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Background: Due to numerous social, economic, and cultural barriers, the sexual health needs of women with physical disabilities are not prioritized. The aim of this scoping review is to identify the unmet sexual health needs of women with physical disabilities. Methods: Scopus, Cochrane Library, Pub Med, Google Scholar, and Web of Science were searched from 2006 to March 2023. English peer-reviewed and grey literature sources were included. The primary search yielded 73 articles. Finally, 20 articles were analyzed using narrative synthesis for qualitative appraisal and data analysis. Results: From the 20 selected articles, four unmet sexual health needs were identified: (1) unmet need for family planning and prevention of unplanned pregnancy, (2) unmet need related to genital tract infections, sexually transmitted infections, and HIV/AIDS, (3) unmet need related to sexual dysfunction, and (4) unmet need related to exposure to sexual violence. Conclusion: In many comprehensive health centers, which are supposed to provide reproductive and sexual health services, the needs of patients with physical disabilities are not specifically considered. Instead, their needs are treated like any other woman's. Because there is no integrity in the provision of health services to women with physical disabilities, there is a gap in the identification of needs and provision of sexual health services to these women. Evidence shows that physical disability can affect a woman's whole sexual life and that patients need specific sexual health services.

IntroductionThe Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is a 14-item measure designed to assess a mother's confidence in successful breastfeeding of her baby. This study aimed to determine the confirmatory factor analyses (CFA) and responsiveness to change of the Persian version of the BSES-SF.MethodsThis study was performed in two phases: In the first phase, 400 women were recruited, and then in another phase, 110 pregnant women at 35–37 weeks gestation were randomly selected and assigned into two equal groups (n= 55). Educational intervention was implemented, and data were gathered in the third trimester and at 2 weeks postpartum.ResultsThe BSES-SF presented a one-dimensional structure with factor loadings of > 0.40 for CFA and Cronbach's alpha coefficient of 0.92. BSES-SF scores in the intervention group (56.76 ± 4.65) were significantly higher than the control group (48.94 ± 4.85).ConclusionBSES-SF can be a valid, responsive, and reliable measure of self-efficacy in response to breastfeeding challenges.

ABSTRACTSchools have the potential to be key settings for promoting health literacy, provided teachers are health literate. To this end, it is critical that pre-service health literacy curricula can adequately prepare teachers to meet the health literacy needs of future generations. In this study, we bring into focus the elements of a health literacy curriculum design, using the Dialogue Education approach. In an iterative process, qualitative inquiry methods were applied to develop the components of a dialogic health literacy curriculum for pre-service teacher education in Iran. The research design included two focus groups interviews with pre-service teachers, 12 face-to-face interviews with an expert panel, and a qualitative survey with 228 practicing teachers in Tehran. Data were analysed using thematic analysis, wherein they were coded and categorised in predetermined themes according to Vella’s [2008. On teaching and learning: Putting the principles and practices of Dialogue Education into Action. San Francisco, CA: Jossey-Bass] curriculum components. This paper focuses on the processes undertaken in the development of a dialogic health literacy curriculum. The curriculum is characterised by a focus on the educational needs of the learners, positioning teachers as health promotion agents and providing neophyte teachers with a range of pedagogic resources for developing key health concepts.

ObjectiveTo assess the relationship between spiritual well-being and health-related quality of life (QOL) among patients with spinal cord injury (SCI).SettingBrain and SCI Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.MethodsThis was a cross-sectional study. A sample of patients with SCI participated in the study and completed two questionnaires: the Short-Form 36-Item Health Survey (SF-36) in order to collect data on vitality, social functioning, mental health and role emotional and the Spiritual Well-Being Scale (SWBS) to measure religious and existential well-being. The association between spiritual well-being and health-related QOL was then assessed.ResultsIn all 213 patients were studied. The mean age of patients was 43.5 (SD = 10.8) years, and most were male (77.5%). The results obtained from generalized linear regression analysis indicated that religious well-being and existential well-being were significant contributing factors to improved vitality, social functioning, mental health and role emotional.ConclusionThe findings suggest that having higher levels of spiritual well-being might improve quality of life in people with spinal cord injury.

