Psychometric Evaluation of the Colorectal Cancer Screening Belief Scale Based on Health Belief Model’s Constructs for the Fecal Occult Blood Test

Background: It is important to validate scales related to cancer screening beliefs in order to better understand perceptions. The aim of this study was to test the psychometric properties of the colorectal cancer screening belief scale based on Health Belief Model (HBM) constructs. Materials and Methods: Data were collected from 600 persons referred to outpatient laboratory units in Iran through a convenience sampling procedure. In this cross-sectional study, exploratory and confirmatory factor analyses were used to examine construct validity of scale. Results: Through exploratory factor analysis, 52 items of the scale converged to five constructs of HBM with 4 items omission. Construct validity was determined by confirmatory factor analysis through which correlated model was supported. Cronbach’s alpha coefficient for the whole scale was obtained as 0.78, which indicates reliability of the scale. Conclusions: The study findings showed that this scale is a valid and reliable instrument that can be used for measuring HBM constructs about colorectal cancer screening with the fecal occult blood test

Factors Predicting Fecal Occult Blood Testing among Residents of Bushehr, Iran, Based on the Health Belief Model

Colorectal cancer is a major cause of mortality worldwide. Fecal occult blood testing has proven a very effective screening tool for early detection and mortality reduction. The aim of this study was to determine predictors factors related to fecal occult blood testing using the Health Belief Model method among residents of Bushehr, Iran. A cross sectional study was performed on a sample of 600 men and women more than 50 years of age. The sample was selected by a convenience method from patients referred to public and private laboratories throughout the city. Each subject filled out a questionnaire which was designed and developed based on Health Belief Model constructs. Statistical analysis was conducted using ANOVA, T-test, chi-square test, and logistic regression. Fecal occult blood tests were performed on 179 (29.8%) out of 600 subjects, of which 95 patients (58.1%) did a periodic examination test and 84 patients (46.9%) had a doctor’s advice for testing. According to the logistic regression model, the perceived barriers (P=0.0, Exp(B)= 0.3), perceived benefits (P<0.01, Exp(B)= 1.9) and self-efficacy (P<0.01, Exp(B)= 1.6) were predictive factors related to occult blood testing among subjects. The results showed that reducing people’s perception of barriers to testing, increasing perceived benefits of screening, and reinforcing self efficacy can have major effect in increasing the rate of fecal occult blood screening for colorectal cancer prevention

Investigation of the relationship between self-esteem and depressive symptoms among young patients with Multiple Sclerosis

For downloading the full-text of this article please click here.Background and Objectives: Multiple Sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, which aggravates the loss of self-esteem in patients and impairs their ability to cope with the disabilities. The present study investigated the relationship between self-esteem and anxiety among MS patients in Shiraz. Materials and Methods: A descriptive-analytical study was carried out on all young MS patients when the disease was not in an acute stage, aged 20-40 years old in Fars Province in 2009-10. 150 MS patients (90 males and 60 females) were selected through in-access sampling method from a pool of patients who received services from Charity Foundation for Special Diseases (CFSD). The data were collected using self-esteem questionnaire and researcher-made questionnaire of anxiety. Data were analyzed with SPSS V.16 using Regression and Correlation with α=0.05. Results: Our findings indicated that there was an inverse and significant relationship between self-esteem and anxiety in MS patients of both sexes, with self-esteem predicting 0.66 anxiety of the participants.Conclusion: According to our findings, holding sessions to provide insights into the importance of self-esteem would help MS patients and their families to deal with the disease problems more rationally, thus decreasing major part of their concerns. Keywords: Multiple Sclerosis (MS), Self-esteem, AnxietyFor downloading the full-text of this article please click here

بررسی ارتباط عزت نفس با نگرانی در جوانان مبتلا به مولتيپل اسكلروزيس (MS)

