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Abstract Background Stress plays an important role in the consequences of gestational diabetes mellitus [GDM]. It is possible to make a change in the lifestyle by providing counseling in the field of self-care based on stress management in order to avoid the adverse consequences of GDM. Therefore, the present study was designed and implemented with the aim of determining the effect of self-care counseling based on stress management on blood sugar control in women with GDM. Methods A randomized trial with two parallel arms was conducted involving 75 pregnant women diagnosed with GDM at 20–30 weeks of gestation, who were referred to Shohada Hospital in Behshahr city from July 2022 to March 2023. The women with GDM were divided into two groups for intervention and control through random block allocation. The intervention group received 8 virtual counseling sessions once a week for 45–50 min continuously based on stress management, while the control group only received antenatal usual care (AUC). The data were measured before and after the intervention using Fasting Blood Sugar [FBS] and HbA1c (glycated hemoglobin) tests, SDSCA [summary of diabetes self-care activities, NuPDQ‑17 [Prenatal Distress Questionnaire]and DASS [stress, depression and anxiety] questionnaires. Results The mean FBS in the intervention group were significantly lower than the control group after the intervention (P

Abstract Background The prevalence and chronic nature of Inflammatory Bowel Diseases (IBD) is a significant global concern. As the essential part of treatments approach, patient adherence to treatment protocols and self-management practices are crucial to = IBD management. Healthcare initiatives focused on chronic conditions are strongly needed to consider various aspects of gamification and how it can positively affect self-management. Aim The current cognitive study aims to develop a mobile application to integrate the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design model and elaborate on a gamification design based on the reputable Sukr Wheel framework. Methods The current study uses the ADDIE approach to integrate behavior change strategies derived from the self-management theory using the Sukr Wheel gamification (My IBD Buddy) framework on the Android platform. Results The final evaluation was conducted over 14 days. User satisfaction comprised 22 participants aged 20 to 64, all diagnosed with inflammatory bowel diseases. System usability was measured on a scale ranging from 50 to 100. The average usability score for the entire user group was 80.68, indicating a “good” level of satisfaction among the program users based on the ranking scale. Conclusion “My IBD Buddy” mobile application, equipped with gamification for IBD patients, enhances self-efficacy and self-management.

Abstract Background Primary dysmenorrhea (PD) is one of the most common pains experienced by women. Stress Inoculation Training (SIT) is a cognitive-behavioral technique that immunizes them against future periods of stress. The purpose of this research is to investigate the effectiveness of a computer-based stress inoculation approach on pelvic pain, depression, and anxiety symptoms in students with PD. Methods The present study is a clinical trial conducted on 100 students with PD. The SIT intervention consisted of eight consecutive sessions. The content of the sessions was created as multimedia on a computer platform of a site. In each session, several interactive questions were asked about the topics of that session, and participants answered them, with responses recorded in the system. Then, each individual session, lasting about 50 min, was sent as a link (offline) to a participant. Data collection tools included the demographics Checklist, McGill Pain Questionnaire (MPQ), Moos Menstrual Distress Questionnaire (MMDQ), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), and Perceived Stress Scale (PSS-14), which were completed on the second menstrual day of the cycle before the study and for three consecutive cycles after the intervention by each student. The data were analyzed using chi-square, generalized linear mixed models (GLMM), and multiple linear regression tests. The significance level was set at P

Abstract Background So far, some training interventions have been carried out to improve the mental health in women with infertility, but designing the need and evidence-based, as well as multimedia mental health self-care interventions based on cyber space has received less attention. Due to the spread of the internet and the role of self-care in improving mental disorders, this study was conducted to evaluate the effectiveness of the multimedia mental health self-care program on mental health and to assess the users' satisfaction. Methods This study is a randomized controlled trial with pretest–posttest follow-up design. The sample was selected using a convenience sampling method (n = 90). The random number function was used to assign random numbers. The research instruments include a demographic, psychological Well-being, depression, anxiety, perceived stress, fertility problems and satisfaction with training questionnaire. Six weeks of intervention was conducted following the pre-test and the link of each session's content was sent to the participants, based on the training schedule, through Eitaa Messenger. The post-test and follow-up were conducted 1 week and 1 month post intervention. The data were analyzed using independent t-test and repeated measures ANOVA. Results A statistically significant difference was observed between the intervention and control group in the mean score of psychological well-being, perceived stress and infertility stress 1 week and 1 month post intervention and in the mean score of depression and anxiety 1 month post intervention. The intervention group scored higher than the control in psychological well-being but lower in perceived stress, depression, anxiety and infertility stress. The intervention had a positive effect and reduced the score of perceived stress, depression, anxiety and infertility in the intervention group over time. The score reduction continued until the follow-up stage. No significant time-interaction effect was observed on psychological well-being and on the control group. Satisfaction with the program and subscales was desirable. Conclusion This program could significantly reduce the depression, anxiety, perceived stress and infertility stress and desirable satisfaction with the program was observed among users. This program can be used in designing the experimental and therapeutic interventions to improve mental-health self-care behaviors. Trial registration RCT Registry: Iranian Registry of Clinical Trials; RCT registration number: IRCT20210526051410N1; Registration date: 2022–11-06. Last update: 2023–01-28 https://irct.behdasht.gov.ir/trial/57874

Background: Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the attention paidto the adverse outcomes of obstetrics, only a few studies have been conducted on the psychological status of womenwith threatened abortion. This study aimed to compare the symptoms of depression and anxiety in women with TAand those without threatened abortion.Materials and Methods: In a case-control study, 136 women with TA (the case group) and 136 women without TA(the control group), were matched with the case group in terms of gestational age, education level, age, and numberof pregnancies, were examined from Obstetric clinics of Babol University of Medical Sciences. Demographic informationand pregnancy history were obtained from all participants. Additionally, the women filled out the BSI-18questionnaire. Statistical analysis was performed using SPSS version 22 software.Results: The results showed that in women with threatened abortion, the likelihood of experiencing depressionsymptoms was 1.9 times higher [odds ratio (OR)=1.91, 95% confidence interval (CI)=1.13-3.23, P=0.015], anxietysymptoms were 1.8 times higher (OR=1.83, 95% CI=1.08-3.10, P=0.024), and somatization was 2.6 times higher(OR=2.65, 95% CI=1.61-4.37, P

Background: Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, andchild. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms.Materials and Methods: This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partumwomen (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, theEdinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and theanalysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors fordepressive symptoms.Results: According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant womangroup in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity(women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs.28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-riskpregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factorswere a significant risk.Conclusion: Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first andsecond trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.

