Developing a Questionnaire for Iranian Women's Attitude on Medical Ethics in Vaginal Childbirth

Background: Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. Objectives: The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery. Patients and Methods: This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. Results: In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95). Conclusions: The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management

Effectiveness of mindfulness integrated cognitive behavioral therapy on the emotional states and quality of life of patients with multiple sclerosis: A clinical trial study

Introduction: The present study was designed to investigate the effectiveness of mindfulness-integrated cognitive behaviour therapy on emotional states (depression, anxiety, & stress) and quality of life (physical health and mental health) of adults with multiple sclerosis. Materials and Methods: The studied population included all patients who referred to Kerman MS society among them 30 patients were selected using purposive sampling method and they were divided by random into the intervention group of MiCBT and a control group. Depression, Anxiety, stress scale (DASS-21) and quality of life of people with MS MSQOL-54 questionnaire was employed as the measurement tool. Results: Results showed that physical health, mental health and quality of life, in general, was significantly increased and depression, anxiety, stress were significantly decreased in the MiCBT group when compared with the control group. Conclusion: As a result, mindfulness-integrated cognitive behaviour therapy is suggested as an effective intervention in decreasing psychological problems of people with MS, including depression, anxiety and stress and in improving their quality of life. © 2020, Semnan University of Medical Sciences. All rights reserved