Masoumeh Rostami , Abbas Ebadi , Hamid Sharif-Nia , Fidan Shabani , Reza Ghanei Gheshlagh ,
Volume 22, Issue 2 (6-2025)
Abstract
Background: Some men use a nuanced set of attitudes, behaviors, and beliefs referred to as “invisible violence” to exert control over women. Although these behaviors are culturally accepted, they remain risk factors for intimate partner violence. Early detection of invisible violence can prevent domestic violence and its negative consequences. Therefore, this study aimed to evaluate the psychometric properties of the Persian version of the Questionnaire for the Invisible Violence Against Women (Q-IVAW).
Methods: This cross-sectional study was conducted on 520 married women who were referred to health centers in Western Iran (Asadabad) in 2023. Sampling was performed using a convenience sampling method. After forward-backward translation, face, content, and construct validity (through exploratory and confirmatory factor analysis) were conducted. Internal consistency was assessed using Cronbach's alpha and McDonald's omega coefficients and stability was assessed using a test-retest. The data were analyzed using SPSS version 16 and Amos version 26 software.
Results: In the exploratory factor analysis, four factors, including ‘utilitarian-benevolent sexist behaviors’, ‘crisis sexist behaviors’, ‘coercive sexist behaviors’, and ‘ambivalent sexist behaviors’, were extracted using the maximum likelihood method and Promax rotation. Cronbach's alpha for the four factors was 0.803, 0.724, 0.733, and 0.704, respectively. These factors account for 47.17% of the total variance. In confirmatory factor analysis, the final model demonstrated a good fit (CMIN/DF = 2.140, GFI = 0.952, AGFI = 0.932, NFI = 0.924, IFI = 0.958, CFI = 0.958, RMSEA = 0.047).
Conclusion: The Persian version of the Q-IVAW has acceptable psychometric properties and can be used to measure invisible violence in Iranian women.
Faride Majdi , Azizeh Farshbaf-Khalili , Mohammadreza Mirzayi , Parvin Hakimi , Khadije Hajizadeh, Mahnaz Shahnazi ,
Volume 22, Issue 2 (6-2025)
Abstract
Background: Polycystic Ovary Syndrome (PCOS) is one of the most significant reproductive and endocrine disorders in women. This study aims to assess the impact of nettle extract on both clinical and paraclinical symptoms in women with PCOS.
Methods: This Triple-Blind Randomized Controlled Clinical Trial involved 60 women (n = 30 per group) aged 18 to 45, all diagnosed with PCOS based on definitive diagnostic criteria in Tabriz, Iran. Participants were randomly assigned in a 1:1 ratio using block sizes of 4 and 6 into two groups: an intervention group (receiving 500 mg of oral nettle extract containing flavonoids, tannins, and sterols daily for three months) and a control group (receiving combined oral contraceptives [COCs] for three months). Independent t-test and ANCOVA test were used in SPSS version 24 for data analysis. A p-value of <0.05 was considered statistically significant.
Results: The study showed that after the intervention, there were no statistically significant differences between the nettle extract group and the control group regarding mean levels of dehydroepiandrosterone sulfate (P=0.197), total testosterone (P=0.24), follicle-stimulating hormone (FSH) (P=0.549), luteinizing hormone (LH) (P=0.398), hirsutism score (P=0.149), or duration of menstrual bleeding (P=0.982), based on ANCOVA adjusted for baseline values, education level, and number of pregnancies. However, the two groups exhibited statistically significant differences in fasting blood glucose levels (P=0.020), intervals between menstrual bleeding (days) (P=0.031), and menstrual bleeding intensity (P = 0.008).
Conclusion: The findings indicate that nettle extract is as effective as low-dose oral contraceptive pills in reducing levels of dehydroepiandrosterone, total testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), as well as in decreasing hirsutism scores and the duration of menstrual bleeding. Midwives can use nettle extract, which is a cheap, easy, and non-invasive method to improve PCO symptoms.
Asieh Sadat Baniaghil , Kosar Amini , Naser Behnampour ,
Volume 22, Issue 3 (9-2025)
Abstract
Background: Domestic violence is a pervasive issue characterized by a pattern of coercive and controlling behaviors within an intimate relationship. While traditional gendered models often portray males as perpetrators and females as victims, this perspective oversimplifies the complex reality of intimate partner violence (IPV). Research indicates that domestic violence can affect individuals of any gender. Therefore, this study aims to examine domestic violence as it is experienced by both males and females.
