Concerns of Women of Reproductive Age with Multiple Sclerosis: A Qualitative Study

AbstractIntroduction: Psychological disorders are the leading cause of disabilities, socialharms, and reduced quality of life in patients with Multiple Sclerosis (MS). Thisqualitative study was conducted to describe the concerns of females with MS.Methods: In this qualitative study, 16 females with MS at the reproductive agewith medical records at the MS Society of Tabriz were selected using the purposivesampling technique and underwent semi-structured in-depth individual interviews.All interviews were recorded, transcribed, and analyzed using conventional contentanalysis.Results: In this study, 23 codes were identified from transcribed interviews andcategorized to two sub-categories, fears and feelings. These two sub-categories formedthe main category, named concerns.Conclusions: Regarding concerns of these patients, their regular health monitoring byphysicians and healthcare providers is recommended in an attempt to alleviate theseconcerns

Respectful maternity care and its relationship with childbirth experience in Iranian women: a prospective cohort study

BACKGROUND: Intrapartum respectful maternity care is defined as a fundamental human right that can affect the mother\u27s experiences. This study aimed to determine the status of respectful maternity care and its relationship with childbirth experience among Iranian women. METHODS: This prospective cohort study recruited 334 postpartum women in postpartum wards of two public and four private hospitals in Tabriz, Iran. Quota sampling was used based on the number of births in each hospital. Data were collected through interviews with the use of the following tools: sociodemographic and obstetrics characteristics questionnaire, respectful maternity care scale (6 to 18 h postpartum), and childbirth experience questionnaire (30 to 45 days postpartum). The General Linear Model was used to determine the relationship between respectful maternity care and childbirth experience. RESULTS: The mean respectful maternity care score was 62.58 with a range of 15 to 75, and the total childbirth experience score was 3.29 with a range of 1 to 4. After adjusting for sociodemographic and obstetrics characteristics, a statistically significant direct correlation was found between respectful maternity care and a positive childbirth experience (P \u3c 0.001). CONCLUSIONS: The findings reveals a direct relationship between respectful maternity care and positive childbirth experience. Therefore, it is recommended that mangers and policy makers in childbirth facilities reinforce facilitating a respectful maternity care to improve women\u27s child birth experience and prevent potential adverse effects of negative childbirth experiences

The effect of counseling with a skills training approach on maternal functioning: a randomized controlled clinical trial

BACKGROUND: The role of the mother can be deeply satisfying, but it is associated with many challenges including challenges during the postpartum period that may impede the optimal development of the infant. Therefore, the aim of the present study was to investigate the effects of counseling using the Skills Training Approach (STA) on postpartum maternal functioning. METHODS: This randomized controlled trial was performed on 68 postpartum women who referred to health centers of Tabriz-Iran in 2019. Participants were assigned to one of two groups - either counseling or control through the block randomization method. The intervention group received four counseling sessions using the Skills Training Approach (STA). Before and two weeks after the completion of the intervention, the Barkin Index of Maternal Functionning (BIMF) was completed by the participants. The independent t-test and ANCOVA (Analysis of Covariance) was used to analyze the data. RESULTS: There was no statistically significant difference between the two groups in terms of sociodemographic characteristics and the baseline scores of the BIMF and its domains (p\u2009>\u20090.05). Before the intervention, the mean (SD) total score of the BIMF in the intervention group was 73.1 (8.5) and in the control group, it was 71.6 (4.8). Post-intervention, the mean (SD) of the total score of the BIMF in the intervention group was 95.8 (11.8) and in the control group, it was 70.3 (4.5). Based on the ANCOVA test and after adjusting the baseline score, the mean total score of the BIMF was significantly higher in the intervention group than in the control group (Mean Difference (MD): 22.9; 95% CI: 18.2 to 27.6; p\u2009<\u20090.001). The post-intervention scores of all domains of the BIMF including self-care (MD: 3.8), infant care (MD: 2.0), mother-child interaction (MD: 4.8), psychological wellbeing (MD: 8.4), social support (MD: 4.0), management (MD: 6.8), and adjustment to new motherhood (MD: 3.2) were significantly higher in the intervention group compared to the control group (P\u2009<\u20090.001). CONCLUSION: In this study, counseling, using STA, was effective in improving maternal functioning in all of the domains. This intervention, aimed at skill-building, should be strongly considered where improved postpartum functioning is the goal

Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes

BACKGROUND: Lack of knowledge and fear of the unknown during pregnancy and childbirth make mothers fearful, worried, and anxious. Maternal fear and anxiety can lead to problems such as preterm childbirth and low birth weight. Increasing women\u27s knowledge through prenatal education can prepare them for childbirth and improve their health. The present study was conducted to compare fear of childbirth, anxiety and depression during pregnancy in three groups of primiparous pregnant women who were either not attending, irregularly attending, or regularly attending childbirth preparation classes. METHODS: A total of 204 primiparous pregnant women attending health centers in Tabriz, Iran, were selected by cluster sampling and assigned to the following three groups: Not attending, irregularly attending (attending one to three sessions of classes) and regularly attending (attending four to eight sessions of classes). Childbirth fear, pregnancy anxiety and depression questionnaires were completed for them through interviews. The general linear model was used to compare their fear of childbirth and prenatal anxiety and depression. RESULTS: According to the general linear model, the scores of fear of childbirth (p \u3c  0.001), anxiety (p \u3c  0.001) and depression (p = 0.006) were significantly lower in the group of pregnant women regularly attending the classes compared to the non-attending group of women. No significant differences were observed between the regularly-attending and irregularly-attending groups in terms of fear of childbirth (p = 0.066), anxiety (p = 0.078), and depression (p = 0.128). CONCLUSION: Prenatal training can reduce fear, anxiety and depression in primiparous women. Incorporating such training into prenatal care helps improve maternal health

The psychometric properties of the Persian menopause rating scale

Background: To measure the severity of menopausal complaints and determine the pattern of menopausal symptoms, a valid and reliable instrument is needed in women’s healthcare. The Menopause Rating Scale (MRS) is one of the best-known tools in response to the lack of standardized scales. The purpose of this study was to examine the psychometric properties of the MRS in an Iranian example. Methods: Participants were randomly selected from women referred to healthcare centers in Miandoab, West Azerbaijan, Iran. A total of 330 questionnaires were completed (response rate of 96.9%). Two samples were considered for analysis in the validation process. An exploratory factor analysis (EFA) was conducted on the first sample (n1 = 165), and a confirmatory factor analysis (CFA) was done using a second study sample (n2 = 165). The psychometric properties process was concluded with assessment of internal consistency and test-retest reliability. Results: The EFA with Principal Component Analysis extracted three factors explaining 75.47% cumulative variance. The CFA confirmed a three-factor structure of the 11-items MRS. All fit indices proved to be satisfactory. The relative chi-square (χ2/df) was 3.686 (p < .001). The Root Mean Square Error of Approximation (RMSEA) of the model was .04 (90% CI = .105–.150). All comparative indices of the model, including the Comparative Fit Index, Normed Fit Index, and Relative Fit Index, were more than .80 (.90, .87, and .80, respectively). For the overall scale, Cronbach’s alpha was .931, whereas the alpha for the subscales ranged from 0.705–0.950. The intraclass correlation was .91 (95% CI = .89–.93), p < 0.001. Conclusion: The results of the study indicate that the Persian model of the MRS is a valid and reliable scale. As a screening tool, the Persian MRS could be used to identify the pattern of symptoms among menopausal, premenopausal, and postmenopausal women to care for and educate them on how to identify and treat the symptoms

The Effect of Counseling on Hemoglobin, Hematocrit and Weight Gain in Teenage Pregnant Women: A Randomized Clinical Trial

