فهرست مطالب maryam modarres

Reproductive-aged breast cancer (BC) survivors have different ideas regarding the experience of motherhood after cancer treatment. Some BC survivors considered motherhood a miracle of God, an unexpected pleasant event, and an incredible opportunity to return to everyday life before a cancer diagnosis. Against these positive aspects of motherhood, the transition to motherhood responsibilities accompanied by the fear of cancer recurrence and becoming an ill mother are some challenges among survivors. Also, fear of losing the ability to breastfeed due to mastectomy, fear of not devoting enough energy to care for the newborn, and meeting the infant or other child’s needs were the most common challenges of BC survivors after childbirth. Motherhood in BC survivors is associated with negative attitudes and fear toward death and breastfeeding. To increase the happiness and psychological well-being among these women regarding motherhood, considering the multidimensional supportive program and survivorship care after treatment regarding fertility issues lead to converting motherhood as an opportunity and hope for these women after experiencing a complicated treatment process.

Recognizing workplace violence, especially in midwifery centers, is one of the serious issues worldwide. So, providing background information on violence against midwives is necessary for proper planning and policy-making. This study aimed to determine the status of verbal and physical violence against midwives working in public hospitals in Tehran in 2021.

Methods & Materials: 

This cross-sectional study was performed on 370 midwives working in public hospitals from February 2021 to July 2021 in Tehran. After 2-stage cluster sampling in selection of the hospitals, ten teaching hospitals with obstetrics and gynecology wards were included in the study and midwives working in the obstetrics and gynecology wards were included based on convenience sampling and according to the inclusion criteria. The data was collected using the workplace violence questionnaire of Rahmani and colleagues which its reliability and validity were also evaluated and confirmed in this study. Data were analyzed in SPSS software version 22 using an independent t-test.

Overall, 41.4 percent of midwives reported experiencing verbal violence and 7.3 percent reported physical violence at work in the last 12 months. Physical and verbal violence were mostly committed by patients (70.4 percent) and then by their companions (52.9 percent), respectively.

Verbal violence is the most dominant violence perpetrated by patients and their companions in midwifery workplaces. Therefore, establishing a formal violence reporting system and teaching how to deal with occupational violence by hospital officials is essential.

Infertility is one of the main problems of the family and is one of the factors that determine the identity and personality of Iranian infertile women. Family-centered empowerment model is a step toward increasing the self-efficacy of patients and enabling them to take responsibility of their illness. This study aimed to determine the effectiveness of applying family-centered empowerment model on irrational thoughts of Iranian infertile women.

This study was a randomized clinical trial conducted on 80 infertile women and their husbands that were randomly divided into two intervention and control groups. Irrational Parenthood Cognitions questionnaire was given to the intervention and control groups to complete before and 3 months after the intervention. Data were analyzed using SPSS Statistics for Windows, version 13.0 (SPSS Inc., Chicago, IL, USA).

The mean (SD) of irrational thoughts’ scores in the control group before and after the study were 33.92 (5.98) and 33.20 (6.83) respectively, and in the intervention group were 34.55 (5.61) and 19.97 (3.52), respectively. The result of independent t-test showed a significant reduction in irrational thoughts of women in the intervention group after the family-centered empowerment model intervention.

The family-centered empowerment model after three months of continuous implementation was able to effectively reduce the irrational thoughts about having children in infertile women.

Due to the high prevalence of vitamin D deficiency, especially in lactating women and the importance of self-care of these mothers to ensure adequate concentration of vitamin D, this study was performed with aim to determine the effect of vitamin D supplementation with self-care on its serum level in lactating mothers.

This randomized clinical trial study was performed in 2019 on 70 lactating mothers with serum vitamin D deficiency (D3 <30 ng / mL) referred to the health centers in Takab city. Concentration of 25OHvit. D3 Serum of all mothers was measured twice at baseline and 3 months after the end of intervention. By block randomization sampling method, the subjects were divided into two groups of 35 people (experimental and control). Self-care training was conducted for the intervention group in 4 sessions, with 7 days interval, in face to face form and telephone follow-up. Data were analyzed by SPSS software (version 16) and independent t-test and Mann-Whitney test. P<0.05 was considered statistically significant.