Abstract Background Internet addiction causes a variety of social, interpersonal, psychological, and physical issues. We are confronting a worldwide crisis about internet addiction and its effects. Objectives Utilizing five questionnaires to survey university students during the COVID‐19 epidemic, the current study sought to evaluate internet addiction and associated risk variables. Methods At the University of Medical Sciences in North Iran, a cross‐sectional analytical investigation was carried out. The sample was done among 318 students, selected through the random cluster sampling method. Data collection was done during August and September 2021. Results Based on our findings, the prevalence of internet addiction was 28.9% (92/318). Our results revealed that women are at twice the twice the risk of internet addiction as men (p = 0.028). Students in the medicinal field (p = 0.043; students with a positive history of mental illness in the family) p = 0.001 (and students with a fear of COVID‐19) p = 0.002 (recognized in the risk of Internet addiction, thus depression) p

Abstract Introduction Pregnancy is an important period of life for women and their husbands as the couple’s health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM). Materials and methods This descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier’s Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker’s Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM. Results The pregnant women’s marital adjustment positively affected their health-promoting behaviors (β = 0.456, 95% Cl: 0.491–0.998, p

Abstract Background Inflammatory bowel disease (IBD) imposes a huge burden on the healthcare systems and greatly declines the patient’s quality of life. However, there is a paucity of detailed data regarding information and supportive needs as well as sources and methods of obtaining information to control different aspects of the disease from the perspectives of the patients themselves. This study aimed to establish the IBD patients’ preferences of informational and supportive needs through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Methods IBD patients were recruited from different centers. Considering inclusion and exclusion criteria, 521 participants were filled a predefined questionnaire. This questionnaire was prepared through literature review of the recent well-known guidelines on the needs of IBD patients, which was further approved by the experts of IBD area in three rounds of Delphi consensus. It includes 56 items in four sections of informational needs (25), supportive needs (15), sources of information (7), and methods of obtaining information (9). Results In particular, EFA was used to apply data reduction and structure detection. Given that this study tries to identify patterns, structures as well as inter-relationships and classification of the variables, EFA was utilized to simplify presentation of the variables in a way that large amounts of observations transform into fewer ones. Accordingly, the EFA identified five factors out of 25 items in the information needs section, three factors out of 15 items in the supportive needs section, two factors out of 7 items in the information sources section, and two factors out of 9 items in the information presentation methods. Through the CFA, all 4 models were supported by Root Mean Squared Error of Approximation (RMSEA); Incremental Fit Index (IFI); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); and SRMR. These values were within acceptable ranges, indicating that the twelve factors achieved from EFA were validated. Conclusions This study introduced a reliable 12-factor model as an efficient tool to comprehensively identify preferences of IBD patients in informational and supportive needs along with sources and methods of obtaining information. An in-depth understanding of the needs of IBD patients facilitates informing and supporting health service provision. It also assists patients in a fundamental way to improve adaptation and increase the quality of life. We suggest that health care providers consider the use of this tool in clinical settings in order to precisely assess its efficacy.

Abstract Background Infertility continued to be a major stressor among women with infertility during COVID-19pandemic. This study aimed to evaluate the impact of primary care posttraumatic stress disorder (PC-PTSD) on fertility problem of Iranian women with infertility during COVID-19 pandemic. Method In this cross-sectional study, 386 women with infertility completed the questionnaires of PC-PTSD-5 and Fertility Problem Inventory (FPI) at an infertility center between 2020 and 2022. Results The mean of fertility problems was 145.20 (± 32.31). In terms of FPI subscales, the means were as follows: Sexual concern 21.80 (± 7.58), social concern 26.53 (± 8.94), relationship concern 26.02 (± 9.18), need for parenthood concern 40.88 (± 8.98), and rejection of childfree lifestyle 29.96 (± 7.69). The highest mean of FPI subscales was related to the need for parenthood concern in women with infertility. The strongest correlation was found between the subscales of sexual concern and social concern followed by sexual concern and relationship concern. The variables of PC-PTSD were a predictor of fertility problems (β = 0.203, P

Abstract Background and Aims The well‐being of physicians in their professional lives has a major influence on the quality of medical care and patient outcomes. This study explored how Professional Quality of Life (ProQOL) and psychological well‐being are connected to workplace spirituality (WPS) and demographic factors like age and gender. It also compared the average levels of ProQOL, psychological well‐being, and WPS between medical residents and interns. Methods In a cross‐sectional study, 230 medical residents and interns completed three questionnaires, including ProQOL, Ryff Scale Psychological Wellbeing–Short Form, and WPS. The data was analysed using Pearson correlation, independent t‐test, ANOVA, and multiple linear regression modeling. Results Residents and interns had moderate ProQOL levels and higher work spirituality. However, medical residents scored lower in occupational spirituality and compassionate care fulfillment compared to interns while experiencing higher levels of emotional exhaustion and secondary mental strain. Gender disparities were significant, with women scoring higher in compassionate care fulfillment but lower in secondary mental strain. Regression analysis showed that occupational spirituality positively predicted professional, compassionate care fulfillment (B = 0.910, p

Abstract Background Premenstrual Syndrome (PMS) is a common public health issue affecting many women of reproductive age worldwide. This study has been designed to investigate of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of university students with PMS. Methods A randomized trial study with two parallel arms was done from 30 October 2022 to 21 June 2023 on 100 university students aged 18 to 38 at Babol University of Medical Sciences. The participants were randomly divided into two groups intervention and control. The data collection tools included questionnaires on demographic-fertility characteristics, the Premenstrual Symptoms Screening Tool (PSST), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-14), the Sheehan Disability Scale (SDS) and Riff’s Psychological Well-being Scale (RPWS). The data were assessed using chi-square, t-student, ANOVA repeated measure, and linear regression tests. A significance level of P

Background: Mizaj (Temperament) is a concept to express individual differences in Persian medicine and according to this theory, there is a relationship between Mizaj type and the abilities of different body organs. This cross-sectional study aimed to investigate the relationship between the type of Mizaj and the memory score (Quotient). Methods: The target population was the 18 to 38 years old students of Babol University of Medical Sciences. Mojahedi’s Mizaj questionnaire (MMQ) was used for determining the whole Mizaj. The physical Persian version of Wechsler Memory Scale III (WMS III) was used to assess memory score. The collected data were analyzed by SPSS Version 22 and the chi square (x2) and t-test were run and p- value 0.05 was considered as significant difference. Results: Forty-two of participants were females and 18 were males. The average age of them was 23.6 (21-27). The average of Memory Quotient (MQ) was 122.1 ± 5.7. The average of MQ in warm Mizaj was 125.46 ± 1.2 and in cold Mizaj was 118.79 ± 6.5. The difference between two groups is statistically significant (p< 0.001). The average of MQ in dry Mizaj was 124.16 ± 2.67 and in wet Mizaj was 118.40 ± 7.64. The difference between two groups is statistically significant (P= 0.005). Conclusion: The results showed there are significant relationship between memory score and warm/cold Mizaj and dry /wet Mizaj. It means students with warm or dry Mizaj had better memory score than students with cold or wet Mizaj. This relation was also detected between subtypes of memory and Mizaj expect between working memory and dry/wet Mizaj. These results are in accordance with theories in PM which indicate people with warm Mizaj and dry Mizaj have better memory and people with cold Mizaj and wet Mizaj have weaker memory and are more at risk of memory dysfunction.

