Explaining Iranian midwives’ experiences of providing healthcare services during the COVID-19 pandemic: a qualitative study

Abstract Background COVID-19 has changed and challenged the way health and maternity care is provided. Midwives are among the first and most influential maternity care providers during the COVID-19 pandemic; however, there is inadequate information about their experiences in providing healthcare services, particularly in Iran. The present study was conducted to explain the midwives’ experiences of providing healthcare services during the COVID-19 pandemic in Gorgan. Methods The present study was conducted qualitatively through the inductive content analysis method in 2022. Data were collected through semi-structured interviews. A total of 21 individuals were selected as participants using a purposeful method and the maximum diversity strategy. Results Data analysis led to the emergence of 377 codes, 12 subcategories, and 3 main categories, including, the laborious occupational challenges for midwives during the pandemic, identifying and creating new opportunities for the development of the midwifery profession, and the lack of perceived organizational and social support. Conclusions During the COVID-19 pandemic, midwives experienced various challenges in providing healthcare services, yet sacrificed themselves to perform their duties and provide quality care incessantly. The COVID-19 pandemic was a combination of laborious occupational challenges and individual and professional growth opportunities for midwives in Iran. Strong and managed organizational support is essential to overcome the crisis, maintain the workforce, and empower them to deal with future crises

Comparing the self-awareness and problem-solving skills training on sexual desire of newly married women: A field trial study

BACKGROUND: Sexual desire of women is one of the most important factors affecting marital and sexual satisfaction. Regarding the association of life skills level with sexual dissatisfaction and sexual desire, the present study aims to compare the effect of self-awareness and problem-solving skills training on the sexual desire of newly married women. MATERIALS AND METHODS: This was an experimental field trial study conducted since October 2019 to September 2020. The participants included 105 married women with a history of up to 5 years of cohabitation assigned randomly to either of the two intervention or control groups. The data collection tools include a demographic form, Hulbert index of sexual desire (HISD), and ENRICH couple scale that were completed by the participants before (T1), immediately (T2), and one month after the intervention (T3). The first intervention group received self-awareness skills training, whereas the second one received problem-solving skills training (four sessions of 90 min) weekly. On the other hand, the control group received no training. Statistical analyses were performed using SPSS 16 software and descriptive-analytical statistical tests including one-way ANOVA, Kruskal–Wallis, Bonferroni test, tests of within-subjects effects, and analysis test with repeated measures. P value < 0.05 was considered significant. RESULTS: The effect of time (statistic test: 51.24, P-value < 0.001) and the interaction effects of Time and Group on sexual desire (statistic test: 2.87, P-value: 0.03) were statistically significant. The mean score of sexual desire both in interventions and control groups showed statistically significant improvement. The mean score of sexual desire in the self-awareness group was 44.31 ± 9.08 (T1), 51.34 ± 10.92 (T2), and 59.48 ± 13.76 (T3) (P < 0.001); in the problem-solving group was 48.74 ± 10.21 (T1), 52.08 ± 10.59 (T2), and 57.40 ± 12.40 (T3) (P < 0.001); and in the control group was 47.74 ± 11.60 (T1), 50.08 ± 10.04 (T2), and 54.94 ± 12.15 (T3) (P = 0.02). CONCLUSION: The present study showed the effectiveness of both self-awareness and problem-solving skills training on newly married women's sexual desire. Moreover, this study showed simply participating in a study related to sexual desire as a control group could be effective on women's sexual desire

Sexual Experience of Iranian Women in Their Middle Life: A Qualitative Approach

Background: Sexual problems are common among the middle-aged women; however, there is no deep understanding of sexuality in midlife. The current study aimed to investigate Iranian women’s attitudes and experiences about sexual life changes in midlife. Methods: This is a descriptive qualitative study. Seventeen women aged 40 -65 years old were purposively selected from urban health centers in Gorgan, Iran, in 2015. Face-to-face, semi-structured and in-depth interviews were conducted for data collection until data saturation was attained. The resulting data were analyzed based on Graneheim and Lundman’s approach. MAXQDA 10 was used for organization of data. Results: Data analysis demonstrated seventh sub-themes and three themes. The emerged themes were entitled (1) “Continuous paradox over being a sexual agent” with three subthemes of beliefs on asexuality as socially accepted view for women in midlife, changing in motivation for sex and changing in sexual performance, (2) “Considering menopause; opportunities and threats for sexual life” with two subthemes of menopause related cons for sexual life and menopause related pros in sexual life, and (3) “Coping strategies for changes in sexuality in midlife” with two subthemes of different psychological reactions to changes that have influenced the sex and take practical steps for restoration of sexual attraction. Conclusion: The findings demonstrated that middle-aged women in a male-dominant culture encounter paradox over being a sexual agent. In a bio-psycho-social approach, they perceived menopause as an opportunity or threat for their own sexuality. Following the conflicts, threats and changes of sexuality in midlife, they adopt diverse coping strategies to improve their sexual relationships and preserve their family

The status, policies and programs of nutrition among in nursing mothers: A review article

Background & Objective: Pregnant or lactating women and children are the two population group most vulnerable to nutritional deficiencies. The aim of this study was to review the nutritional status of lactating women, as one of the main loops of the chain of effective factors on health of the generation and society, assessing the supportive nutrition programs in Iran and to provide solutions in this regard. Method: This review was conducted in April 2014. All related articles on the databases of IranMedex, SID (Scientific Information database) and PubMed were investigated with no time limit. After reviewing the abstracts, 15 Persian articles and 13 English articles were fully reviewed. Results: The results of the few available studies on the nutritional status of lactating women indicate deficiencies or inappropriate nutritional patterns among lactating women. Although in formulation of nutritional strategies, pregnant or lactating women and children often receive equal attention, women are practically the target of nutrition and health programs to improve the growth of the fetus and little attention have been paid to their health and nutritional needs. Nutrition of lactating women have been forgotten and solely focus on prenatal nutrition of women means ignoring the more fundamental nutritional problem in women throughout their lives. Conclusion: Implementing a holistic approach to health and nutrition of women instead of the traditional approach, which focuses solely on a particular period of life, leads to health promotion and ensuring the health of women and the next generation

Relationship between Sexual Self-Concept and Sexual Health of Middle-Aged Women in Gorgan, Iran

Background and Objective: Middle age is associated with various biopsychosocial changes. Sexual health is one of the most important aspects of health, which is less addressed in middle age. The study aimed to determine the relationship between sexual self-concept and sexual health in middle-aged women in Gorgan, Iran. Methods: This descriptive-analytical study was carried out on 428 eligible married women (mean age: 46.38±5.46 years) who had electronic records in one of the comprehensive health centers of Gorgan, Iran. Data collection was done in 2019 using a demographic checklist, the Persian version of Snell’s multidimensional sexual self-concept questionnaire, and the sexual health of middle-aged women scale. Results: The mean score of sexual self-concept was 115.10±26.88 in the positive domain, 18.09±11.22 in the negative domain, and 39.92±11.88 in the situational domain. The mean score of sexual health was 129.18±18.71. There was a significant positive correlation between sexual health and the positive (r=0.67, P<0.001) and situational sexual self-concept (r=0.63, P<0.001). There was also a significant inverse correlation between sexual health and negative sexual self-concept (r=-0.48, P<0.001). Conclusion: This study showed that the sexual health of married middle-aged women has a direct relationship with the positive sexual self-concept and an inverse relationship with the negative sexual self-concept