Background and Objectives: Multiple Sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, which aggravates the loss of self-esteem in patients and impairs their ability to cope with the disabilities. The present study investigated the relationship between self-esteem and anxiety among MS patients in Shiraz. &nbsp;Materials and Methods: A descriptive-analytical study was carried out on all young MS patients when the disease was not in an acute stage, aged 20-40 years old in Fars Province in 2009-10. 150 MS patients (90 males and 60 females) were selected through in-access sampling method from a pool of patients who received services from Charity Foundation for&nbsp;Special Diseases&nbsp;(CFSD). The data were collected using self-esteem questionnaire and researcher-made questionnaire of anxiety. Data were analyzed with SPSS V.16 using Regression and Correlation with α=0.05. &nbsp;Results: Our findings indicated that there was an inverse and significant relationship between self-esteem and anxiety in MS patients of both sexes, with self-esteem predicting 0.66 anxiety of the participants. Conclusion: According to our findings, holding sessions to provide insights into the importance of self-esteem would help MS patients and their families to deal with the disease problems more rationally, thus decreasing major part of their concerns.سابقه و اهداف: بیماری مولتیپل اسکلروز (MS) نوعی بیماری علاج‌ناپذیر مغز است که شدیداً موجب نگرانی و کاهش عزت نفس مبتلایان می‌شود و آن‌ها را مجبور به سازگاری با ناتوانی‌های ناشی از بیماری می‌سازد. این مطالعه با هدف تعیین رابطه‌ی میان عزت نفس با نگرانی در جوانان بیمار مبتلا به مولتیپل اسکلروز در شهر شیراز انجام گرفته است. &nbsp;مواد و روش­ ها: پژوهش حاضر از نوع توصیفی- تحلیلی است. جامعه‌ی آماری مورد بررسی این پژوهش را تمامی جوان 20- 40 ساله‌ی مبتلا به مولتیپل اسکلروز استان فارس که تا پایان سال 1391 عضو انجمن بیماران MS فارس بودند، تشکیل داده‌اند. از بین بیماران تحت پوشش انجمن بیماری‌های خاص، 150 نفر (90 زن و 60 مرد)، بیمار مبتلا به ام. اس. با روش نمونه‌گیری در دسترس انتخاب شدند. ابزار جمع‌آوری اطلاعات، پرسش‌نامه‌ی عزت نفس و پرسش‌نامه‌ی محقق‌ساخته‌ی نگرانی بود. داده‌ها پس از ورود به نرم افزار آماری SPSS &nbsp;نسخه‌ی 16 و با استفاده از آزمون‌های آماری همبستگی و رگرسیون در سطح خطای 05/0 مورد تجزیه و تحلیل قرار گرفت. يافته­ ها: نتیجه‌ی تجزیه و تحلیل داده‌ها نشان داد، بین عزت و نگرانی در بیماران مبتلا به مولتیپل اسکلروز در دو جنس، رابطه‌ی معکوس معنی‌داری وجود دارد و عزت نفس می‌تواند 66% نگرانی را در این قشر پیش‌بینی کند. نتیجه­ گیري: با توجه به یافته‌‎های پژوهش برگزاری جلسه‌های آموزشی برای آگاهی دادن درباره‌ی اهمیت عزت نفس موجب می‌شود، بیماران و خانواده‌های آن‌ها به روش منطقی‌تری با مشکل‌های بیماری مولتیپل اسکلروز روبرو گردند و این مسئله می‌تواند نگرانی‌های آن‌ها را تا حدی کاهش دهد. واژگان کلیدي: بیماری مولتیپل اسکلروز، عزت نفس، نگران

Association of between mental health and spiritual health among students in Shiraz University