Abstract Background The study aimed to examine the predictors of treatment nonresponse and low adherence to Internet-based cognitive behavioral therapy and face-to-face therapy for treating depression and anxiety in women facing the couple’s fertility problems. Methods This is a secondary analysis based on a previous randomized controlled trial including 152 depressed/anxious women facing the couple’s fertility problems. The study defines low adherence as receiving less than 4 sessions (out of 8 sessions). Nonresponse to treatment refers to a

Background: A high percentage of pregnant women experience anxiety symptoms. A review of recent studies shows that current psychological interventions have not focused on pregnancy. Therefore, considering the importance of investigating anxiety disorders during pregnancy and the impact of these disorders on the mental health system, the evaluation of anxiety disorders should be considered in controlled clinical studies. Aims: The aim of this study was to investigate the effect of computer-based cognitive-behavioral psychotherapy (ECBT) on emotion regulation in pregnant women with anxiety. Method: This study was quasi-experimental. The studied population consists of pregnant women from 13 to 30 weeks pregnant, singletons, and suffering from anxiety disorders in Babol city. In a pre-test and post-test design, 84 pregnant women at 13-30 weeks of pregnancy were divided into two experimental groups (n = 42) and control (n = 42). The participants in both groups completed Garnevsky's (2002) cognitive emotion regulation questionnaire in two pre-test and post-test series. The data were analyzed using variance analysis of repeated measurements and SPSS 26 software. Results: The results of this study showed that ECBT is able to improve emotion regulation in pregnant women (p

Abstract Background Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. Methods A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. Results The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P

Abstract Background and Aims Inflammatory bowel disease (IBD) is a chronic inflammatory gastrointestinal tract disease subdivided into Crohn's disease (CD) and ulcerative colitis (UC). There is currently no cure for IBD, and individuals with IBD frequently experience a lower health‐related quality of life (HRQOL) than the general population. Gamification has become an increasingly popular topic in recent years. Adapting game design concepts to nongaming contexts represents a novel and potential approach to changing user engagement. This study will be conducted with the aim of evaluating the effect of a gamified mobile‐based self‐management application on disease activity index, quality of life, and mental health in adults with IBD. Methods A multicenter, parallel, two‐arm, exploratory randomized controlled trial with a 6‐month follow‐up per patient will be designed to compare the impact of the gamified mobile‐based tele‐management system on primary and secondary health outcomes and outpatient visits in 210 patients with all types of IBD which are divided equally into a control group with standard care and an intervention group which will use the developed mobile application named MY IBD BUDDY. All patients will attend study visits at baseline, 12 and 24 weeks, and routine IBD clinic visits or telephone consultations based on randomization group assignment. Disease activity or disease activity index, mental health (anxiety and depression) symptoms, quality of life, self‐efficacy, and IBD‐specific knowledge will be measured at baseline with two follow‐ups at 12 and 24 weeks. Conclusions In sum, the outcomes of our trial will demonstrate the impact of the gamified mobile‐based self‐management system on disease activity, quality of life, and anxiety and depression by means of interactive care and patient empowerment. Trial Registration IRCT: IRCT20200613047757N1. Registered November 16, 2021. Prospectively registered and visible at OSF (https://doi.org/10.17605/OSF.IO/AWFY9).

Abstract Background Scientific developments have brought hope to infertile couples; however, the results are not always favorable. This makes women suffer psychological pressure. Therefore, previous studies have investigated the effectiveness of many psychological interventions but no research identified the most common psychological interventions. In this regard, the present review aimed to investigate different psychological interventions that promote mental health in infertile to identify the most frequent (common) ones. Methods In the present study, the search was carried out using appropriate keywords Infertility, psychological interventions, mental health, stress, anxiety, depression and women in the Google Scholar، Magiran، SID، Pubmed، Scopus، Science Direct، ProQuest، Web of Science databases and One of the leading websites in health- WHO with Persian and English languages and two operators of “AND” and “OR” between 2000 and 2021. Results First, 7319 articles were searched, 6948 articles of which were removed due to irrelevant subjects, and 31 articles were removed due to duplication. 340 abstracts were examined and the results of 60 articles were extracted. Two approaches (examining the type and content of intervention) were used to extract findings. The first approach indicated high diversity in psychological interventions, leading to the categorization of the interventions into 4 categories of cognitive behavioral therapy (CBT), mind-body interventions (MBI), stress management skills, and others. CBT and MBI and stress management skills were found as the most frequent promoting interventions for mental health in infertile women. The second approach indicated the differences in protocols (number of sessions and time of interventions). Conclusion Despite differences in protocol of interventions under study, the results of all articles revealed the effectiveness of interventions in improving infertile women’s mental health; therefore, it is suggested to apply the most common psychological interventions based on scientific evidence (CBT, MBI, and stress management skills) along with infertility treatment methods. The results will help the specialists, policy-makers, and planners to select and implement the most appropriate psychological interventions for infertile women.

Abstract Objective: Psychiatric symptoms are common mental issues in pregnancy and the postpartum period. There is limited information regarding the psychiatric symptoms of women with high-risk pregnancy in the postpartum period. This study aimed to compare the severity of psychiatric symptoms and psychological distress in women with high-risk and low-risk pregnancies in the postpartum period. Methods: This case-control study examined 250 women in the postpartum period in two groups with low-risk (n = 112) and high-risk (n = 138) pregnancies. Women completed the Brief Symptom Inventory-53 (BSI-53) and the Risk Postnatal Psychosocial Depression Risk Questionnaire (PPDRQ). Results: The mean severity of psychiatric symptoms in women with high-risk pregnancies was significantly higher than that in women with low-risk pregnancies (39.34 ± 17.51 vs. 30.26 ± 17.08). Additionally, the frequency of psychological distress in women with high-risk pregnancies was approximately twice higher than that in women with low-risk pregnancies (30.3% vs. 15.2%). Furthermore, the risk factors for depression in women with high-risk pregnancies were almost 1.5 times (59.8% vs. 39.8%) higher than the factors in women with low-risk pregnancies. The results of the logistic analysis indicated that high-risk pregnancies could be twice the odds ratio of developing postpartum psychological distress (ß = 2.14, 95% CI 1.4-6.3, p= 0.036). Conclusion: Psychiatric symptoms and the psychological distress index are higher in postpartum women with high-risk pregnancies than in postpartum women with low-risk pregnancies. The study suggests that obstetricians and pregnant women's health care providers should strongly consider screening of psychiatric symptoms in women with high-risk pregnancies both during pregnancy and after delivery as the women's routine care priorities.