Methods: This cross-sectional study investigated 240 cohabiting couples in Gorgan, northern Iran, in 2022. The researchers used a simple random sampling method, facilitated by R software (version 4.4.2) and the national electronic health information system, to identify eligible participants. Participants included females aged 20–49 and their husbands, all of whom had been married for at least two years. Data were collected via the online, self-administered Persian version of the Conflict Tactics Scale 2 (CTS2), which measures the following subscales of conflict: Psychological aggression, physical assault, sexual coercion, and injury. Data analysis included descriptive statistics (mean and standard deviation) and qualitative statistics (frequency and percentage). The Kruskal-Wallis test was employed to compare mean scores between groups, with statistical significance set at P < 0.05.
Results: This study's findings revealed that 52.8% of couples (95% confidence interval [CI]: 40.72–58.45) experienced domestic violence. The research further specified the prevalence of various forms of violence as follows: Bilateral violence: 25% (95% CI: 19.48–30.52), male-to-female partner violence (MFPV): 19.58% (95% CI: 14.53–26.64), and female-to-male violence (FMPV): 7.5% (95% CI: 4.14–10.86). The most frequently reported types of abuse were psychological aggression (male: 5.0 ± 3.48; female: 5.07 ± 3.67) and sexual coercion (male: 2.71 ± 1.8; female: 2.93 ± 2.42).
Conclusion: The results of this study suggest that IPV can be perpetrated by any individual within a relationship, regardless of gender. Consequently, educational initiatives and screening programs should be developed to include both members of a couple, instead of being focused on a single individual. These findings can be utilized by healthcare professionals to develop more comprehensive prevention strategies and to enhance the effectiveness of existing screening protocols for IPV.
Tayebeh Mokhtari Sorkhani, Mahshid Bokaie , Farzan Madadizadeh , Manoj Sharma , Seyed Saeed Mazloomy Mahmoodabad,
Volume 22, Issue 3 (9-2025)
Abstract
Background: The total fertility rate (TFR) has dropped to below the replacement levels in numerous countries, which necessitates new educational approaches and behavioral models to encourage a more positive societal view of childbearing. The present research aims to design, implement, and evaluate an intervention based on the multi-theory model (MTM) aiming at boosting childbearing intentions among Iranian single-child women of reproductive age.
Methods: This mixed-methods study, designed in three phases, will first explore childbearing intentions qualitatively through in-depth interviews, with the resulting data analyzed using a directed content analysis based on the MTM. Second, the themes identified from this phase will then be used to develop and psychometrically validate a new measurement tool. Third, a field trial will be conducted to implement and evaluate an MTM-based educational intervention. Data will be collected with the validated tool both pre- and post-intervention, with follow-ups at three, six, and nine months to assess pregnancy outcomes. The effectiveness of the program and participant feedback will be analyzed via descriptive statistics, paired t-tests for within-group comparisons, and repeated measures analysis of variance (ANOVA) for between-group differences over time. All statistical analyses will be performed using SPSS version 22.
Conclusion: This study represents the first known application of the MTM to investigate childbearing intentions among single-child women. Developing and assessing a culturally-adapted intervention has the potential to boost individuals’ childbearing intentions and generate evidence for guiding reproductive health policies in settings experiencing a decline in fertility.
Nurdan Kaya Yilmaz , Ümmügülsüm Demirci , Tuğçe Söylemez , Hamdiye Alper ,
Volume 22, Issue 3 (9-2025)
Abstract
Background: Emotional violence during pregnancy may negatively affect maternal and fetal health and impair sleep quality. The study aimed to evaluate pregnant women’s exposure to emotional violence and their sleep quality.
Methods: A cross-sectional study was conducted with 262 pregnant women at Samsun Education and Research Hospital in the city of Samsun, Turkey, between February and May 2024. The sample was obtained using simple random sampling. Data were collected using the Sociodemographic and Obstetric Checklist, the Pittsburgh Sleep Quality Index (PSQI), and the Exposure to Emotional Violence Scale (EVS). Data were analyzed using independent samples t-test, one-way analysis of variance (ANOVA) with Tukey’s post hoc comparisons, and all data were analyzed using SPSS v.25. Statistical significance was set at p <0.05.