AbstractBackground and aim:  Spiritual health is one of the most important social – cultural factors that may predict mental health. The main purpose of this study was to assess association between mental health and spiritual health among students in Shiraz University.Materials and Method:  A descriptive-correlational design was used for the study.The study was conducted in 2012. A total number of 474 students (237 female and 237 male) were recruited in this study using a cluster sampling method. Data were collected using Goldberg’s Mental Health Questionnaire and Pulutzyn and Ellison spiritual health questionnaires. Data were analyzed by SPSS16 software and two categories of descriptive and inferential statistical methods correlation and regression and t- tests.Findings:  The results of the study indicated that there is a significant relationship between mental health and spiritual health scores in both sexes (P&lt;001). Variable of spiritual health, can predict 70 percent mental health in female and male. T-test results showed that there is a difference between the means of spiritual health in boys and girls (p&lt; 0/05).Discussion &amp; Conclusion:  Changings in the educational system and paying attention to mental health and spiritual health to meet the needs of students may be necessary. There is a need for further applied research for testing interventions to promote mental health and spiritual health students.Key Words: Mental health, spiritual health, Students REFERENCES Alahbakhshian M Jafarpour - Alavi M, Parvizi S Haghani H (2010). A survey on relationship between spiritual wellbeing and quality of life in multiple sclerosis patients. Zahedan Journal of Research in Medical Science. 12(29-33). Bahrami E Hosseini Vajari K (2003)[ The Relationship Between Religious Coping and Spiritual Happiness with Mental Health in Women]. Master’s thesis,Theran university. (Persian). Boivin M J Kirby A L Underwood L K Silva H (1999). Spiritual Well- being Scale. Measures of Religiosity. Birmingham. Religious Education Press. Corrigan P Mccorkle B Schell B (2003). Religion and spirituality in the lives of people with serious mental illness. Commmmunity Mental Health Journal. 39(6) 487-499. Craven R Hirnle C. (2003). Fundamental of Nnursing:Human Health and Function. Philadelphia, Lippincott &amp; Williams &amp; Wilkins Company. Esmaeil Riahi M Aliverdi -Nia A Bani Asadi M R. (2009) The impact of religiosity and religious orientation on the mental health of the students of University of Mazandaran. Journal of Social Science. 5(2) 51-90. Fernsler J I Klemm P Miller M A (1999). Spiritual well-being and demands of illness in people with colorectal cancer. Cancer Nursing. 22(2) 134-140. Ghamari-Givi H (2008 (Spirituality, identity and mental health in life span. Journal of Psychology and Religion, 1(4) 43.71(Persian). Moreira-Almeida (2006). Religiousness and Mental Health: a review, Center for the Study of Religious and Spiritual Problems (NEPER), São Paulo (SP), Department of Psychiatry,Universidade de São Paulo (USP). Mueller P S Plevak D J RummansT A (2001). Religious involvement, spirituality, and medicine: Implication for clinical practice. Mayo Clinic Proceeding, 76, 1225-1235. 1393 راهب ،84 هرامش ،24 هرود / 58 ناراکمه و ییافو اضر رتکد Narimani M Aghamohammadian H Rajabi S (2007)[ A comparison between the mental health of mothers of exceptional children and mothers of normal children]. Journal of Fundamentals of Mental Health. 9(33&amp;34) 15-24.(Persian). Nelson C J Rosenfeld B Breitbart W Galietta M (2002). Spiritual, religion, and depression in the terminally ill. Psychosomatics. 43(3) 213-220. Omidvari S (2008). Spiritual health; concepts and challenges. Quranic Interdisciplinary Studies Journal of Iranian Students Quranic Organization. 1(1) 6-17. Palahang H (1996) Epidemiological Assessment of Mental Disorders in Kashan. Master’s thesis. Iran’s Institute of Psychiatry.(Persian). Rahimian-Boogar A Asghar Nejad A (2008). [The Relationship between psychological hardiness and ego-resiliency with mental health in adolescent and adult survivors of Bam earthquake. Iranian Journal of Psychiatry and Clinical Psychology.14(1) 62-70. Rajaei A. R. (2008). Religious Cognitive-Emotional Therapy(RCET). The 5th congress for psychotherapy. Beijingm China. SAED, A. &amp; ROOSHAN, R. (2008). Spirituality and mental health. Journal of Psychology and Religion,2, 76-84. Salimi H Azad Marz-Abadi E Abedi Darza M (2010)[ Determining the mental health condition and its correlation with job burnout and life satisfaction in a military university personnel]. Journal of IRIAF Health Administration, 13(3) 10-17(Persian). Sanagoo A AliGhoodneh Z Asadi H (2008)[ The relationship between spiritual health and loneliness between the Persian and Turkmen youth]. Research Center of Gorgan University of Medical Sciences.(Persian). Shojaian R Zamani Monfared A (2002). The relation between use of prayers, mental health, and Job performance among technical workers of Tehran ammunition industries. Journal of Thought and Behavior. 8(30) 33-39.(Persian). Unterrainer K H Ladenhauf M L MoazediS et al (2010). Dimensions of religious/spiritual well- being and their relation to personality and psychological well-being. Personality and Individual Difference. 49(3) 192-197. Ya-Chu H Hui-Ying C Li-Yu C (2010). An exploration of the status of spiritual health among nursing students in Taiwan. Nurse Education Today. 30(5) 385-392