The two groups were homogeneous in demographic variables before the intervention. There was significant increase in vitamin D3 concentration in the intervention group compared to the control group after self-care training (p <0.001).

In addition to prescribing a vitamin D-rich diet to lactating mothers, sels-care and psychological induction of self-care behaviors are effective in taking vitamin D supplements in breastfeeding mothers.

Cognitive therapy training reduces the negative thoughts of pregnant women and increases the likelihood adapting to normal delivery. 

The purpose of this study was to investigate the effect of mindfullness based cognitive therapy on the self-efficacy of pregnant women in adapting to with normal vaginal delivery.

This research was a quasi-experimental pretest-posttest study with a control group. The statistical population includes all pregnant women reffering to Kamali Hospital and Karaj Health centers affiliated to the Alborz University of Medical Sciences from January 2020 to July 2020 and the sample includes 80 pregnant women who selected by purposeful sampling method. Both groups completed the CBSEI-Standard Birth self-efficacy questionnaire before and immediately after the intervention. Data analyzed with Covariance by SPSS-25.

The mean self-efficacy for delivery adjustment increased from 2.99 in the pre-test to 3.08 in the post-test in the control group and in the intervention group from 1.92 to 4.06. After the intervention, a statistically significant increase was observed in the mean score of self-efficacy in coping with normal delivery in pregnant women in the intervention group  (P<0.05) and the effect of the intervention was 0.379.

Cognitive therapy based Mindfulness training increased the self- efficacy of pregnant women in adapting to normal vaginal delivery.

Evaluation is one of the most important tools for determining the quality of any educational program, which can lead to reformation, revision, or termination of programs. Quality in higher education requires assessment and judgment of goals and strategies, executive policies, operational processes, products, and outcomes. The Context, Input, Process, and Product (CIPP) model is a comprehensive perspective that attempts to provide information in order to make the best decisions related to CIPP. Due to the importance of this topic, the present study examined the application of the CIPP model in the evaluation of medical education programs through a systematic review.

In this systematic review, Persian databases including ISC, SID, Mag Iran, CivilicaL, and Noormags and English databases including PubMed, Web of Science, Scopus, ProQuest Dissertations, Embase, CINAHL, ERIC, and Google Scholar were searched using relevant keywords, such as evaluation, program evaluations, outcome and process assessment, educational assessment, and educational measurements. The search was done with no time limits and 41 papers were obtained until May 22, 2020. This systematic review was performed by following the data extraction steps and assessing the quality of the studies and findings. Critical Appraisal Skills Programs and Mixed‑Methods Appraisal Tool checklists were used to check the quality of the papers.

This systematic review was conducted on 41 studies, 40 of which were research papers and one was a review paper. From the perspective of the CIPP model of evaluation, most papers showed quite a good level of evaluation of educational programs although some studies reported poor levels of evaluation. Moreover, factors such as modern teaching methods, faculty members, financial credits, educational content, facilities and equipment, managerial and supervisory process, graduates’ skills, produced knowledge, and teaching and learning activities were reported as the factors that could influence the evaluation of educational programs.

Due to the important role of evaluation in improvement of the quality of educational programs, policymakers in education should pay special attention to the evaluation of educational programs and removal of their barriers and problems. To promote the quality of educational programs, policymakers and officials are recommended to make use of the CIPP model of evaluation as a systemic approach that can be used to evaluate all stages of an educational program from development to implementation.

Psychological health in postmenopausal women is important. For this reason, to enhance their sense of biological happiness, religion-based spiritual therapy has been sought as a way to create happiness. This study was conducted to determine the effect of religion-based spirituality education on the happiness of postmenopausal women.