Abstract Background Infertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women. Method In a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022. Result The results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (β = 0.27, p

Abstract Background Some studies indicate that more than 10% of pregnant women are affected by psychological problems. The current COVID‐19 pandemic has increased mental health problems in more than half of pregnant women. The present study compared the effectiveness of virtual (VSIT) and semi-attendance Stress Inoculation Training (SIT) techniques on the improvement of the symptoms of anxiety, depression, and stress of pregnant women with psychological distress. Methods This study was conducted on 96 pregnant women with psychological distress in a 2-arm parallel-group, randomized control trial between November 2020 and January 2022. The semi-attendance SIT received treatment for six sessions, sessions 1, 3 and 5 as individual face-to-face and sessions 2, 4 and 6 as virtual once a week for 60 min continuously [n = 48], and the virtual SIT received six sessions simultaneously once a week for 60 min (n = 48) in pregnant women of 14–32 weeks’ gestation referred to two selected hospitals. The primary outcome of this study was BSI-18 [Brief Symptom Inventory] and NuPDQ-17 [Prenatal Distress Questionnaire]. The secondary outcomes were the PSS-14 [Cohen’s General Perceived Stress Scale]. Both groups completed questionnaires measuring anxiety, depression, pregnancy-specific stress, and generally perceived stress questionnaires before and after the treatment. Results The post-intervention results showed that the stress inoculation training technique in both VSIT and SIT interventions effectively reduced anxiety, depression, psychological distress, pregnancy-specific stress and general perceived stress [P

Background: Infertility is a stressful condition that can lead to either emotional disturbance or personal growth. Maritalrelationship is one of the factors affecting the consequences of infertility. This study aimed to explore the role ofmarital relationship quality in development of women's personal growth after experiencing infertility.Materials and Methods: In the cross-sectional study, 122 infertile women (mean age 28.79 ± 6.3) were invited tocomplete the survey, including ENRICH Marital Satisfaction Scale, Posttraumatic Growth, Fertility problem inventory,State-Trait Anxiety Inventory, and Beck Inventory Depression.Results: Higher scores of quality of marital relationships were a protective factor against infertility stress and state/trait anxiety. Additionally, infertility stress was a strong negative predictor of personal growth. Furthermore, infertilewomen with a high level of marital relationships may have more chances to experience personal growth rather thanstress in infertility treatments.Conclusion: The study suggests that high quality of marital relationships may provide positive opportunities for women’spersonal growth after experiencing infertility.

Abstract Aim This study investigated the impact of spiritual intelligence and demographic factors in the prediction of occupational stress, quality of life and coronavirus anxiety among nurses. Design A cross‐sectional study was planned. Methods The study was conducted among full‐time nurses who were employed in two teaching hospitals of Babol city which were referral centres for caring patients infected with COVID‐19 from February–May 2021. One hundred and twenty‐nine nurses completed five questionnaires including the demographic questions, Quality of life (WHOQOL‐BRIF), Occupational Role Questionnaire (ORQ), Spiritual Intelligence and Coronavirus Anxiety Scale. Results The findings revealed that 69% of the nurses experienced moderate occupational stress, moderate quality of life and low coronavirus anxiety. Spiritual intelligence was the only significant negative predictor of occupational stress (β = −0.517, p =

Abstract Background A widespread outbreak of epidemics like Covid-19 is a lethal threat to physical and mental health. Recent studies reported a higher prevalence of mental problems in younger individuals, contrary to the general assumption expected in older people. Therefore, it is necessary to compare anxiety, stress, depression and PTSD (post-traumatic stress disorder) symptoms in different age groups during the Covid-19 crisis. Methods A cross-sectional online survey was performed (from Dec. 2020 to Feb. 2021) on three age groups of elderly, middle-aged and young people. Data were collected by DASS-21 (Depression, Anxiety and Stress Scale) and IES-R (Impact of Event Revised Scale) and analyzed using ANOVA, χ2 test and logistic regression analysis. Results Overall, 601 participants completed the questionnaires, including 23.3% of the elderly (≥ 60 years), 29.5% of the young (18–29 years) and 47.3% of the middle-aged (30–59 years) with 71.4% of women. The logistic regression analysis revealed that the risk of PTSD in young people was higher than in the elderly (β = 2.242, CI: 1.03–4.87, P = 0.041), while the risk of depression, anxiety and stress did not differ significantly among the three age groups. Female gender, occupation, lower economic status, solitary life, and chronic disease were risk factors for psychological symptoms during the Covid-19 pandemic. Conclusion Findings on the higher odds ratio of PTSD symptoms in younger individuals have interestingly potential implications to meet the needs of mental health services during Covid-19.

Abstract Background Pregnant women with suspected fetal anomalies experience a great deal of stress following prenatal screening tests. The present study aimed to investigate women's worries about prenatal screening tests suspected of fetal anomalies. Methods Through the use of qualitative content analysis, the reports of women whose prenatal screening tests were suspected of fetal anomalies were analyzed and the results were interpreted. The participants were selected from four public and private maternity care clinics of Babol, Iran, from December 2021 to January 2022, using targeted convenience sampling. Data were collected from 20 women aged 24 to 41 years old, who underwent prenatal screening tests and were suspected of fetal anomalies, using semi-structured face-to-face interviews. Results The four main themes included the "causes of worries" (with sub-themes of challenge with spouse and relatives, medical diagnosis processes, previous unpleasant experiences, physical and mental problems, financial worries, and misinformation), "anxiety-coping styles" (with cognitive emotion-oriented, behavioral emotion-oriented, and problem-oriented sub-themes), "reactions to a possible diagnosis of anomaly" (with three sub-themes, namely concealment, extreme fear and worry, and denial), and "attribution of the cause of the anomaly" (with sub-themes of consanguine marriage, evil eyes, tendency to have a baby of a particular gender, a history of anomalies in the previous child, the spouse's medical illness, unplanned pregnancy, and high maternal anxiety). Conclusion Women with suspected fetal anomalies experience a great deal of stress, the most important reason for which is the "physician’s uncertainty". "Sharing worries with relatives" was the most common style of coping with worries. Establishing emotional support and empathetic communication between midwives and physicians with pregnant women suspected of fetal anomalies were important ways to reduce their worries.

Objectives: The present study compared the prevalence and psychosocial factors affecting posttraumatic growth (PTG), posttraumatic stress disorder (PTSD), and psychological distress in nurses, physicians, and medical students. Materials and Methods: In a cross-sectional study, three groups of medical staff including nurses (n = 57), physicians (n = 40), and medical students (n = 34) who were responsible for the care/treatment of COVID-19 patients admitted to a general hospital for 4 months responded to Posttraumatic Growth Inventory, Brief Symptom Inventory-18, Resilience Questionnaire, PTSD Screen, and Social Capital-Integrated Questionnaire. Results: After the exposure of medical staff to at least 4 months of treatment/care of COVID-19 patients, PTG prevalence was higher than PTSD (38.2% vs. 14.6%), but they experienced some degrees of psychological distress (65.5%). The nurses had 8.33 (confidence interval [CI]: 2.5–26.7) times higher PTG rate than medical students (P < 0.001). Physicists also experienced 5.00 (CI: 1.4–26.7) times higher PTG than medical students (P < 0.001). PTG was aided by age, married status, strong resilience, and high social capital, but gender had no influence. Resilience played an important protective role to prevent the incidence of psychological distress in nurses, medical students, and physicians. Conclusion: Despite the fact that the PTSD and psychological distress were same in the three groups of medical staff, the nurses had a greater rate of PTG than physicians and medical students.

Abstract Background Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB. Methods This case–control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants. Results The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947–0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB. Discussion This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.