Objective Quality of life (QoL) in breast cancer patients is still an important topic. Despite numerous quantitative scales, qualitative studies can help to in-depth understand the QoL of breast cancer patients. The purpose of this systematic review was to integrate qualitative studies on the QoL of women with breast cancer.Methods A literature search was performed in electronic databases including PubMed, Scopus, and Web of Science from January 1, 2010 until June 28, 2022 to find out qualitative studies assessing breast cancer patient’s QoL. Two authors independently evaluated methodological quality according to the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were extracted and reported by themes for cancer-free women and patients with metastatic cancer separately.Results In all, 1565 citations were retrieved. After removing 1387 duplicate and irrelevant papers, the full texts of 27 articles were reviewed and finally, 9 were eligible for evaluation. In quality checking of the citations, all articles gained the required quality score. After examining and merging similar topics, nine major themes were extracted. Physical, spiritual, and psychological aspects of QoL were the common issues in cancer-free women (before and after the COVID-19 pandemic) and patients with metastatic cancer. Perception of cancer and social life were the other main concerns in cancer-free women, whereas, in metastatic patients’ overall survival and planning for the future and their children’s life was the focus of interest. Women with metastatic disease showed more vulnerability in coping compared to cancer-free women.Conclusion This review provides an opportunity to have a closer look into the several domains of QoL in women with breast cancer. In-depth information provided by this review might help to develop interventions for patients and their families to support women to cope much better with their life challenges.

Objectives Substance-dependency is a significant health problem that might affect couples’ relationships and lead to several complications such as burnout. This study aimed to assess and compare couple burnout in women with and without substance-dependent partners.Methods In this cross-sectional study samples of women with and without substance-dependent partners were studied. Couple burnout was assessed using the Couple Burnout Measure (CBM). The data then were compared between the study groups by performing descriptive statistics, independent t-test, and chi-square. Logistic regression analysis was carried out to examine the association between couple burnout and independent variables.Results In all 264 women with (n = 121) and without (n = 143) substance-dependent partners were studied. Couple burnout was assessed using the Couple Burnout Measure (CBM). There were significant differences between both groups in most characteristics. The mean score of couple burnout in women with and without substance-dependent partners were 3.8 ± 1.2 and 2.6 ± 0.85 respectively (p < 0.001). In logistic regression analysis, the probability of couple burnout in women with substance-dependent partners was 4.5 times more than those without substance-dependent partners (OR = 4.50, CI = 2.48-8.17, p < 0.001).Conclusion The findings showed that women with substance-dependent partners might suffer from higher couple burnout. Indeed, implementing appropriate interventions such as educational and counseling programs in health centers and substance abuse treatment centers is recommended. In fact, the current study highlights the extra burden that women with substance-dependent partners experience.

The theory of reasoned action (TRA) is one of the most common models in predicting health-related behaviors and is used more often in health education studies. This study aimed to add two control constructs (perceived behavioral control – PBC and self-efficacy – SE) to the TRA and compare them using the structural equation modeling (SEM) for substance use avoidance among Iranian male adolescents in order to find out which model was a better fit in predicting the intention. This was a cross-sectional study carried out in Tehran, Iran. Data were collected from a random sample of high school male students (15–19 years of age) using a questionnaire containing items related to the TRA plus items reflecting two additional constructs (SE and PBC). In all, 433 students completed the questionnaires. The results obtained from SEM indicated a better fit to the data for the TRA with SE compared to the TPB (TRA with PBC) and TRA (χ2/df=2.55, RMSEA=0.072, CFI=0.96, NFI=0.94, NNFI=0.95, SRMR=0.058). Comparing SE and PBC, the results showed that self-efficacy was a better control construct in improving the TRA and predicting substance use avoidance intention (41%). The TRA with SE had a better model fit than TPB and the original version of the TRA.

AbstractThe compositions of the essential oils of leaf, flower and stem of Melissa officinalisL. were analyzed by GC-MS. Twenty-seven volatile components in the leaf oil, twenty-eight components in the flower oil, and thirty five components in the stem oil were identified. The main constituents of the leaf oil were: β-caryophyllene oxide (27.8 %), geranial (21.3 %), neral (12.9 %), β-caryophyllene (8.0 %) and geranyl acetate (5.6%); while the major components of the flower oil were: geranial (27.4 %), neral (18.0 %), β-caryophyllene (15.6 %), β-caryophyllene oxide (7.5 %) and E-cadina-1(6),4-diene (7.1 %). The main constituents of the stem oil were: n-hexadecanoic acid (47.4 %), (Z,Z)-9,12-octadecadienoic acid (14.9 %), dodecanoic acid (4.6 %), β-caryophyllene (4.2 %) and geraniol (2.2 %). Oils of the leaf and flower were almost completely composed of mono- and sesquiterpenoids, while oil of the stem is mainly consisted of the saturated and unsaturated fatty acids as well as some normal saturated hydrocarbons along with minor quantities of volatile terpenoids.