This randomized interventional study was performed on 70 postmenopausal women in 2019. They were randomly allocated into two groups (35 control and 35 intervention). Spirituality therapy was held in six 90-minute sessions once a week, through interactive lectures, group discussion, brainstorming, memory and storytelling, and feedback. Demographic data and the Oxford happiness questionnaire were used for data collection. These questionnaires were completed by both groups before, immediately after, and one month after the intervention, with the researcher’s presence to answer the research questions. The obtained data were analyzed using the Chi-square, independent t test, and Analysis of Variance (ANOVA) with repeated measure in SPSS 16.

The mean score of happiness in postmenopausal women was significantly higher in the intervention groups immediately (P<0.001) and one month after the intervention (P=0.04) compared to the control group. The effect size of intervention on happiness was 0.123.

Religion-based spirituality education is recommended as a practical and straightforward way to promote the happiness of postmenopausal women. However, further studies are recommended, due to insufficient evidence.

Changing the mental structure of students and identifying creativity inhibitors are essential for academic survival and the pursuit of innovation. This study aimed to identify the inhibitory cognitive factors in medical students.

This study was a directional qualitative content analysis that conducted based on scientific literature review and opinions of experts in a semiformal expert panel by using semi-structured interviews ranging from 20 to 70 minutes from February 2015 to October 2016. Seventeen talented students were interviewed and conversations were recorded with a digital voice recorder at the Exceptional Talent Development Center (ETDC). The extraction and content analysis was continuously done by listening and writing through several times. The students were in various medical disciplines, and most of them were first rank students in scientific performance and they were collaborating with ETDC.

The inhibition variables of creativity were classified in the four main subcategories according to the semantic relationship and after compression, these classes of inhibitory factors included: teacher-related inhibitors, teaching and assessment methods related inhibitors, student barriers and inhibitors of the university's educational system. Finally, 10 codes were extracted from the 4th categories, which were mentioned as inhibitory variables of creativity. The teachers' lack of enthusiasm with the new ideas, the lack of creativity in the academic context and the lack of motivation among the students were the main inhibitors of creativity that were extracted from interviewing with talented students.

In this study, the most important cognitional inhibitory factors in creativity promotion were the inhibitors related to the teacher’s character and his attitude to creativity, methods of teaching and the university environment. Planning for the removal of these barriers in medical students recommended.

Promoting students’ creative thinking with new techniques is important in order to foster innovation in a pleasant educational atmosphere. This study aimed to determine the effect of technical simulation using Goldfish Bowl (GFB) method on creative thinking of midwifery students in Tehran University of Medical Sciences.

During 2015-2016, 70 students in two groups (n = 35 midwifery students in each group) were enrolled in this study and educational intervention was conducted on one of the groups. The intervention was the new GFB method. The students’ creative thinking was assessed using Dr. Abedi’s standardized creative thinking questionnaire in both groups before and after the intervention and in one-month follow-up. The results were gathered and entered into the SPSS software version 16. For data analysis, descriptive and analytical statistical tests were used to compare the scores of three stages of creative thinking, and variance analysis in the intervention and control groups with the significant level of 0.05.

There were no significant differences between the results of the two groups before the intervention. The statistical results showed changes at different levels after intervention, indicating an improvement in the students’ creative thinking. The mean score of creative thinking was 70.71 ± 15.75 before the intervention, 80.40 ± 14.68 at the end of the eighth week of the intervention, and 72.09 ± 14.98 in the follow-up. The effect size of this technique on creative thinking was 0.91 in week 8.

The use of Goldfish Bowl technique in teaching medical students is recommended to promote their creative thinking.

Students' curriculum textbooks play an important role in the formation of their professional identities and their learning. The study of the attitudes of people associated with a profession is necessary to create optimization in education and improve the performance of the individuals involved in it. The purpose of this study is to determine the attitude of midwifery in order to benefit more from midwifery textbooks in midwifery education. Therefore, the aim of this study is to design and assess the reliability and validity of midwifery attitude questionnaire towards midwifery lessons. This is an analytical study. To determine the content validity, the Lavasian table method was used. Acceptance of phrases based on the score of at least 0.62 for content validity ratio and 0.79 for content validity index. For reliability, the questionnaire was completed by 30 midwifery teachers and then reliability was calculated using Cronbach's alpha and acceptance criteria was 0.75. The calculations were performed using SPSS software version 17. According to interviews, 17 terms were determined. The three words were deleted because the content validity ratio was less than 0.62. The average value of the content validity ratio for the remaining terms was 0.83. Cronbach's alpha coefficient was 0.89. The midwives' attitude about midwifery textbooks is a lasting instrument and can measure the attitudes of various midwifery groups such as instructors, students and midwifery graduates to midwifery lessons.