BackgroundThe present study introduces informational and supportive needs and sources of obtaining information in patients with inflammatory bowel disease (IBD) through a three-round Expert Delphi Consensus Opinions method.MethodsAccording to our previous scoping review, important items in the area of informational and supportive needs and sources of obtaining information were elucidated. After omitting duplicates, 56 items in informational needs, 36 items in supportive needs, and 36 items in sources of obtaining information were retrieved. Both open- and close-ended questions were designed for each category in the form of three questionnaires. The questionnaires were sent to selected experts from different specialties. Experts responded to the questions in the first round. Based on the feedback, questions were modified and sent back to the experts in the second round. This procedure was repeated up to the third round.ResultsIn the first round, five items from informational needs, one item from supportive needs, and seven items from sources of obtaining information were identified as unimportant and omitted. Moreover, two extra items were proposed by the experts, which were added to the informational needs category. In the second round, seven, three, and seven items from informational needs, supportive needs, and sources of obtaining information were omitted due to the items being unimportant. In the third round, all the included items gained scores equal to or greater than the average and were identified as important. Kendall coordination coefficient W was calculated to be 0.344 for information needs, 0.330 for supportive needs, and 0.325 for sources of obtaining information, indicating a fair level of agreement between experts.ConclusionsOut of 128 items in the first round, the omission of 30 items and the addition of two items generated a 100-item questionnaire for three sections of informational needs, supportive needs, and sources of obtaining information with a high level of convergence between experts' viewpoints.

Abstract Background and Aims Studies regarding the risk factors of prenatal anxiety disorders are inconclusive and sometimes contradictory. The current study aimed to define the prevalence and risk factors for anxiety disorders in women during pregnancy. Methods This is a cross‐sectional and hospital‐based survey of two public hospitals (Ayatollah Rohani and Yahyanejad) of inpatients/outpatients, obstetric wards/clinics, and four private outpatient obstetric clinics in the city of Babol. Convenience sampling was utilized to recruit 432 pregnant women. A trained clinical psychologist conducted the Structured Clinical Interview for DSM‐5 (SCID‐5) to diagnose anxiety disorders. In addition, the Brief Symptom Inventory 18 (BSI‐18) was completed by the participants to assess the severity of psychological distress. Results Of 432 pregnant women, 132 (30.5%) were diagnosed with anxiety disorders. Anxiety disorders included 61 cases of pregnancy adjustment disorder (47.7%), 52 cases of generalized anxiety disorder (40.6%), and 15 cases of specific phobia (to delivery) (11.7%). The logistic regression results showed that the age, pregnancy, education, parity, and high‐risk pregnancy variables predicted 28% of the variance of anxiety disorders. Furthermore, as the age (β = 0.94, p = 0.003) and gestational age (β = 0.9, p

Abstract Background Pregnancy is associated with substantial stressful experiences. There are controversies concerning the positive and negative roles of social support during pregnancy. This research aimed to study the association of social support with the pregnancy-related stress. Methods In the current cross-sectional research, 200 pregnant women were recruited through convenience sampling from two teaching hospitals affiliated with Babol University of Medical Sciences and a private obstetric clinic. The women completed two self-reported questionnaires during prenatal care appointments. The questionnaires included the Revised Prenatal Distress Questionnaire (NuPDQ) and Social Support Questionnaire (SSQ). Results A significantly positive association was observed between the social support of neighbors and the total score of pregnancy stress (P

Abstract Background & aim Pregnancy is associated with numerous physical and psychological changes and affects the sexual function of couples. Since the root of many marital problems lies in the quality of the relationship and sexual function, the present study investigates the effect of virtual cognitive-behavioral sexual counseling on pregnant women’s sexual function and intimacy. Methods & Materials This study is a randomized clinical trial, and 80 pregnant women aged 18 to 35 years and in 16–24 weeks of pregnancy were assigned to two intervention and control groups based on randomized blocks from June 2021 to July 2021. The control group received routine prenatal care, but the intervention group, in addition to routine prenatal care, underwent virtual counseling with a cognitive-behavioral approach during eight sessions of 90 minutes. Data were collected using the Female Sexual Function Index (FSFI) and sexual intimacy questionnaire. SPSS software was used for statistical analysis. Results The comparison of mean scores of sexual function and intimacy in the two groups before the intervention was not statistically significant with each other. However, after the intervention, the mean scores of sexual function and intimacy in the intervention group were significantly increased compared to the control group (p

Abstract Background Dysmenorrhea is one of the most common disorders among young women. Medicinal herbs are one of the alternative methods for the treatment of dysmenorrhea. This study will investigate the effect of Rosa foetida extract, along with self-care behavior education on primary dysmenorrhea among female students of Babol University of medical sciences. Methods/design A randomized clinical trial will be performed on single students, aged 18 to 24 years. The research samples will be divided into three groups. The students will receive self-care behavior education on dysmenorrhea. Following the education, two of the groups will receive Rosa foetida extract capsules and placebo capsules in two consecutive cycles every 8 h for two successive days, respectively. The capsules will have similar physical appearance. The third group will not receive any medication. Data will be collected through demographic characteristic questionnaire, visual analog scale, dysmenorrhea self-care behaviors scale questionnaire, pictorial chart, and menstrual distress scale questionnaire. In order to determine and compare the effect of pharmacological and educational interventions on the severity of dysmenorrhea in groups, an ANOVA analysis of variance test with repeated measures will be used by SPSS software version 22. Discussion The results will show the effects of Rosa foetida extract along with self-care behavior education on primary dysmenorrhea, and beneficial effects that may be found in the trial of this plant may be of use for women with the same problem. Ethics and dissemination The study is approved by the Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.REC.1397.059). Trial registration IRCT 20190318043086N1. Registered on 14 June 2019.

Background: Recurrent pregnancy loss (RPL) and infertility are associated with significant psychiatric complications.The study aimed to investigate the effectiveness of cognitive behavioral therapy (CBT) and sertralinein the treatment of in depression, anxiety, and infertility stress of depressed infertile women with RPL in comparisonwith usual care.Materials and Methods: A triple-arm randomized controlled trial was carried out on the 60 depressed infertilewomen with RPL, a population of Infertility Center of Babol city, Iran, who were randomly assigned into threegroups: pharmacotherapy with sertraline (n=20), psychotherapy with CBT (n=20), and a usual care as controlgroup (n=20). The participants of psychotherapy received CBT sessions (90 minutes each) over 10 weeks. Theparticipants in the pharmacotherapy group took 50 mg/day sertraline daily for 22 weeks. Outcomes were assessedusing the Beck Depression Inventory (BDI-II), fertility problem inventory (FPI), and State-Trait AnxietyInventory Form Y (STAI-Y) at the beginning of the trial, 10-weeks post-trial, and three months of follow-up.Using statistical package for the social sciences (SPSS) software, data were analyzed.Results: CBT considerably reduced the depression symptoms more than sertraline with a moderate effect sizeat the post-trial (g=0.11, 95% CI: -0.03 to -0.50). Sertraline showed reduced the scores of state-anxiety moreconsiderably in comparison with control group by a large effect size of post-trial (g=-1.04, 95% CI: -1.70 to-0.38). CBT reduced the total scores of FPI more considerably than sertraline, with a large, small size at followup-trial [95% CI=-0.03(-0.65, -0.58)]. Both CBT and sertraline were superior to the control group in reducingdepression and infertility stress.Conclusion: Depression and infertility stress diminished under CBT and sertraline in depressed infertile women withRPL, with a significant advantage of CBT. Sertraline was superior to CBT in reduction of anxiety (registration number:IRCT201304045931N3).

