The Effect of Telephone Support on Postpartum Depression: A Randomized Controlled Trial

Introduction:Postpartum depression is a common disorder. Systematic reviews emphasized the need to conduct more trials about interventions to prevent postpartum depression. The aim of this study was to determine the effect of postpartum telephone support on maternal depression. Methods:366 postpartum women with no history of known depression were randomly assigned into control (244 subjects) and intervention (122 subjects) groups. The control group received only routine postpartum care. In the intervention group, telephone support was provided twice in the first week and once a week during the second to sixth week of postpartum by a trained midwife in addition to the routine care. In order to meet their unpredicted needs, the mothers could contact the consultant 24 hours a day. Postpartum depression was assessed using the self-administered Edinburgh Depression Scale at 60 to 65 days of postpartum. Mothers with scores of 13 and above were considered to have depression. Logistic regression and Student’s t-test were used for the data analysis. Results:There was no significant difference regarding frequency of depression between the intervention and control groups (29.9% vs. 31.6%; Odds ratio 0.91, 95% CI 0.56 to 1.49). Mean of depression score was not significantly different between the groups [9.2 (6.1) vs. 10.4 (5.8); mean difference -1.19, 95%CI -2.5 to 0.13]. Conclusion:This study did not provide evidence to show that telephone support of a midwife during postpartum period have a preventive effect on postpartum depression

Comparison of the Effects of Educational Software and Training Booklet on Maternal Self-efficacy and Infant Care Behavior in Iranian Mothers: A Randomized Controlled Trial

Background: To achieve the optimal care of baby, mothers need to have sufficient self-efficacy in infant care. This study aimed to compare the effects of educational software and training booklet on the maternal self-efficacy and infant care behavior. Materials and Methods: This randomized controlled trial was done on 126 Iranian pregnant women. The Participants were assigned into two intervention groups (42 women received software and 42 women received booklet) and a control group (42 women received routine trainings) through block randomization. A training session was provided orally to the participants in both intervention groups. Then they were provided with the booklet or software. The questionnaires of standard maternal self-efficacy and researcher-made infant care behavior were completed before intervention and at the end of the fourth week of postpartum. Results: Before the intervention, there was no significant difference in terms of the mean scores of the maternal self-efficacy (P=0.192) and infant care behavior (P=0.937) between groups. Controlling the baseline values, a statistically significant increase was observed in the mean scores of the maternal self-efficacy in the booklet group (mean difference: 3.7; 95% Confidence Interval: 2.2 to 5.2) and software group (2.5; 1.0 to 3.9) compared to the control group; however, no statistically significant difference was observed between the two intervention groups. In addition, there was no statistically significant difference in the infant care behavior mean score between the groups at the end of the study (P=0.398). Conclusion: The results indicate the effectiveness of both the software and booklet in enhancing the maternal self-efficacy. The effect of booklet was more compared to the Educational Software, but not statistically significant

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

Psychometric properties of satisfaction with the childbirth education class questionnaire for Iranian population

Background: Childbirth preparation classes can reduce pregnant women's anxiety and fear for their childbirth. However, to evaluate women's feedback and their satisfaction with these classes, there is a need for a standard instrument that is suitable for Iranian context. This study is aimed to translate and conduct a psychometric analysis of the Satisfaction with the Childbirth Education Class Questionnaire (SCECQ) for Iranian population. Methods: The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. Results: The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2/df ratio was smaller than 5. The overall model validity was confirmed by having the Root Mean Square Error of Approximation (RMSEA) smaller than 0.08. Cronbach's alpha and intraclass correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. Conclusion: The Persian version of this questionnaire, entitled SCECQ is a valid and reliable instrument for measuring Iranian women's satisfaction with childbirth education classes

Designation and psychometric properties of the Short Form Postpartum Quality of Life Questionnaire (SF-PQOL): an application of multidimensional item response theory and genetic algorithm