Perceived Threat about Cigarette Smoking among Adolescents: Optimistic Bias

Background and Objectives: Cigarette smoking is one of the important health problems in adolescents and one of the preventable causes of morbidity and mortality. The present study was carried out with the aim of determining the perceived threat about cigarette smoking among adolescents with emphasis on optimistic bias. Methods: The present study was carried out as a descriptive cross-sectional study on 2nd grade secondary school male students in Shiraz, Iran. A multi-step cluster sampling method was used in the present study. A questionnaire including questions about demographic characteristics, knowledge, and perceived threat, was used. The reliability of the questionnaire was confirmed by Cronbach's alpha coefficient and its validity by a panel of experts. The data were analyzed using descriptive tests and Pearson correlation coefficient. Results: In the current study, the majority of students (3.3%) initiated cigarette smoking at the age of 13 years. Also, there was a significant relationship between perceived susceptibility and having smoker friends and offering cigarette by them. Also, the findings of this study showed that there was a negative correlation between perceived susceptibility and severity. &nbsp; Conclusion: According to the findings of this study, in spite of high perceived severity, the perceived susceptibility was low among the students. Also, optimistic bias in adolescents causes that although they believe in high severity of high-risk behaviors, they do not feel themselves exposed to the risk of morbidity due to health problems

Investigation of correlation between mothers’ marital satisfaction and depression among their adolescent in Shiraz