Background: Primary dysmenorrhea is the usual medical status in medical students that are defined as painduring the menstrual period. This study was done to evaluate the psychological problems associated with dysmenorrhea.Materials and Methods: Three hundred forty students aged 18 to 20 years participated in this cross‑sectionalstudy (194 with dysmenorrhea and 150 without dysmenorrhea). In this cross‑sectional study, data were collectedthrough the sociodemographic checklist, the verbal multidimensional scoring system (VMS), and the revisedversion of the Symptom Checklist-90 (SCL-90-R) questionnaire using the convenience sampling method. Thisquestionnaire includes 9 Subscale and a GSI index. We considered psychological distress to be equivalent tothe Global Severity İndex (GSI), which is obtained by dividing 90 questions by 90. The significance level of thetests was considered 0.05.Results: The GSI of the SCL-90 score in the 194 students with dysmenorrhea and 150 students without dysmenorrheawas 1.02 ± 0.42 and 0.34 ± 0.15 respectively (P1 were a family history of dysmenorrheaand mother’s education [odds ratio (OR)=2.33, 95% confidence interval (CI), 1.43-4.15 and OR=0.45, 95% CI,0.24-0.87, respectively].Conclusion: According to the result, dysmenorrhea is associated with psychological distress. Psychological interventionsand counseling in addition to drug treatment are suggested for treatment of primary dysmenorrhea.Therefore, it is necessary to formulate strategies and health policies to recover psychological issues of menstrualhealth.

Background: Dysmenorrhea is among the most common conditions among young women. Herbal medicine is one of the alternative ways to treat dysmenorrhea. The purpose of this study was to determine the effect of Rosa Foetida extract along with self-care behaviors on primary dysmenorrhea. Methods: A randomized clinical trial was conducted on 135 students residing in dormitories. The subjects were aged 18 to 24 years and unmarried. They divided into three groups of 45. The students received self-care behavior training on dysmenorrhea. After the training, two of the three groups received medications; one with Rosa Foetida extract and another with placebo capsules. The physical appearance of the capsules was similar. The third group received no medication. Data were collected through questionnaires including demographic characteristics questionnaire, a visual analogue scale (VAS), menstrual distress scale questionnaire (MDQ), dysmenorrhea self-care behaviors scale questionnaire (DSCS), and Pictorial Blood Loss Assessment Chart (PBAC). Repeated measurement of analysis of variance (ANOVA) was performed using SPSS software version 22 (IBM Corp., Armonk, NY, USA) to determine and compare the effects of interventions on menstrual pain and distress severity. Results: Comparison of the mean pain intensity before and after intervention implied a reduction in pain; especially in the Rosa Foetida extract group (p < 0.001). Menstrual distress also showed reduction which was greater in the case of the Rosa Foetida group. In addition to those, the reduction of menstrual bleeding was statistically significant in the Rosa Foetida group (p = 0.041). Conclusions: The results showed Rosa Foetida extract prescription, along with self-care behavior education did not have a positive effect on primary dysmenorrhea; however, it was seen to be effective on reducing menstrual distress. Clinical Trial Registration: the study was registered at https://www.irct.ir (registration number IRCT20190318043086N1).

Introduction: Physical activity is a predictor of the health outcomes of the older adults, and many approaches have been introduced for its implementation. The present study aimed to investigate the effect of group physical games on life quality (QOL) of older adults at an adult day care center. Methods: This quasi-experimental study was conducted using pre-test and post-test. Using convenience sampling, a total of 50 senior citizens above 60 years of age from two adult daycare centers of Babol and Amol in 2017 was placed in an intervention (25) and a control (25) group, respectively. The intervention group received physical games program twice a week for 6 weeks. The SF12 questionnaire was used to assess the QOL. The statistical analysis of the variables was carried out using t-tests, Wilcoxon, and Mann-Whitney tests at a significant level (P < 0.05) with SPSS software. Results: The QOL scores of the participants in the intervention group, compared to the control group have significantly improved (p < 0.001). The calculated difference for the quality of life of the intervention group was (d = 4.40 ± 2.36) being (d = 1.68 ± 1.74) and (d = 2.72 ± 1.51) in the physical and mental aspects, respectively. Conclusion: Physical exercise program (especially stationary physical game) can improve the quality of life of the older adults both physically and mentally. Therefore, such activities can be used to improve the quality of life of the older adults.

Objective: Infertility can be associated with unfavorable psychological consequences such as a sense of marital incompatibility and sexual inadequacy. To address these issues, this study aimed to assess the effectiveness of group psycho-sexual training in improving marital adjustment and sexual self-efficacy of infertile women. Method: A randomized controlled clinical trial (RCT) study was conducted in Babol, Iran, with 72 infertile women, randomly assigned to either the intervention group (n = 36) or the control group (n = 36). The intervention group underwent psychosexual training, while the control group received routine care. The Dyadic Adjustment Scale (DAS) and Sexual Self-Efficacy Scale (SSES) were used to assess their marital adjustment and sexual self-efficacy. Data analysis was performed using various tests, including the independent t-test, Chi-squared test, paired t-test, ANCOVA, and MANCOVA. Results: Most infertile women had moderate sexual self-efficacy (80%). The intervention group had a significantly better response to group psycho-sexual training compared to the control group. This intervention improved sexual self-efficacy and marital adjustment and its subscales including marital consensus, satisfaction, cohesion (P < 0.0001), and affectional expression (P < 0.001). The mean pre-to-post treatment scores of sexual self- efficacy, marital adjustment, and its subscales increased significantly in the intervention group, while no significant difference was observed in the control group (P < 0.0001). Conclusion: Based on the findings, it is recommended to provide educational services alongside the infertility treatment process for enhancing the quality of marital adjustment and promoting sexual self-efficacy.

