How Baloch Women Make Decisions About the Risks Associated With Different Childbirth Settings in Southeast Iran

Background: In Zahedan City in Southeast Iran, some women prefer to give birth at home despite the availability of the equipped hospitals and expert advice that hospital births are safer. Objectives: This study explains how Baloch women make decisions regarding the risks associated with childbirth at home versus a hospital. This study identifies and defines the factors that influence the choice of the place of delivery by Baloch women. Materials and Methods: The article draws on data from a grounded theory. In particular, on in-depth interviews with 25 Baloch women, 21 of whom had planned home births and 4 planned hospital births in their most recent childbirth. Results: Six categories emerged from the data as follows: 1) deliberation and risk assessment; 2) obstacles to hospital births; 3) preference for hospital births; 4) obstacles to homebirth; 5) preference for homebirth; and 6) risk management. The core category was deliberation and risk assessment. Our interviews showed that Baloch woman weighed the negative and positive aspects of each option when deciding on a childbirth setting. In this process, their assessment of risk included physical wellbeing and social-cultural values. Furthermore, their assessment of risk can, in some circumstances, result in delays or avoidance of having hospital childbirth. Conclusions: Managers and service providers need to know an ordinary woman’s perception of risk to address the gap between current and desired childbirth services and encourage women to use current hospital services

Home birth and barriers to referring women with obstetric complications to hospitals: a mixed-methods study in Zahedan, southeastern Iran

<p>Abstract</p> <p>Background</p> <p>One factor that contributes to high maternal mortality in developing countries is the delayed use of Emergency Obstetric-Care (EmOC) facilities. The objective of this study was to determine the factors that hinder midwives and parturient women from using hospitals when complications occur during home birth in Sistan and Baluchestan province, Iran, where 23% of all deliveries take place in non- hospital settings.</p> <p>Methods</p> <p>In the study and data management, a mixed-methods approach was used. In the quantitative phase, we compared the existing health-sector data with World Health Organization (WHO) standards for the availability and use of EmOC services. The qualitative phase included collection and analysis of interviews with midwives and traditional birth attendants and twenty-one in-depth interviews with mothers. The data collected in this phase were managed according to the principles of qualitative data analysis.</p> <p>Results</p> <p>The findings demonstrate that three distinct factors lead to indecisiveness and delay in the use of EmOC by the midwives and mothers studied. Socio-cultural and familial reasons compel some women to choose to give birth at home and to hesitate seeking professional emergency care for delivery complications. Apprehension about being insulted by physicians, the necessity of protecting their professional integrity in front of patients and an inability to persuade their patients lead to an over-insistence by midwives on completing deliveries at the mothers' homes and a reluctance to refer their patients to hospitals. The low quality and expense of EmOC and the mothers' lack of health insurance also contribute to delays in referral.</p> <p>Conclusions</p> <p>Women who choose to give birth at home accept the risk that complications may arise. Training midwives and persuading mothers and significant others who make decisions about the value of referring women to hospitals at the onset of life-threatening complications are central factors to increasing the use of available hospitals. The hospitals must be safe, comfortable and attractive environments for parturition and should give appropriate consideration to the ethical and cultural concerns of the women. Appropriate management of financial and insurance-related issues can help midwives and mothers make a rational decision when complications arise.</p

Psychometric properties of the Persian version of Social Adaptation Self-evaluation Scale in community-dwelling older adults

Pouya Farokhnezhad Afshar,1 Mahshid Foroughan,1 AbouAli Vedadhir,2 Mahmood Ghazi Tabatabaie2 1Department of Gerontology, Iranian Research Center On Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Department of Anthropology, Faculty of Social Sciences, University of Tehran, Tehran, Iran Introduction: The Social Adaptation Self-evaluation Scale (SASS) is used to measure social function and social motivation in depressed patients. There is little attention to social function in the treatment of depression. The aim of this study was to assess the validity and reliability of the Persian version of SASS (P-SASS) for older adults.Participants and methods: This is a cross-sectional and methodological study. The participants were 550 community-dwelling older adults living in Tehran who were selected randomly from the primary health care centers. To assess the psychometric properties of SASS, we first did translation and cross-cultural adjustment on SASS and then used P-SASS and the Geriatric Depression Scale (GDS) for gathering data. A number of analyses, including Pearson&rsquo;s correlation, exploratory factor analysis, and Cronbach&rsquo;s &alpha;, and receiver operating characteristic curve were used to manage the data with the IBM SPSS Statistics V.22. Results: The mean age of the participants was 66.09&plusmn;6.67&nbsp;years, and 58.9% of them were male. The Cronbach&rsquo;s &alpha;&nbsp;was 0.97. The test&ndash;retest reliability correlation coefficient was 0.78. Principal component analysis showed that P-SASS consists of two components. P-SASS score showed a significant negative correlation with GDS (r=-0.91, P&lt;0.01), which suggests good convergent validity. The P-SASS cutoff point was 28 (sensitivity: 0.97 and specificity: 0.94).Conclusion: P-SASS has good reliability and validity for older adults. So, it can be considered as an appropriate tool to evaluate the social function and social motivation of older persons with and without depression. Keywords: reliability, validity, Social Adaptation Self-evaluation Scale, older adult, social functio

The relationship between employees’ emotional intelligence and their job satisfaction using structural equation model in one of the oil industries in Tehran

Introduction: Emotional intelligence as the ability to understand and control feelings and emotions, and job satisfaction as positive attitudes of employees towards their jobs is amongst the effective indicators in the workplaces. Therefore, this research invetigated the effect of emotional intelligence of employees on their job satisfaction in one of the Oil refineries in Tehran. &nbsp; Methods and Materials: This research is a practical and cross-sectional study. The statistical population consisted of 300 employees selected by stratified random sampling method. Bar-On questionnaire (90-item) and JDI questionnaire (70-item) were used in order to measure emotional intelligence and job satisfaction, respectively. LISREL8.72 software was employed to estimate causal effect between study variables and calculation of descriptive indices and comparison of variables were done by means of SPSS software version 18. &nbsp; Results: According to results, there was a direct association between emotional intelligence of employees and their job satisfaction. In other words, the higher emotional intelligence, the higher rate of job satisfaction. Of the 15 sub-scales of emotional intelligence, Responsibility and Self-expression obtained the highest and the lowest scores, respectively. Furthermore, Supervisor and Salaries were ranked as the highest and the lowest valued subscales of job satisfaction. According to the results, employees job satisfaction level are improved in parallel to increase of education level and the maximum score of this variable was belonged to the age group of 30-45 years.} &nbsp; Conclusion: Emotional intelligence, as a psychological variable, affects the worker's job satisfaction. Considering the direct relationship between these two variables, by training and increasing the emotional intelligence of employees, job satisfaction and consequently their efficiency and productivity can be improved in the workplaces