AbstractIntroduction:  Depression is the most prevalent malady of the century. About 20 per cent of adolescents between 13 and 19 experience at least a fit of depression before 18. The present study investigated the relationship between mothers’ marital satisfaction and depression among their adolescents in Shiraz, Iran.Materials and Methods:  A correlational study was carried out on 300 teenagers of 14-19 years old (160 females and 140 males) and their mothers in educational year of 2009-10, whom were randomly selected among a pool of students from Shiraz’s four Educational Districts. A depression questionnaire with 21 items and a questionnaire of marital satisfaction with 47 items helped in collection of data. Pearson’s correlation of coefficients, regression, and independent t-tests helped in data analysis.Findings:  The current study found depression among teenagers as 43.4 per cent and their mothers’ marital satisfaction as 19.2 per cent. We found an inverse significant relationship between marital satisfaction and adolescent depression in both genders (P&lt;0.00d1), with mothers’ marital satisfaction accounting for 0.52 per cent of depression among their teenagers. There was a difference between male and female teenagers in their depression scores (P&lt;0.05). There was also a negative significant relationship between teenagers’ depression and mother’s education and family economic status.Conclusion:  Our findings underscored the importance of educational programs intended to prevent depression among teenagers.Keywords: Marital Satisfaction, Depression, Adolescents REFERENCES Anderia A)2002 (College student and depression pilot initiative. National Mental Health Assocation. 24 (30): 4-5. Ahadi B (2002) Marital satisfaction of parents expressing emotions and emotional problems - child behavior. Journal of Psychology. 8 (1): 13-7. (Persian). Atkinson R (2001). Hilgard Psychology. Translated by Rafiee H, et al. Tehran, Arjmand, (Persian). Burns D (1989). Cognitive Therapy for Depression. Translated by Qaracheh Daghi M. Tehran: khatam, (Persian). Butler (2002) Depressive disorder. American Family Physician . 65 (7): 1393-1396. Bakhshi H, Asadpour M, khodadadi Zadeh A) 2007) [Sexual satisfaction in couples with depression. Journal of Qazvin University of Medical Sciences. 11 (2): 37-43. (Persian). Carily S, Pataki MD (2000) Mood disorders and suicide in children and adolescents. In: Comprehensive Textbook of Psychiatry. 6th ed. Philadelphia: Williams &amp; Wilkins. Elizabeth B. Weller MD, Ronald A, et al (2004) Mood disorders in prepubertal children and adolescents. In: Wiener D, editor. Textbook of Child and Adolescent Psychiatry. 3rd ed. USA: The American Psychiatric  Pulishing.   Goldberg DP, Williams P (1989). The User Guide to General Health Questionnaire. Windsor: Nelson Guilder M (2002) Psychology at Oxford. Translated by Rajabi, M. and others. Tehran, Andisheye rafie Havtvn C, Salkvvys C (2007) Cognitive Behavioral Therapy. Practical manual of mental disorders (translation: i. Ghasem-Zadeh). tehran, Publications arjmand. Jacqueline B (1998). Children healthy lillness and family influences. In: Pitts M, eitor. The psychology of   health. London: Rontledge. Jeremy D, Jewel Ph, Keven D, Stark Ph)2003) Comparing the family environments of adolescent with conduct or depression. Journal of Child and Family Studies. 12 (1): 77-89.     Kuroshnia M, Latifian M (2007). Study of the relationship of family communication patterns with anxiety and   depression in children. Journal of Family Research. 3 (10):587-600. (Persian). Lavar D (2002) Late life depression. Geriatrics.51 (2): 198-210.     Mazloomy SS Mirzaei A Mohammadi S (2009). [Study of depression prevalence in the patients with types diabetes reffering to Yazd diabetes researches center in 2008] The Journal of Toloo-e-Behdasht. 7 (1-2) 30-   6. (Persian).   Mohammadi D Ghorabi B) (2007) [Behavioral disorders associated with emotional intelligence in students]. Journal of Kerman University of Medical Sciences. 14 (4): 289-299. (Persian). Pinarulu I, Fisiloghlu H (2002). The relationship between Turkish children’s perceptions of marital onflict and   their internalizing and externalizing problems. International Journal of Psychology. 37 (6) 369-378.   1393 راهب ،84 هرامش ،24 هرود / 24 ناراکمه و بیغتسد ارهز Rice F Harold G Shelton K Thapar A (2006) Family conflict interacts with genetic liability in predicting   childhood and adolescence depression. Journal of the American Academy of Child and Adolescent Psychiatry. 45 (7) 841-848. Rostami M,Yonesi j Sajadi H,Sedghi N (2013). 6th International Congress on Child and Adolescent Psychiatry. (Persian).     Sayadi Anari AR. (2002). [Ageing issues in Iran and the world].1rst Edition,Tehran, Publications Ashena.   (Persian). Saroukhani M . (2006). Introduction to Sociology of the Family. Seventh Edition,Tehran: Soroush Publications. (Persian).     Soltanifar, A. Mehdinia. (2007) [ Prevalence of depressive symptoms in children 9 to 11 years old Tehran and its relationship with the family]. Journal of Mental Health. 9 (39-40) 7-14. (Persian). Taheri S, Nawabi C.[ Study of women 50-18 years old attitudes towards women’s issues in Zanjan]. A summary of a number of research projects and dissertations, Research Zanjan University of Medical Sciences. 2001   - 2002; 114. (Persian). Warner V, Wejssman MM. (1999) Grand parents, parents, and grand children, at high risk for pression. Journal of the American Academy of Child and Adolescent Psychiaty38 (3) 289-96.   Wang L, Crane R. (2001) The relationship between marital Satisfaction, Marital stability, nuclear family triangulation, and childhood depression. The American Journal of Family Therapy. 29 (4) 337-347.   Weller EB, Weller RA, Rowan AB, Wratch S. (2002) Depressive Disorders in children. In: Lewis M, editor. Child and Adolescent Psychiatry: Acomprehensive Textbook. 3rd ed. Philadelphia, Williarns &amp; Wilkins.   Zimmer KP, Minkovitz CS. (2003) Maternal depression: an old problem that merits increased recognition by child health care practitioners. Current Opinion in Pediatrics.15 (6) 636-40.     Zahir Aldini AR, Hosseini M, Semnani Y (2004)[ Prevalence of depression and its related factors in high school students of Firouzkouh]. Pejouhandeh. 9 (1) 61-64. (Persian).

Assessing the factors influencing delivery method selection in pregnant women referred to Public hospitals in Shirazr