Pain is a common problemamong patients after hysterectomy and patient health status and recovery process is severely affected. Therefore, this study aimed to determine the effect of foot massage on pain of patients after hysterectomy.
This study is a clinical trial with two groups. Sixty patients with hysterectomy were eligible to enter the study by random sampling from two hospitals including Shariati and Valiasr hospitals in Tehran in 2012 (30 interventions, 30 controls)and they were randomly assigned to two groups by drawing a color card. The intervention group received foot massage for 20 minutes once a day during the two consecutive days after surgery. The control group received routine care without intervention. Before and after 30 minutes of intervention or routine care, the pain was measured by visual analogue pain scale (VAS). Data were analyzed by independent t-test, chi-square and Fisher exact test.
It was seen that the mean difference of scores before and after the two sessions of massage in the intervention group was 2.56 and in the control group was 1.01. The result of the comparison of the two groups showed significant difference (P Foot massage can be useful as an effective nursing intervention in controlling pain after hysterectomy.

Hysterectomy is stressful in women operation, due to increased release the level of catecholamines some physiological reactions including increase in breathing, heart rate and blood pressure are clinically observed. Massage therapy helps to improve the nervous and cardiovascular system and modifies physiological responses. This study was done to determine the effect of foot massage on the vital signs of patients after hysterectomy.
In this clinical trial study 60 women underway hysterectomy were randomly divided into intervention (n=28) and control (n=29) groups. Subjects in intervention group were received a 20 minute foot massage according to the mentioned method in two sessions first and second day after surgery, with 24-hours interval. Before and 30 minutes after intervention , vital sign including systolic and diastolic blood pressure, pulse, breathing were recorded for each subject.
In the intervention group, all of the signs of vital signs before and after massage in the first and second days after the operation showed a significant decrease (P Foot massage improves systolic blood pressure and breathing at the first day after hysterectomy, which may indicate an increase in parasympathetic activity.

Sexual self-concept is providing recognition of sexual aspects of each person, which is derived from previous experiences, points out the recent experience and guides the sexual behaviors. The aim of the present study was to evaluate the relation between sexual self-concept and attachment styles in married women who referred to the health centers of Tehran in 2014.
Methods & Materials: This descriptive analytical cross-sectional study was conducted on 365 women of reproductive age (15 to 44 years old) who referred to the health centers affiliated with Tehran University of Medical Sciences. Data gathering tools were demographic characteristics questionnaire, the standard questionnaire for sexual self-concept and the standard questionnaire for attachment. Data were analyzed by SPSS version 16 using descriptive statistics and Pearson correlation coefficient with a significant level of α = 0.05.
Results showed a direct correlation between negative sexual self-concept and anxious attachment (p Considering the direct correlation between positive sexual self-concept and secure attachment and also between negative sexual self-concept and non-secure attachment (anxious and avoidant), it is predicted that by appropriate planning for secure attachment, health sexual behaviors could be reached.

Although vitamin D deficiency has been linked to potential complications in reproductive women, the recommended intake dosage of this vitamin in populations with high incidence of deficiency in preconception period has not been defined.. The study investigated the effect of consuming a dosage of 2000 IU/day oral vitamin D for 105 days, on serum levels of this vitamin in reproductive women.. 229 women with 18-35 years old, who were confirmed to be vitamin D deficient (vitamin D < 75 nmol/L), were randomized into the intervention and control groups and after 15 weeks consumption of the supplement and placebo, their serum samples were obtained.. At baseline the mean serum levels of vitamin D in the control group was 23.34 ± 15.87 nmol/L and in intervention group was 25.13 ± 18.46 nmol/L, that these values didn’t have any significant difference (P = 0.43), while after intervention, significant differences between the two groups was noticed (P < 0.001). The affecting factors to achieve normal range of vitamin D in the intervention group included basal amounts of vitamin D and two underlying factors based on questionnaire data: use of oral supplements (except vitamin D and calcium) in daily life and perfect sun exposure.. This study showed positive effect of the 2000 IU/day oral vitamin D on the serum level elevation of this vitamin in reproductive women..