Life-threatening illnesses and subsequent hospitalization in the intensive care unit (ICU) often occur unexpectedly. In many cases, this event is devastating for families and may lead to emotional stress, anxiety, and fear. To offer comprehensive and high-quality nursing care, critical care nurses not only provide critical care to patients but also attend to the psychological and social needs of patients and their families.

Abstract: Purpose: Existing data show a rising prevalence of overweight and obesity among Iranian adolescents. The current study investigates adolescents’ perceptions regarding overweight/obesity and explores barriers to a healthy life style among Iranian adolescents. Methods: A grounded theory approach was used for analyzing the participants’ experiences, and their perceptions. To collect data, semi-structured focus group discussions and in-depth interviews were conducted with 51 adolescents (27 girls and 24 boys), aged 15–17 years, who were either overweight or obese. Qualitative content analysis of the data was conducted manually and differences in coding were resolved via discussion by four independent reviewers. Results: Two main barriers, personal and environmental emerged from data analysis. Positive perception of condition, priority of studying, lack of willingness, unsatisfactory results, low self-esteem, and perceived lack of control were the major personal barriers while lack of family and cultural support, inadequate education and scarcity of resources were the common environmental barriers to adolescents’ healthy lifestyles. Conclusions: Findings demonstrated the main personal and environmental barriers for a healthy life style as perceived by adolescents. Understanding these barriers might contribute to existing literature by providing evidence from a different culture, and help to design effective preventive strategies, and implement appropriate interventions.

Abstract: Objectives: To assess subjective quality of life of an Iranian general population sample.Methods: This was a population-based study. Quality of life was measured using the WHOQOL-BREF. The associations between socio-demographic variables and quality of life were assessed by both univariate and multivariate analyses. Results: In all, 1,164 individuals were studied. The mean age of the participants was 37.6 (SD = 13.2) years, and the mean score for quality of life domains (physical, psychological, social relationship and environment domains) was 14.3 (SD = 2.6), 13.4 (SD = 2.6), 13.9 (SD = 2.6), and 12.3 (SD = 2.4), respectively. The results obtained from univariate analysis did not show a consistent pattern for association between demographic variables and quality of life domains. However, multivariate regression analysis showed that self-reported health condition was the most significant contributing factor to the decreased scores for all domains. Conclusions: Overall, quality of life scores were found to be low among an Iranian general population and greatly varied by socio-demographic variables. In addition, self-reported health condition was found to be the strongest factor affecting people’s quality of life.

Objective— Improving the quality of life (QoL) in patients with coronary artery disease (CAD) requires the determination of the risk factors that have an impact on physical functioning and mental health. The present study sought to determine the risk factors influencing QoL in patients with CAD and to assess the relationship between preoperative QoL and early outcome of CABG.Methods and results— The SF-36 questionnaire was completed through interviews with 275 consecutive patients who underwent isolated CABG in the Tehran Heart Centre between May and-09-2006. The present study measured the two scores of physical and psychological component summary scores and assessed their relationships with preoperative characteristics and postoperative complications. The mean scores of physical and psychological components were 65.78 ± 24.13 and 67.72 ± 20.55, respectively. Diabetes mellitus (P= 0.007), family history of CAD (P= 0.032), low education level (P= 0.015), high Euroscore (P= 0.022), and high functional class (P< 0.001) were the main predictors for the low physical score of QoL. In addition, female gender was associated with a low QoL psychological score (P< 0.001). However, the elderly patients had a higher psychological score in comparison with the younger ones (P= 0.032). No relationship between the studied postoperative complications and preoperative psychological and physical scores was found.Conclusions— Female gender and lower age show specific influences on the patients’ mental health. Our findings also indicate a major direct influence of general risk factors for CAD and education level on CAD patients’ physical functioning before CABG. Nonetheless, preoperative QoL does not influence the postoperative complications.

This was a cross-sectional study to examine the association between anxiety, depression and quality of life and the use of complementary and alternative medicine. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS), and quality of life was measured using the global quality of life subscale selected from the European Organization for Treatment and Research of Cancer (EORTC) quality of life core questionnaire (QLQ-C30). In all, 177 breast cancer patients were studied, and 32% (n=57) reported that they used or were using complementary medicine. Users and nonusers did not differ significantly in almost all variables studied, with the exception of duration of their diagnosis. The most commonly used complementary medicine was prayer and spiritual healing (n=45, 73.8% of responses). Performing the logistic regression analysis controlling for age, marital status, educational level, knowledge of diagnosis, time since diagnosis, global quality of life, depression, and anxiety scores, the results indicated that the use of complementary medicine among breast cancer patients was associated with sever depression (odds ratio 2.49, 95% CI 1.06–5.89, P 0.04). The other variables studied did not show any significant results. The study findings confirm that the use of complementary medicine is more common among depressed breast cancer patients and might be a marker of greater psychological distress in this group of patients.

