbach's alpha = 0.94) and the correlation between items and total score was satisfactory. Conclusion: The Persian version of PPSS with 20 items is a valid and reliable scale to assess postpartum support

Socio-demographic predictors of dyadic sexual communication among Iranian married women

Background and aim: Couples’ communication concerning sexual issues is influenced by various individual and social factors. The present study investigated the socio-demographic predictors of dyadic sexual communication among married women of reproductive age. Methods: A cross-sectional survey study was conducted from May to October 2019 in comprehensive health centers of Qazvin City, Iran. The participants comprised 400 married women with mean age of 35.66 years recruited via a two-stage sampling method. The Dyadic Sexual Communication Scale (DSCS) and a socio-demographic questionnaire were used for data collection. Univariable and multivariable linear regression models with a significance level of 0.05 were used for statistical analysis. Results: The mean score of sexual communication was 59.19 out of 78 (SD = 12.63). Based on multivariable linear regression model, life satisfaction (β = 0.34 high vs. moderate), frequency of sexual intercourse (β = 0.20), moderate vs. poor economic status (β = 0.12), and using contraception (β = −0.09) were predictors of good dyadic sexual communication. These variables explained 32% of the variance concerning dyadic sexual communication among married women of reproductive age. Conclusion: Life satisfaction, frequency of sexual intercourse, moderate economic status, and using contraception were predictors of good dyadic sexual communication

Estimation of behavioral addiction prevalence during COVID-19 pandemic: a systematic review and meta-analysis

Purpose of Review: The COVID-19 pandemic changed people’s lifestyles and such changed lifestyles included the potential of increasing addictive behaviors. The present systematic review and meta-analysis aimed to estimate the prevalence of different behavioral addictions (i.e., internet addiction, smartphone addiction, gaming addiction, social media addiction, food addiction, exercise addiction, gambling addiction, and shopping addiction) both overall and separately. Recent Findings: Four databases (PubMed, Scopus, ISI Web of Knowledge, and ProQuest) were searched. Peer-reviewed papers published in English between December 2019 and July 2022 were reviewed and analyzed. Search terms were selected using PECO-S criteria: population (no limitation in participants’ characteristics), exposure (COVID-19 pandemic), comparison (healthy populations), outcome (frequency or prevalence of behavioral addiction), and study design (observational study). A total of 94 studies with 237,657 participants from 40 different countries (mean age 25.02 years; 57.41% females). The overall prevalence of behavioral addiction irrespective of addiction type (after correcting for publication bias) was 11.1% (95% CI: 5.4 to 16.8%). The prevalence rates for each separate behavioral addiction (after correcting for publication bias) were 10.6% for internet addiction, 30.7% for smartphone addiction, 5.3% for gaming addiction, 15.1% for social media addiction, 21% for food addiction, 9.4% for sex addiction, 7% for exercise addiction, 7.2% for gambling addiction, and 7.2% for shopping addiction. In the lockdown periods, prevalence of food addiction, gaming addiction, and social media addiction was higher compared to non-lockdown periods. Smartphone and social media addiction was associated with methodological quality of studies (i.e., the higher the risk of boas, the higher the prevalence rate). Other associated factors of social media addiction were the percentage of female participants, mean age of participants, percentage of individuals using the internet in country, and developing status of country. The percentage of individuals in the population using the internet was associated with all the prevalence of behavioral addiction overall and the prevalence of sex addiction and gambling addiction. Gaming addiction prevalence was associated with data collection method (online vs. other methods) that is gaming addiction prevalence was much lower using online methods to collect the data. Summary: Behavioral addictions appeared to be potential health issues during the COVID-19 pandemic. Healthcare providers and government authorities should foster some campaigns that assist people in coping with stress during COVID-19 pandemics to prevent them from developing behavioral addictions during COVID-19 and subsequent pandemics

Fear of COVID-19 and its association with mental health-related factors: systematic review and meta-analysis

Background: The severity of COVID-19 remains high worldwide. Therefore, millions of individuals are likely to suffer from fear of COVID-19 and related mental health factors. Aims: The present systematic review and meta-analysis aimed to synthesize empirical evidence to understand fear of COVID-19 and its associations with mental health-related problems during this pandemic period. Method: Relevant studies were searched for on five databases (Scopus, ProQuest, EMBASE, PubMed Central, and ISI Web of Knowledge), using relevant terms (COVID-19-related fear, anxiety, depression, mental health-related factors, mental well-being and sleep problems). All studies were included for analyses irrespective of their methodological quality, and the impact of quality on pooled effect size was examined by subgroup analysis. Results: The meta-analysis pooled data from 91 studies comprising 88 320 participants (mean age 38.88 years; 60.66% females) from 36 countries. The pooled estimated mean of fear of COVID-19 was 13.11 (out of 35), using the Fear of COVID-19 Scale. The associations between fear of COVID-19 and mental health-related factors were mostly moderate (Fisher's z = 0.56 for mental health-related factors; 0.54 for anxiety; 0.42 for stress; 0.40 for depression; 0.29 for sleep problems and –0.24 for mental well-being). Methodological quality did not affect these associations. Conclusions: Fear of COVID-19 has associations with various mental health-related factors. Therefore, programmes for reducing fear of COVID-19 and improving mental health are needed