Dysmenorrehea is one of the most common side effects of IUD. Considering public enthusiasm to the use of herbal medicine and positive effects of cumin on muscle cramps، this study conducted to compare the effects of cumin and mefenamic acid capsules on secondary dysmenorrhea due to IUD. This crossover triple-blind randomized clnical trial study was performed on 100 IUD users who came to 6 health centers in Karaj. Research took place in three stages. In the first stage severity of dysmenorrehea was measured using Visual Analogue Scale (VAS). In the second stage all participants were randomly allocated to mefenamic acid and cumin groups. They took capsules for two consecutive cycle. In the third stage each research unit received the same treatment of the opposite group with replacing the medicine for two more consecutive cycle. Severity of pain was assessed using VAS for 5 cycle. Considering that the maximum efficacy time for cumin was 24 hours and for Mefenamic acid was 6 to 8 hours،the use of drugs in 7 days duringmenstruation،had no effect on subsequent cycles. Data، was analyse by Chi-square and Fisher''s exact test، paired t-test، Wilcoxon،and one way ANOVA. The mean pain intensity before treatment was 4. 28 ± 1. 72 and after treatment was 1. 89 ± 1. 37 and 2. 01 ± 1. 33 in the mefenamic acid and cumin groups. There was a significant difference in decrease of pain intensity in both groups (P<0. 001). There wasn’t a significant difference in decrease of pain intensity between two groups. This study showed that cumin same as mefenamic acid capsules can decrease the severity of dysmenorrehea effectively. Therefore it is recommended to use it in the treatment of secondary dysmenorrhea due to IUD.

Hysterectomy is the second most common major surgery among women of reproductive age. Studies have suggested that women do not usually receive adequate information regarding hysterectomy before the surgery. Depression is a common psychiatric condition diagnosed after hysterectomy. The aim of this study was to assess the impact of pre-hysterectomy counseling on depression among women. Methods & Materials: In this clinical trial، 100 women who had undergone hysterectomy for non-malignant conditionswere selected from two hospitals (women’s’ hospital and Imam Khomeini hospital) and completed the informed consent forms. Participants were randomly divided into two intervention and control groups. In the intervention group، we implemented the supportive counseling within two sessions. Depression was assessed 1-2 weeks before the surgery and two monthsafter the surgery. Data were gathered using the 30-item SAMA questionnaire (modified BECK questionnaire in Iran) for depression and a demographic questionnaire. The two groups were assessed using the Wilcoxon rank-sum test، Mann Whitney U test and paired-t test. Data were analyzed in the SPSS-14. 0. The p-value less than 0. 05 was considered significant forall tests. Mann Whitney U test showed no significant difference between the control and intervention groups in the mean score of depression (p<0. 001). In the intervention group، the mean score of depression was 44. 46 ± 6. 7 at baseline and 20. 86 ± 5. 9 after the intervention. Pre-hysterectomy counseling should be provided for women in order to reduce negative psychological consequences.

Hysterectomy is a common gynecologic surgery leading to great concerns in women. This study aimed to determine the effect of foot massage on anxiety level after hysterectomy. Methods & Materials: In this double-group randomized clinical trial، 60 women undergone hysterectomy were selected using convenience sampling method and were randomly allocated into two intervention or control groups. Patients in the intervention group received foot massage three sessions during three consecutive days (every session lasted 20 minutes). In the control group، the researcher was only beside the women for 20 minutes. The Spilberger anxiety questionnaire was used to measure the anxiety level. Data were analyzed using repeated measures ANOVA and independent t-test. The mean of the anxiety score was not significantly different between the two groups before the intervention (P=0. 21). After the intervention، there was significant difference between the two groups in the anxiety scores (P<0. 001). There was also significant difference between the two groups in the anxiety scores one week after the surgery (P<0. 001). Foot massage can reduce anxiety in patients who underwent hysterectomy.