Background Pregnant women’s health is a major health priority in all countries. Teenage pregnancies can be high-risk. This study was conducted to determine the effect of counseling on hemoglobin, hematocrit and weight gain in teenage pregnant women. Materials and Methods This randomized, controlled, clinical trial was conducted on 120 teenage women with a gestational age of 20 to 24 months presenting to medical centers in Ardabil, Iran, in 2016 to 2017. The participants were assigned to a counseling (n=60) and a control (n=60) group through randomized blocked sampling. The intervention group received counseling on self-care, symptoms and risks of teenage pregnancy and methods for its prevention in five 60-minute sessions and booklets were distributed among them, too. Each woman and her husband received private counseling in the last session based on their questions and problems. The control group received routine care. Hemoglobin and hematocrit levels and weight at the beginning of pregnancy and before delivery were evaluated. The independent t-test and ANCOVA with adjusted baseline values were used to analyze the data. Results: The two groups did not differ significantly in terms of demographic details, except the mother’s age and baseline hemoglobin and hematocrit levels (P>0.05). There were no significant differences between the two groups after the intervention (with adjusted baseline values) in terms of hemoglobin (adjusted mean difference: -0.07, 95% confidence Interval: 0.31 to -0.46, P=0.710), hematocrit (-0.14, 0.76 to -1.05, P=0.747), and pregnancy weight gain (0.07,1.80 to -1.65, P=0.931). Conclusion The results showed that providing counseling to teenage women during pregnancy does not affect their hemoglobin and hematocrit levels and pregnancy weight gain

The Effect of Metoclopramide on Prolactin Levels in Breastfeeding Mothers: A Systematic Review and Meta-Analysis

Background: Exclusive breastfeeding is beneficial to not only infants, but also mothers. Since prolactin stimulates milk production, increasing its levels through dopamine antagonists, such as metoclopramide, may enhance milk production. However, the efficacy of this method should be further studied. Therefore, this systematic review sought to determine the effects of metoclopramide on prolactin levels in breastfeeding mothers.   Materials and Methods:  In this systematic review study, International and National data bases such as PubMed,Google Scholar, Cochrane Library, Scopus, Web of Sciences, SID,Magiran, and Iranmedexwere searched for the keywords of lactation, breastfeeding, prolactin, metoclopramide and breast milk. Articles published during 1979 to 2016 in either English or Persian was selected. The review was limited to human clinical trials examining the effects of metoclopramide on mothers’ serum prolactin levels. Two authors independently evaluated the eligibility the studies and cases of disagreement were resolved through consensus. Results: Five studies on the effects of metoclopramide on mothers’ serum prolactin levels were included in this systematic review. Based on their results, compared to placebo, two weeks of metoclopramide administration did not have significant effects on mothers’ serum prolactin levels (mean difference: 73.06; 95% confidence interval [CI]:-19.99 to 166.11) However, placebo-controlled studies showed significant changes in prolactin levels after using metoclopramide for three weeks (mean difference: 111.06; 95% CI: 1.93 to 220.20).         Conclusion: The result of meta-analysis showed that the use of 10 mg of metoclopramide three times a day for three weeks increased mothers’ serum prolactin levels after childbirth

Validation of the Iranian version of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises (PSAS-IR-RSF-C)

BackgroundDue to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Specific Anxiety Scale - Research Short Form - for use in global Crises [PSAS-IR-RSF-C] has not been used in Iran for postpartum women during a health system shock. Consequently, this study was conducted to determine the validity and reliability of the Persian version (PSAS-IR-RSF-C) during the COVID-19 pandemic.MethodsThis cross-sectional study was performed with 180 women who were between six weeks and six months after delivery, by random sampling method from December 2021 to June 2022. The validity of the PSAS-RSF-C in terms of face, content, was analyzed, and the construct validity was assessed using exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability of the questionnaire were measured using (Cronbach's alpha, McDonald's ω) and intraclass correlation coefficient (ICC), respectively.ResultsThe content validity index and content validity ratio of the Persian version of the PSAS-IR-RSF-C were 0.96 and 0.98, respectively. A three-factor structure was extracted during the exploratory factor analysis process, and model validity was confirmed by the values of fit indices. Cronbach's alpha coefficient, McDonald's ω and intra-cluster correlation coefficient (95% confidence interval) were 0.74, 0.92 (0.78 to 0.93) and 0.97 (0.93 to 0.98), respectively.ConclusionsFor the specific assessment of postpartum anxiety among Iranian women during crises, the Persian version of the PSAS-IR-RSF-C is a valid and reliable tool