BackgroundInflammatory Bowel Disease (IBD) affects the quality of life. Patient education and support needs are crucial components of comprehensive chronic illness care. The main purposes of this review were to (i) explore the informational and supportive needs of these patients to improve the quality of life in the existing literature and (ii) identify the gaps related to the needs of the patients in articles.MethodsThe scoping review is based on the Daudt methodological framework, a modified version of Arksey and O'Malley. Electronic databases were extensively searched from January 01, 2000 to April 30, 2022. Four electronic databases (PubMed/Medline, CINAHL, APA PsycInfo, Psychology and Behavioral Sciences Collection, APA PsycArticles, and ProQuest) were searched using controlled vocabulary, and specific keywords. The searched terms were matched to each database. We manually searched two key journals, namely the Journal of Inflammatory Bowel Disease and the Journal of Crohn's and Colitis.ResultsIn the review, 75 studies on the assessment of the information and support needs of patients with IBD were reviewed. In this regard, 62 and 53 studies were regarding information needs and support needs, respectively. Most of the information needs of patients with IBD reported in the studies were related to diet needs, and educational needs were the most essential support needs.ConclusionsHealth policymakers and managers can develop care and educational programs related to this disease in health centers according to the needs of the patients. Health professionals, especially gastroenterologists, are the primary referral sources for information on patients. Therefore, gastroenterologists can take the lead in planning and educating the patients and sharing their decisions.Systematic review registrationOSF, https://doi.org/10.17605/OSF.IO/3MWGJ.

Background: Despite a large body of evidence supporting the effectiveness of internet-based cognitive behavior therapy (ICBT) for the treatment of depression and anxiety, there is no report of the efficacy of ICBT program in the Iranian population. The present study aimed to test the acceptability, feasibility, and effectiveness of ICBT program for the treatment of depression or anxiety in infertile women. Method: This study consisted of two phases. In the first phase, we designed “Peaceful Mind”, an eight-session therapist-guided ICBT program. In the second phase, we tested the efficacy of the program by conducting 2-arm parallel group, non-inferiority randomized control trial, between October 2020 and July 2021.60 infertile women diagnosed with depression or anxiety disorders were divided randomly to ICBT treatment (n = 30) and face-to face CBT (n = 30). The participants received individual CBT sessions (60 min, over 8 weeks) and completed the questionnaires at the beginning, in mid-trial, and 8 weeks after the trial. The outcomes comprised Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI, Fertility problem inventory (FPI), Client Satisfaction Questionnaire (CSQ-8), and System usability scale (SUS). Results: The usability scores of the “Peaceful Mind” ICBT (M = 67.07, SD = 17.23, range = 1–100) and satisfaction with the treatment (M = 25.06, SD = 4.18, range = 1–32) were high. Patient adherence to the treatment in the ICBT group (86.6%) was the same as that in the CBT (73.3%). The between-group mean differences at the post-trial were −4.79 (CI 95% = −10.81 to 1.23) for depression scores and −4.15 (CI 95% = −9.52 to 1.22) for anxiety scores; both differences were within the non-inferiority margin points for the lower 95%CI. Conclusion: “Peaceful mind” ICBT was found to be feasible and accessible for delivering the treatment to the patients. The study confirmed that both ICBT face-to face CBT were equally effective in reducing depression and anxiety of the patients.

Abstract Aim Little is known about the link between spiritual well‐being and health promotion behaviours in pregnant women. The study aimed to explore the direct and indirect effects of spirituality on health promotion behaviours with the mediatory roles of pregnancy stress, anxiety and coping ways. Design Cross‐sectional. Methods Two hundred women aged above 18 years completed Spiritual Well‐Being scale (SWBS), State‐Anxiety Inventory (SAI), Promoting Lifestyle Profile (HPLP), Prenatal Coping Inventory (Nu‐PCI) and Revised Prenatal Distress Questionnaire (NuPDQ). Results Spirituality directly and negatively affected the state anxiety (β = −.41; p

Abstract Background and Aims Although previous studies have reported some psychological factors to prevent the worry of vaccination against COVID‐19 in pregnant women, the role of psychological self‐care is unclear. The present study aimed to investigate the role of psychological self‐care in pregnant women on the depressive symptoms, psychological distress, and worry of vaccination against COVID‐19. Methods The present cross‐sectional study was conducted during the peak of the Delta variant of COVID‐19 in Babol city (North, Iran) from August to November 2021. Two hundred pregnant women referring to three prenatal clinics completed five questionnaires including; demographic characteristics, Edinburgh postnatal depression scale, psychological self‐care, brief symptom inventory 18, corona disease anxiety scale, and acceptance of vaccination‐3 inventory. Results Pregnant women were in relatively good condition based on psychological self‐care but were not significantly associated with demographic characteristics, such as age, gestational age, educational background, pregnancy, and risk of parity. It was psychological self‐care of pregnant women which negatively predicted the depressive symptoms (β = −0.311, p

Objectives: The study investigated the role of social capital, self-efficacy, and depression as determinants of stress during pregnancy. Materials and Methods: In a cross-sectional study, 200 low-risk pregnant women with at least 5 years of education and ages 18 or more were enrolled in public obstetric clinics of Babol University of Medical Sciences. The participants completed four questionnaires including Social Capital, Revised Prenatal Distress Questionnaire (NuPDQ), Perceived Stress, and General Self-efficacy. Results: Women at late phase of pregnancy had lower mean scores of total social capital (61.5 ± 17.1 vs. 47.1 ± 18.1) and self-efficacy (60.1 ± 9.7 vs. 55.1 ± 15.2) compared to those at early pregnancy. Social capital was the negative independent variable associated with pregnancy-specific stress in the adjusted model (β = −0.418, P = 0.020). Both social capital (β = −0.563, P ≤ 0.001) and self-efficacy (β = −0.330, P ≤ 0.001) were negative independent variables associated with general stress. Conclusions: Our findings suggest that health professionals should note the benefits of social capital in stress management and encourage women in establishing stronger relations and neighborhood environments during pregnancy.

Abstract Background Shared Decision Making (SDM) is as ideal model for resident-patient relationship which may improve medical outcomes. Nevertheless, predictive psychological factors influencing residents’ perspective regarding SDM are unclear. The current study investigated the relationship between two psychological factors, mental health and personality traits, and residents’ views toward SDM. Method In a cross-sectional study, 168 medical residents of the Babol University of Medical Sciences studying in 13 field specialties were recruited. The residents completed three questionnaires including Shared Decision-Making Questionnaire (SDM-Q-Doc, physician version), General Health Questionnaire (GHQ-12), and Big Five Personality (NEO-FFI). Results Residents had an overall agreement of about 88% regarding SDM with patients. There was no significant difference between male and female residents in terms of the degree of agreement for SDM. Concerning SDM, there was no significant relationship either between residents’ views and neuroticism, extraversion, agreeableness, and conscientiousness. In multivariate regression, mental health did not predict the SDM, but openness to experience negatively predicted residents’ views concerning SDM (β = − 0.388, p

Background & aim: Sexual self-concept is a cognitive perspective of humans towards their sexual aspects, which reflects their thoughts, feelings, and functions about themselves as sexual creatures and could be a predictor of sexual outcomes. This study aimed to investigate the predictive role of sexual self-concept about marital satisfaction and sexual function in reproductive-aged women. Methods: This correlational study was conducted on 707 married women (aged 15-49 years) in Sari, North of Iran, in 2016. The subjects were selected by systematic sampling. The data were collected using Snell Multidimensional Sexual Self-concept Questionnaire, ENRICH Marital Satisfaction Scale, and Rosen Female Sexual Function Index. Data analysis was performed using Pearson correlation coefficient, independent t-test, ANOVA, and linear regression tests in SPSS software (version 16.0). Results: The positive domain of sexual self-concept had the maximum mean score (130.38±19.71). In this domain, the maximum score belonged to motivation to avoid risky sex. The negative domain of sexual self-concept (9.10±9.16) had the minimum score, with sexual monitoring having the maximum score. The results of the linear regression model showed that sexual self-concept could predict 43% and 36% variances of marital satisfaction and female sexual function, respectively. Conclusion: This study facilitates the conceptualization of sexual health issues. Based on the findings, it is recommended to pay attention to the transactional correlation of sexual self-concept with marital satisfaction and sexual function in primary healthcare settings.