A prospective study was designed to investigate the factors predicting fatigue in breast cancer patients using the Cancer Fatigue Scale (CFS) in addition to the Hospital Anxiety and Depression Scale (HADS) and a questionnaire containing items on demographic and clinical data, and measures of patients' physical symptoms. The CFS measures total fatigue score ranging from 0 (lowest level) to 60 (highest level) and contains three subscales namely: physical, affective and cognitive fatigue. The questionnaires were administered to a consecutive sample of breast cancer patients attending the Iranian Center for Breast Cancer either for their treatment or follow-up examination. In all, 112 patients were studied. The mean age of the respondents was 45.7 years (SD11.0). Most had stage II breast cancer (67%) and had completed their initial treatment (45%). The mean total fatigue score of the patients was 18.7 (SD 13.5) and overall 49% reported experiencing fatigue to some degree (from quite a bit to very much). Severe anxiety and depression was reported by 16% and 32%, respectively. The regression analysis revealed that fatigue was predicted by depression ( P=0.003), pain ( P=0.005), current tamoxifen use ( P=0.001), undergoing mastectomy ( P=0.03) and anxiety ( P=0.04). The other variables studied did not emerge as significant predictors of fatigue in the regression analysis. The study findings suggest that in comparison to treatment factors, physical and psychological symptoms have a more important role in cancer-related fatigue and that fatigue should be recognized and managed even before commencing breast cancer treatment.

This study was carried out to examine the status of cancer patient education in Iran. Using the Multinational Association of Supportive Care in Cancer's (MASCC) patient education questionnaire, 310 individuals – a sample of heterogeneous cancer patients (n=167) and their relatives (n=143) – were enrolled in the study. The pooled results indicated that only 15% of respondents believed more than 80% of cancer patients were told of their diagnosis. In contrast, 30% of respondents thought less than 20% of patients knew their cancer diagnosis. When asked, "Were you given written materials about (i) cancer, (ii) treatment, and (iii) symptom management", the vast majority of respondents said "No" (91%, 87%, and 87%, respectively). When respondents were asked, "Would you like to learn more about cancer and treatments", 97% said "Yes". Most respondents indicated the need for information on the treatments available (27%) and general information about cancer (20%); most had sought information from health professionals (31%), other cancer patients and friends (29%), and television (22%). Finally, it was found that concern about patients' depression (17%), lack of printed materials (13%), the idea that it was better for patients not to know (12%), and families' requests not to tell the patient (11%) were the most frequently stated barriers to or reasons for restricted cancer patient education. The findings of the study suggest that cancer patient education in Iran is very poor and there is an urgent need to develop policy guidelines on disclosure of cancer diagnoses and patient education.

Given that lung cancer is one of the common cancers world-wide, the implications of focusing on quality of life as well as survival require to be understood. We have carried out a study of the relationship between survival and quality of life in patients with lung cancer comparing patients those who lived with those who died within 3 months. The design of the study allowed every patient in a defined geographical area with a potential diagnosis of lung cancer to be studied from first outpatient consultation till after a definitive treatment has been given. Quality of life was measured using three standard questionnaires: the Nottingham Health Profile (NHP), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ–C30) and its lung cancer supplementary questionnaire (QLQ–LC13) in addition to a study specific questionnaire collecting data on demographic, social, clinical and performance status. The contribution of quality of life in relation to survival adjusted for known prognostic factors was determined using Cox's proportional hazard model. In all 129 lung cancer patients were interviewed, and 96 patients were alive at 3-months follow-up. Only 90 of 96 patients alive at 3-months follow-up were assessable. Descriptive analyses showed that those who were dead had more perceived health problems, greater level of symptoms and significant lower physical and role functioning and global quality of life at presentation. On the other hand, univariate analyses showed that patients’ aggregate scores on the NHP, the functioning scores, and global quality of life scores alone were significant predictors of survival (P<0.03, P<0.04, P<0.04, respectively ). The multivariate analyses showed that pre-diagnosis global quality of life was the most significant predictor of the length of survival even after adjusting for known prognostic factors (age, P<0.04; extent of disease, P<0.03; global quality of life, P<0.02), while performance status, sex and weight loss were not. This study confirmed that pre-diagnosis quality of life was a significant predictor of survival. Indeed, pre-diagnosis quality of life should be considered as a clinical status which has to be established by physicians before treatment starts as it is such an important predictor of survival.