Results: Spousal violence during pregnancy was reported by 16.0% (CI 95%: 11.5 – 20.5) of participants. The mean (standard deviation) total PSQI score was 5.77 (3.49), and 54.2% (CI 95%, 48.2–60.2) of the pregnant women had poor sleep quality. The mean (SD) total EVS score was 38.80 (13.25), indicating a low level of emotional violence exposure. Pregnant women with poor sleep quality had significantly higher EVS total scores (p=0.020), as well as higher scores in the subdomains of obstruction (p=0.044), humiliation (p=0.046), harm (p=0.021), and verbal abuse (p=0.022).
Conclusion: It was demonstrated that half of the pregnant women had poor sleep quality and were exposed to low levels of emotional violence. Pregnant women with poor sleep quality were found to be more exposed to emotional violence.
Habiba Khanom , Sharmin Hossain , Rabiul Islam , Liton Baroi , Eashmin Akter Rima R , Jannatul Ferdoues Mitu , Chandra Das , Sumaia Afroz , Jannatul Ferdowsy , Aysha Sultana Luvna, Lita Bose , Shukla Sarker , Alamgir Hossain ,
Volume 22, Issue 4 (12-2025)
Abstract
Background: Fear of childbirth (FOC) is a widespread maternal health concern associated with heightened anxiety, increased medical interventions, and negative birth experiences. While prevalent globally, FOC remains underexamined in low-resource settings such as Bangladesh. This study aimed to determine the level of FOC and identify associated factors among pregnant women in Bangladesh.
Methods: A cross-sectional study was conducted among 262 pregnant women attending antenatal care at Shariatpur Government Upazila Health Complex (December 2023–May 2024). Data were collected using a structured questionnaire and the Melender FOC Scale. Participants were selected using a convenience sampling technique. Fear was categorized as low, moderate, or high. Descriptive analysis, Chi-square tests, ordinal logistic regression, and multivariate logistic regression were performed to identify predictors of FOC using SPSS version 25.
Results: A survey of 262 pregnant women revealed a moderate mean level of fear of childbirth (FOC) (47.45 ± 6.9). Regression analysis identified several significant predictors of higher FOC. The strongest associations were with limited spousal support (AOR = 2.64; 95% CI: 1.38–5.06; p = 0.003) and not attending childbirth classes (AOR = 2.33; 95% CI: 1.21–4.49; p = 0.011). Other significant factors included younger maternal age, lower education (in both the woman and her husband), rural residence, and lower socioeconomic status. These findings underscore the multifactorial nature of FOC, highlighting the need for interventions that address its key social and educational determinants.
Conclusion: FOC is highly prevalent among pregnant women in Bangladesh and is influenced by sociodemographic, obstetric, and psychosocial factors. Routine screening, culturally sensitive prenatal education, improved communication, and partner-inclusive support are recommended to reduce FOC and improve maternal outcomes.
Sakineh Nazari, Zohreh Keshavarz, Mohammad Jalal Abbasi- Shavazi, Abbas Ebadi, Seyedeh Mahboobeh Rezaeean, Zohre Abbasi,
Volume 23, Issue 1 (5-2026)
Abstract
Background: Assessing fertility levels is considered one of the most critical indicators in population forecasting and reproductive health research. Therefore, this qualitative study was conducted to explore women’s and experts’ perspectives on childbearing, including the views of healthcare professionals, university faculty members, and sociologists, regarding factors influencing childbearing.
Methods: This qualitative study was conducted in 2025 in North Khorasan Province, Iran. Participants were selected through purposive sampling and included three groups: women with two or fewer children (n = 35), women with more than two children (n = 16), and experts in the field of childbearing (n = 13). Data were collected through in-depth individual interviews and analyzed using MAXQDA 10 software according to conventional content analysis procedures.
Results: Analysis of the participants’ narratives identified four main themes influencing the decision to have more than two children: “gaining power, passive social acceptance, inefficiency of educational and health approaches, and a specific lifestyle pattern.” In contrast, rethinking the value of children and reconsidering fertility emerged as key factors influencing the decision to have fewer than two children.