Abstract Purpose This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high‐risk pregnancy. Design and Methods In this cross‐sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53‐items (BSI‐53), and the BSI‐18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. Results The usual cutoffs (≥13 for EPDS, T‐score of 63 for BSI‐53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI‐53, and GSI = 0.5 for BSI‐18. Practice Implications The use of psychological tools among pregnant women with high‐risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.

Background: Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City. Methods: This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data. Results: The prevalence of depressive disorders was 15.4%% for Edinburg scores ≥13. The overall rate of maternal psychiatric symptoms (global severity index or GSI scores ≥ 1.75) was 48.5%. The prevalence of psychiatric symptoms was high; for 25% somatization, 258% anxiety, obsession-compulsion disorders or OCD 6.4%, 8.8% interpersonal sensitivity, 5.3% phobia, 7.6% paranoid ideation, and 1.2% psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (β=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17). Conclusion: The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women.

Background: Various treatment methods are used to deal with sexual problems. Objective: This study was applied to answer the question of whether psychosexual therapy (PST) can be a reliable alternative to bupropion extended-release (BUP ER) to promote sexual function in infertile women. Materials and Methods: In this randomized clinical trial, 105 infertile women with sexual dysfunction were randomly allocated to three groups: PST, BUP ER, and a control group. The PST group participated in a total of eight 2-hr group sessions. In BUP ER group, 150 mg/day Bupropion ER was administered for eight weeks. The control group did not receive any interventions. The female sexual function index (FSFI) and a clinical interview were used to assess their sexual dysfunction. Results: The mean pre-to-post treatment scores of FSFI and its subscales increased significantly in PST and BUP ER groups (except in the subscale of sexual pain) (p = 0.0001, p = 0.0001). The changes in the subjects were not significant in the control group. After adjusting for the baseline values, the results remained significant for the mean FSFI (p = 0.0001), and its subscales between the groups. Compared to the control group, a significant increase was observed in the mean FSFI (p = 0.0001, p = 0.002) and its subscales in the PST group and in the BUP ER group (except in the subscale of sexual pain). Comparison of two intervention methods showed that PST had the better effect on the sexual function improving (p = 0.0001) and its subscales (exempting the subscale of orgasm) than BUP ER. Conclusion: PST can be considered not only a reliable alternative to pharmacotherapy; it also produces better results in terms of improving sexual function in infertile women.

Background: There are no proper tools for measuring pregnancy-specific stress in Iranian population. The aim of this study was psychometric evaluation of the Persian version of Revised Prenatal Distress Questionnaire (NuPDQ) for the first time in Iranian society. Materials and Methods: In a descriptive-analytic study, 269 pregnant women completed the NUPDQ at Obstetrics clinics of Mazanderan Province, Iran. The reliability of the 12-item NuPDQ and 17-item NuPDQ was reevaluated using Cronbach's alpha and internal consistency. Concurrent validity was assessed using the Spielberger state-anxiety Inventory. Moreover, exploratory factor analysis was used to assess the structural factors of the questionnaire. Results: Factor analysis revealed that the 12-item NuPDQ consisted of four areas in the second trimester including medical and financial problem, physical symptoms, infant health, and parenting with the explained variance of 64.15%. The Persian version of 17-item NuPDQ consisted of 5 areas in the third trimester, including medical and financial problems, physical symptoms, infant health, parenting, and labor and delivery with an explained variance of 61.94%. In addition, interclass correlation coefficient in all 4 areas and overall scale score exceeded 0.90. Finally, the reliability was high based on Cronbach's alpha of 0.78 for 12-item NuPDQ and 0.79 for 17-item NuPDQ. Conclusions: The Persian version of 12-item NuPDQ in the second trimester and 17-item NuPDQ in the third trimester, as well as all the extracted subscales, had a good validity and reliability for assessing pregnancy-specific stress in Iranian society and can be used in clinical practice.

Background Infertile females experience some types of distress such as social stress, depression, and sexual dys- function that may be exacerbated by polycystic ovary syndrome (PCOS). The current study aimed at comparing psychological profile of infertile females with PCOS with that of women without PCOS with respect to four domains: infertility stress, depression, sexual dysfunction, and alexithymia. Materials and Methods The current case-control study was conducted on 240 infertile females (120 with PCOS and 120 without PCOS) in Fatemeh Azahra Infertility and Reproductive Health Research Center (Babol, Iran) from 2016 to 2017. The following questionnaires were used to collect data: the fertility problem inven- tory (FPI), the female sexual function index (FSFI), the Beck depression inventory-II (BDI-II), and the Toronto alexithymia scale (TAS-20). Results Females with PCOS had higher FPI total scores than the ones without PCOS (120.68 ± 29.42 vs. 112.83 ± 30.94). Of the subscales of infertility stress, the mean scores of social stress and rejection of a future life without a child were higher in females with PCOS than the ones without PCOS (P < 0.05). Also, the mean total scores of alexithy- mia symptoms (TAS-20) in females with PCOS were significantly higher than those of the ones without PCOS (59.83 ± 11.36 vs. 55.69 ± 11.52). There was no significant difference between the two groups regarding the mean scores of depression symptoms and sexual function. Conclusion Infertile females with PCOS experienced higher levels of infertility stress and inability to distinguish and describe their feelings compared with the ones without PCOS. It is suggested that infertility care providers should provide more psychosocial support for infertile females with PCOS.

Background and purpose: Physiological changes in pregnancy cause profound challenges to mental health. The aim of this study was to investigate the effect of counseling based on Information-Behavioral Motivation Model on health promoting lifestyle behaviors and psychological well-being in overweight and obese pregnant women. Materials and methods: This randomized clinical trial was performed in 137 pregnant women with a BMI ≥25 and 12 to 16 weeks gestational age. The participants were divided into two groups of counseling (n=67) and routine care (n=70). The counseling group attended four sessions of counseling based on the Information-Behavioral Motivation Model, while the other group received routine care. Demographic information was recorded and Health-Promoting Lifestyle Profile [HPLP II] and Ryff's Psychological Well-being scale were completed before and 8 weeks after the intervention. Descriptive and inferential tests, ANOVA, and Multivariate Covariance Analysis (MANCOVA) were used to analyze the data. Results: Using the ANCOVA and MANCOVA test after adjusting the pre-intervention scores in both groups, the mean scores for health-promoting lifestyle behaviors and psychological well-being were found to be higher in intervention group compared to those in the group that received routine care (158.72±24.15 vs 141.29±24.88, P