Background: Utilizing multidimensional item response theory (MIRT) and genetic algorithm(GA) we aimed to design and test the psychometric properties of the short form Postpartum Quality of Life Questionnaire (PQOL). Methods: In this methodological study, 500 women aged 18 to 42 were enrolled through multistage random sampling scheme in Tabriz, Iran. We used MIRT model and GA to identify a short form of the 40-item PQOL measure (SF-PQOL). Construct and criterion validity of theSF-PQOL was assessed by confirmatory factor analysis (CFA) and the correlation between SFPQOL scores with a 12-item short form of QOL (SF-12) and Edinburgh Postnatal Depression Scale (EPDS) scores, respectively. The internal consistency, test-retest reliability and feasibility of the measure were evaluated. Results: sixteen- and 13-item SF-PQOL were identified based on MIRT and GA, respectively.The results indicate the better performance of the MIRT based 13-item SF-PQOL; Construct and criterion validity, the test-retest and internal consistency reliability, and the feasibility were confirmed in the MIRT based SF-PQOL, but not in the GA-based SF-PQOL. Conclusion: The MIRT suggests a 13-item SF-PQOL with adequate content which demonstrated satisfactory validity, reliability, and feasibility. SF-PQOL could be used across the population for both research and clinical objectives

Predictors of Health-Related Quality of Life in Postmenopausal Women: A Population-Based Study

Introduction: There have been limited studies on quality of life and its predictors among postmenopausal women. Due to the importance of this subject in health promotion, this study was performed to assess quality of life and its predictive factors in postmenopausal women living in Ilam, Iran. Methods: In this descriptive correlational study, 400 postmenopausal married women who aged 50-59 years old and lived in Ilam were recruited from 80 randomly selected clusters. The participants were interviewed by a female interviewer using the standard questionnaire of quality of life (SF-36). Data was analyzed by analysis of variance (ANOVA), student's t-test, and linear regression analysis in SPSS. Results: Mean scores (standard deviation) of quality of life in 4 dimensions of physical functioning, general health, mental health, and vitality were 76.8 (19.2), 71.1 (29.2), 74.3 (18.8), and 73.1 (19.6), respectively (with possible range of 0-100). According to linear regression analysis, women with chronic diseases, vasomotor symptoms, or insufficient family income and divorced and widowed subjects had significantly lower scores in all the 4 dimensions of quality of life. Aging was associated with reduced quality of life only in physical functioning dimension (p < 0.001). Although in univariate analysis, quality of life was significantly lower among illiterate participants and those with more children and longer duration of menopause at least in one dimension, the differences were not found to be significant in linear regression analysis. Conclusion: Chronic diseases, vasomotor symptoms and insufficient income were strong predictors of all the 4 dimensions of quality of life of postmenopausal women. Therefore, interventions are necessary to improve quality of life and health among this group of individuals

Inhaled Lavender Effect on Anxiety and Pain Caused From Intrauterine Device Insertion

Introduction: Intrauterine device (IUD) is the most common reliable, effective and reversible contraceptive method used worldwide and in areas with high growth rate is of particular importance. IUD insertion is associated with high anxiety in most people that causes pain and discomfort. The aim of this study was to determine the effects of aromatherapy on anxiety and pain caused by IUD insertion. Methods: This study was conducted on 106 women in a health care center located in Ardebil, Iran. Participants were divided into two groups by randomized blocks of 4 and 6. In the experimental group lavender scent was inhaled and in the control group the placebo was inhaled 30 minutes before IUD insertion. The anxiety of the participants was measured by Spielberger questionnaire, and the pain of IUD insertion was measured immediately after the insertion using visual analog scale (range 0-10). Results: The mean score (standard deviation) of anxiety before intervention was 43.2 (9.2) in the experimental group that decreased after intervention to 39.0 (10.5) (p < 0.001), while this score was 42.2 (9.0) and 41.5 (8.4) before and after the intervention in the control group (p = 0.21). Mean differences of anxiety in both groups was statistically significant (p < 0.001). The pain score after intervention did not show significant difference between two groups (p = 0.51). Conclusion: Aromatherapy with lavender inhalation was effective in decreasing anxiety in IUD procedure, and this method can be used in health care centers as complementary treatments