AbstractBackground and aim:  Although cesarean section is the preferred mode of delivery for some mothers ,the rate of cesarean section deliveries has increased to more than 50 percent in some countries. While the World Health Organization has emphasized, cesarean section be performed only based on the indication. This study will assesses the causes and factors influenced on choosing the delivery method in pregnant women referred to Public Hospitals in Shiraz.Material &amp; Methods:  A descriptive design was used to assess factors related to mothers’ decisions about mode of delivery. Using a cluster random sampling method, a total number of 417 Pregnant women admitted to hospitals in Shiraz were included in the study. Data were collected by a questionnaire and interview. Data were analyzed by Chi-square, and fisher exact test with using SPSS software.Findings:  The results showed significant relation among factors Urbanity, Infant health status, Concern about genital injuries , Spouse views and Willingness to cesarean with choice of cesarean (p &lt;0/05).Conclusion:  Due to significant positive attitude of women’s towards the cesarean, rather than normal delivery, it is necessary to inform them about the advantages of normal delivery and health hazard which might cause by Cesarean to the mother and child. The change of women’s Knowledge and attitude about cesarean is needed to avoid further complication.Key Word: delivery, Cesarean, Public hospitals, Shiraz REFERENCES Alimohamaian M, S. M., Mahmoodi M, Ramezanzadeh F( 2003)[ The influence of maternal request on the elective cesarean section rate in maternity hospitals in Tehran, Iran]. Payesh Journal  2(2) 133-139(Persian).   Cnattingius R , C. S., Notzon C (1998). Obstacles to reducing cesarean rates in a low cesarean seting:the effect of maternal age , height and weight. Obstetrics and Gynecology . 92(4 Pt 1) 501-506. Cunningham F, M. P., Leveno K( 1993)     Cesarean section and cesarean hysterectomy . Williams’ Obstetrics. 19th ed texa Prentice Hail International, INC, 591-594.   Cunningham FG (2001). Cesarean section and postpartum hysterectomy. in:cunningham FG; Norman FG.;larry CG, Williams’ Text book of Obstetrics: From Appleton &amp; lange Asimond Schusler company, 537-64. Darvishi E, M. S., Nedjat S, Holakouie Naieni K( 2013)[ Experiences of women and gynecologists on the choice of delivery method: A qualitative research]. Health System Research Journal . 8(1) 59-68.(Persian) Decherncy , P. M. (1999) Current Obstetric and Gynecologic Diagnosis and Treatment.     lange Medical Book  703-709. Fabri RH , Murta. E F.(2002)Socioeconomic factors and cesarean section rates.     International Journal of GYnecology and Obstetrics . 76(1) 87-88.   Faraji Darkhaneh R.Zahiri Sarvi Z, Farjad Bastani F( 2003)[Knowledge and attitudes of pregnant women towards birth methods]. Journal of Guilan University of Medical Sciences . 12(46) 69-75.   Ghaffari M,, Akbarai Z , Khorshidi M, Hassanzadeh A( 2012)[ Health belief model-based education &amp; reduction of cesarean among pregnant women: An interventional study]. Health System Research. Journal . 7(2) 200-208.   Loverro G Greco P Vimercatia A et al( 2005). Maternal complications associated with cesarean section, Journal of Perinatal Medicine , 29(4) 322-326. Goulld JB,Davey BStafford R S. (1989). Socio-economic differences in rates of cesarean section.     The New England Journal of Medicine . 321(4) 223-290.   Lapman C Phelps A.( 1997) College students’ knowledge and attitudes about cesarean birth. Birth  24(3) 159-64.   Naghibi KH, Montazeri K( 1991)[ Painless delivery or cesarean section. Which is better?] First ed. Isfahan: University of Medical Sciences Press (Persian). Negahban T, Ansari Jaberi A, Kazemi M ( 2006) Prefered method of delivery and it’s relevant causes in view of pregnant women referring to public and private clinics in Rafsanjan city. Journal of Rafsanjan University of Medical Sciences  5(3) 161-171(Persian).   Poma P. (1998) Effect of departmental policies on cesarean delivery rates: A community hospital experience. Obstetrics and Gynecology  91(6) 1013-108.   Rice PL Nakzook C (1998) Cesarean or vaginal birth: perception sand experience of Thai women in Australian hospital. Australian and New zeland Journal of Public Health  22(5) 604-680.   Ryding EL( 1993) Investigation of 33 women who demanded a cesarean for personal reasons. Acta Obstetrica et Gynecologica Scandinavica . 72(4) 280-285.   Schneider, F. G., Winn HN (2000) Cesarean section and vaginal birth after cesarean section. In: Clinical maternal: New York: Parthenon Press, 15-18. Schuitemaker N Van Roosmalen J Dekker G et al( 1997) Maternal mortality after cesarean section in the Netherlands. Acta Obstetrica et Gynecologica Scandinavica  76(4) 332-334. Tumbull D A Wilkinson C Yaser A et al (1999). Women’s role and satisfaction in decision to have a cesarean section.     The Medical Journal of Australia . 170(12) 580-630.   Wirakusmah FF 1995. Maternal and prenatal mortality/morbidity associated cesarean section in Indonesia. Journal of Obstetrics and Gynecology  (Tokyo 1995) 21(5) 475-81.   Assessing