One of the first‑line assessment tools for fetal surveillance is nonstress test (NST), although it is limited by a high rate of false‑nonreactive results. This study was performed to investigate if external stimulation from vibroacoustic and halogen light could help in provoking fetal responsiveness and altering NST results. This is a clinical trial. Sampling was done from April to July 2010. One hundred pregnant women with nonreactive NST for 20 min were allocated in two groups: Vibroacoustic stimulated NST (VNST, n = 50) who received vibration from a standard fetal vibratory stimulator and halogen light stimulated NST (LNST, n = 50) who received a halogen light source for 3 and 10 sec, respectively. Results were compared together and then compared to biophysical profile (BPP) scores as a backup test. We used Mann-Whitney U test, Chi‑square test, and Fisher’s exact test to compare the variables in the two groups through SPSS version 14. P < 0.05 was considered as statistically significant. Following stimulations, 68% nonreactive subjects in halogen light stimulation group and 62% in vibroacoustic stimulation group changed to reactive patterns. Time to onset of the first acceleration (VNST: 2.17 min; LNST: 2.27 min) and the test duration (VNST: 4.91 min; LNST: 5.26 min) were the same in the two groups. In VNST 89.5% and in LNST 87.5% of nonreactivity followed by score 8 in BPP. There was no significant relation between stimulus NSTs and BPPs. Vibroacoustic and light stimulation offer benefits by decreasing the incidence of nonreactive results and reducing the test time. Both halogen light stimulation and vibroacoustic stimulation are safe and efficient in fetal well‑being assessment services.

Most of the psychological turmoil of marital conflicts is related to sexual dissatisfaction. Sexual satisfaction is influenced by physical and mental illnesses. Pelvic floor muscle relaxation is a major health problem in which prolapsed pelvic floor muscles causes paralysis، pelvic organs'' prolpases، pelvic organs'' dysfunction، dyspareunia، and back pain. The aim of this study was to assess the effect of pelvic floor muscle exercise on sexual satisfaction in primiparous women. Methods & Materials: This clinical trial was conducted among 100 primiparous women selected through cluster randomized sampling from five clinics of Tehran University of Medical Sciences. Samples were randomly divided into two equal groups. The intervention group received pelvic floor exercises (Kegel) for 16 weeks. The control group did not receive any intervention. Data were collected using the Linda Berg questionnaire before the intervention and 16 weeks after the intervention in both groups. Data were analyzed using descriptive statistics and chi-square، t-test in the SPSS v. 18. After 16 weeks، significant differences were reported in the levels of sexual satisfaction in the intervention and control groups (P<0. 001). The Kegel exercises are easy and non-expensive methods that should be offered by health professionals to increase sexual satisfaction in women after childbirth.

Recent research suggests that a proportion of women may develop post-traumatic stress disorder (PTSD) after childbirth. This study aimed to test relationship between cesarean section and vaginal delivery with PTSD after childbirth in Bushehr. This study was an analytic cross-sectional one. Participants were recruited from post-partum women who attended health medical centers in Bushehr (n = 400) and for women with traumatic delivery completed posttraumatic symptoms scale-I (PSS-I) and reproductive questionnaire. Data were analyzed by univariate and multivariate logistic regression. Women with PTSD had higher odds ratio for emergency cesarean section (Odds ratio = 3.55, CI=1.69-8.07) and insufficiency income (Odds ratio=4.50, CI=1.71-11.84). Duration of labor lower than 3 hours (Odds ratio=0.15, CI=0.04-0.55) and higher education level (Odds ratio=0.15, CI=0.04-8.58) were associated with significantly decreased risk for PTSD. Interventions aimed at reducing the incidence of PTSD after childbirth needs further research but it seems that consultation about decreased cesarean section during prenatal care is useful.