Iranian women’s perception on the determinants of birth experience : A qualitative study

Background The prevalence of cesarean birth in Iran is very high. Having a negative childbirth experience is one of the reasons that primiparous women provide to prefer caesarean birth over a vaginal birth. This study is aimed to understand women’s perspective on what determines a positive or negative birth experience for them. Methods This qualitative study is a part a mixed method study that was conducted among primiparous women with a previous vaginal birth experience. The purpose of the main study was to develop a guideline based on Iranian primiparous women’s birth experiences. The quantitative phase of the study was a cross-sectional study where women’s childbirth experiences was measured in a survey via the Childbirth Experience Questionnaire-2. In the qualitative part of the study, women were invited for an in-depth interview via a random stratified sampling method based on their childbirth mean score (women with 10% of the upper bound score which indicated a positive birth experience and 10% of the lower bound indicating negative birth experience, n = 17). Conventional content analysis was used for data analysis. Results We extracted three main themes: (a) “Internal control”, (b) “External control”, and (c) “Support”. Possessing internal control, having a balanced external control to feel cared and feeling supported were the main reasons for women to feel positive about their birth experiences. Whereas, loss of internal control, imbalanced external control and unsupportive environment were related to their negative childbirth experiences. Conclusion Considering that women’s sense of control, the care and support that they receive can influence their childbirth experiences, there is a need for changing maternity policies and practices to highlight the importance of a woman-centred care to create a pleasant, respectful and positive memory for primirparous women who experience normal vaginal births

Evaluation of Sleep Quality and Its Socio-demographic Predictors in Three Trimesters of Pregnancy among Women Referring to Health Centers in Tabriz, Iran: A Cross-sectional Study

This study aimed to determine sleep quality and its socio-demographic predictors regarding three trimesters of pregnancy. This cross-sectional study was conducted on 605 pregnant women referred to health centers in Tabriz, Iran, using a two-stage cluster sampling method. Data were collected using socio-demographic characteristics questionnaire and the Pittsburgh Sleep Quality Index. The mean±SD of the total sleep quality scores were estimated at 5.22±2.52, 5.82±3.07, 8.60±3.03, and 6.56±3.24 in the first, second, and third trimester, and during the whole pregnancy, respectively. Moreover, the study results showed that 81 (40.1%), 105 (53.0%), 172 (83.9%), and 358 (59.2%) mothers experienced sleep disorder in the first, second, and third trimester, and during the whole pregnancy, respectively. According to the results of this study, sleep quality predictors may help health providers identify high-risk pregnant women in terms of sleep disorder to provide them with appropriate interventional programs

Fatigue and sleep quality in different trimesters of pregnancy

Objectives: Fatigue is one of the most common and persistent complaints of pregnant women. Increased severity of fatigue during pregnancy can increase the risk of preterm labor, prolonged labor, cesarean section, and postpartum depression. Therefore, this study aimed to determine the fatigue status in different trimesters of pregnancy and its relationship with sleep quality in pregnant women. Material and Methods: This cross-sectional study was performed by two-stage cluster sampling on pregnant women referred to Tabriz health centers. Data were collected using socio-demographic questionnaire, multidimensional assessment of fatigue and Pittsburgh sleep quality index. Results: Among the 605 pregnant women studied, 94.2% of women suffered from fatigue during pregnancy. The mean (standard deviation) of fatigue score in the first, second and third trimesters of pregnancy was 23.53 (8.05), 25.78 (6.56) and 26.46 (6.72), respectively. There was also significant reverse correlation between total fatigue score with total sleep quality score (p=0.031) and with an increase in fatigue, sleep quality was reduced. Discussion: The findings of this study may be used to design interventional measures for fatigue and medical care to improve quality of sleep in pregnancy