Conclusion: The findings indicate that fertility preferences are shaped by a complex interplay of social and personal factors. While empowerment, passive social acceptance, ineffective educational and health strategies, and lifestyle considerations tend to promote larger family sizes, reassessment of the value of children and fertility considerations support smaller family choices. These results highlight the need for tailored reproductive health policies and context-sensitive educational interventions to support informed decision-making and balanced population strategies.
Hediye Karakoç , Huriye Altinkaynak , Cenner Nur Bircan ,
Volume 23, Issue 1 (5-2026)
Abstract
Background: Although societal change and evolving family roles shape generational identities, limited research has investigated whether these shifts are reflected in psychosocial adaptation during pregnancy. This study compared marital adjustment, pregnancy acceptance, and maternal role adaptation between pregnant women from Generation Y and Generation Z.
Methods: This cross-sectional study was conducted between November 30, 2022, and February 29, 2023, among 347 married pregnant women in Türkiye (Generation Y: n = 170; Generation Z: n = 177). Participants were recruited from pregnancy-related social media platforms using non-probability convenience sampling. Inclusion criteria were birth between 1980 and 2015, being married and pregnant, being literate, and providing consent to participate. Data were collected online using the Prenatal Self-Evaluation Questionnaire and the Marital Adjustment Test. Independent-samples t-tests, chi-square tests, and multiple linear regression analyses were performed using IBM SPSS Statistics version 27.0 (IBM Corp., Armonk, NY, USA).
Results: In bivariate analyses, marital adjustment scores were higher among Generation Y participants (p = 0.026). However, this association was no longer statistically significant after adjustment for age, duration of marriage, number of pregnancies, employment status, and planned pregnancy (β = -0.148, p = 0.122). No significant generational differences were observed in pregnancy acceptance or maternal role adaptation (p > 0.05).
Conclusion: Initial comparisons suggested a generational difference in marital adjustment; however, this difference was attenuated after adjustment for sociodemographic and reproductive characteristics and was no longer statistically significant. No statistically significant differences were observed between generations in pregnancy acceptance or maternal role adaptation. Because the overall regression model was not statistically significant, adjusted findings should be interpreted cautiously.
Tayebeh Mokhtari Sorkhani, Seyed Saeed Mazloomy Mahmoodabad, Mahshid Bokaie , Manoj Sharma , Farzan Madadizadeh ,
Volume 23, Issue 1 (5-2026)
Abstract
Background: Declining fertility and childbearing are significant public health concerns. The Multi-Theory Model (MTM), which addresses both the initiation and maintenance of behavior, may provide a useful framework for promoting childbearing intentions. However, no validated theory-based instrument currently exists to measure MTM constructs in this context. Therefore, this study aimed to develop and validate a Persian questionnaire based on MTM to assess childbearing intentions among women of reproductive age.
Methods: A cross-sectional descriptive survey was conducted in 2025 with 275 married women recruited from comprehensive health centers in Yazd, Iran. Women with only one child and willing to participate from the selected health centers were included in this study. An initial 37-item researcher-developed instrument based on MTM was refined through expert evaluation (CVR, CVI) and quantitative face validity (Impact score). Construct validity was assessed via confirmatory factor analysis (CFA), and reliability evaluated using via Cronbach’s alpha and test–retest ICC analyzed with SPSS 22 and AMOS21.
Results: During the psychometric validation process, four items were removed. The final questionnaire with 33-items demonstrated high reliability (Cronbach’s α = 0.93; construct-level α = 0.71-0.92; test-retest ICC =0.81 (95% CI: 0.68-0.90)) and acceptable construct validity (CFA: CFI =0.932, TLI =0.921, RMSEA = 0.06, χ²/df =1.97). Content validity was strong, with CVR ranging from 0.62-1, S-CVI/Ave =0.929, and overall CVI =0.91. All items also showed acceptable face validity (Impact score >1.5).
Conclusion: The validated MTM-based Persian childbearing intention questionnaire is a reliable and valid tool for assessing childbearing intentions among women with only one child. It can guide public health research, educational interventions, and policy planning to support informed reproductive decisions.
