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.
Background: Respectful maternity care (RMC) involves providing healthcare that upholds women's dignity, privacy, and confidentiality. It also entails protecting women from harm, supporting informed decision-making, and providing continuous support throughout labor and delivery. This study aimed to evaluate the knowledge and practices of midwives working in hospitals in Golestan Province regarding respectful maternity care. Methods: In a cross-sectional study conducted in 2023, a total of 137 midwives working in the maternity wards of hospitals in Golestan Province, Iran, were selected through census sampling. Data were collected using the Respectful Maternity Care questionnaire, which covers emotional support, safe care, and the prevention of mistreatment. The data were analyzed using SPSS 18 and the Mann-Whitney U test, Kruskal-Wallis test, generalized linear models (GLMs), and Wilcoxon signed-rank test, with the significance level set at P < 0.05. Results: The median (Interquartile range) knowledge and practice scores for respectful maternity care were 95.62 (13.04) and 90.21 (11.41), respectively. Knowledge scores were significantly higher than practice scores for the overall score (P < 0.001) and in the domains of providing emotional support (P < 0.001) and preventing mistreatment (P < 0.001). In the generalized linear regression analysis, the RMC knowledge score was significantly associated with education level (B = -67.60, 95% CI: -132.82 to -2.39, P = 0.04), whereas the RMC practice score was significantly associated with the overall knowledge score (B = 246.73, 95% CI: 152.94-340.52, P < 0.001). Conclusion: Midwives demonstrated high levels of knowledge and practice regarding respectful maternity care. However, discrepancies between knowledge and practice in some domains highlight the need for interventions that facilitate the translation of knowledge into routine clinical practice.
Background: Career choice is a critical decision that influences an individual's future and social role. In this process, family factors may be associated with career choice by shaping perceptions of traditional gender roles, particularly in sociocultural contexts where traditional values coexist with modern social structures, including Türkiye. This study aimed to evaluate family influence and gender roles in the career choices of midwifery students. Methods: A cross-sectional study was conducted between November 2023 and February 2024 with 337 midwifery students at a state university in Samsun, Türkiye, using a census (Total population) sampling approach. Research data were collected using the "Student Information Form", "Gender Roles in Career Choice Scale (GRCCS)", and "Family Influence on Career Choice Scale (FICCS)." Data were analyzed using independent-samples t-tests, one-way ANOVA with Tukey's post hoc comparisons, Pearson correlation, and multiple linear regression in SPSS v.25. Statistical significance was set at p < 0.05. Results: The mean total GRCCS score of the students was 44.53±6.69 (Obtained score range: 21-85), while the mean total FICCS score was 67.82±8.15 (Obtained score range: 43-105). A weak but statistically significant positive correlation was found between the students' GRCCS and FICCS total scores (r = 0.265, p < 0.001), and between GRCCS scores and the FICCS sub-dimensions of Information Support (r = 0.125, p = 0.021), Financial Support (r = 0.234, p < 0.001), Family Expectations (r = 0.143, p = 0.009), and Values and Beliefs (r = 0.164, p = 0.002). In the regression analyses, career counselling (B = 2.77, 95% CI: 0.70 to 4.84), family relationship quality (B = 1.83, 95% CI: 0.70 to 2.96), and year of study (B = -1.31, 95% CI: -2.26 to -0.36) were independently associated with FICCS scores, while desiring midwifery as a profession (B = 1.62, 95% CI: 0.18 to 3.05) and income level (B = -2.29, 95% CI: -3.60 to -0.98) were associated with GRCCS scores. Conclusion: The findings suggest that family influence and gender-role perceptions may be related to career-choice attitudes among midwifery students. Therefore, career guidance practices should consider family expectations and gender-based role perceptions. Educational programs that promote independent decision-making and gender awareness may support students in making informed career decisions.
Background: Heart failure (HF) is a chronic condition requiring effective self-care to improve clinical outcomes and quality of life. Psychological factors such as anxiety and depression, as well as religious attitudes, may influence self-care behaviors, but evidence remains inconsistent. Thus, this study aimed to examine the relationships among self-care, religious attitudes, anxiety, and depression among patients with HF. Methods: This cross-sectional study involved recruiting 114 HF patients through convenience sampling at two educational hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences in Iran in 2023. Participants completed a demographic questionnaire, the European Self-Care Behavior Questionnaire (ESCBQ), the Hospital Anxiety and Depression Scale (HADS), and a Religious Attitude Questionnaire. Data were analyzed using SPSS v.22 running t-tests, one-way ANOVA, Chi-square tests, Pearson correlations, and multiple and simple regression analyses. Results: Participants had a mean age of 55.47±13.90 years, and hypertension was the most common comorbidity (15.8%). The mean self-care score was 38.92 ± 7.86 (moderate level; higher scores indicate poorer self-care). Their anxiety (9.83±4.22) and depression (9.61±4.75) were at moderate levels, while their religious attitudes averaged 69.05 ± 10.08. Self-care behaviors were significantly negatively correlated with both anxiety and depression (p<0.05), but not with religious attitude. Multiple regression analysis revealed anxiety as the only independent predictor of self-care (β=0.50, p<0.001). Conclusion: Anxiety is a key determinant of self-care in patients with HF, whereas depression has an indirect effect, and religious attitudes show no significant influence. Interventions focusing on anxiety reduction and psychological support may prove effective in enhancing self-care behaviors and improving clinical outcomes in this population.
Background: Pain is a prevalent and distressing symptom among intensive care unit (ICU) patients, and inadequate management may lead to serious complications and adverse outcomes. Roy’s Adaptation Model provides a structured nursing framework for improving patient adaptation and health outcomes. This study aimed to evaluate the effect of the Roy Adaptation Model on pain levels in ICU patients. Methods: This quasi-experimental study was conducted in 2026 among 100 patients admitted to the ICU in Pakistan. Two comparable ICU wards were randomly assigned to the intervention or control group before participant recruitment. Eligible patients were then consecutively enrolled and assigned to the study groups according to the ICU ward to which they were routinely admitted. Outcome assessors were blinded to group allocation. Patients in the intervention group received care based on the Roy Adaptation Model for 7 days, whereas those in the control group received routine care. Data were collected using the Behavioral Pain Scale (BPS). Data were analyzed using SPSS software version 26. Descriptive statistics (Mean, standard deviation, frequency, and percentage) and inferential statistics (Independent t-test and ANOVA) were applied. A p-value of less than 0.05 was considered statistically significant. Results: Pain scores decreased over the seven-day follow-up period in both groups; however, the reduction was significantly greater in the intervention group than in the control group. For daytime pain, repeated-measures ANOVA showed significant effects of group (F = 16.84, P < 0.001, ηp² = 0.147), time (F = 6.54, P < 0.001, ηp² = 0.063), and the time × group interaction (F = 4.72, P < 0.001, ηp² = 0.046). Similar findings were observed for nighttime pain, with significant effects of group (F = 18.32, P < 0.001, ηp² = 0.157), time (F = 6.87, P < 0.001, ηp² = 0.066), and the time × group interaction (F = 4.15, P < 0.001, ηp² = 0.040). Independent samples t-tests showed no significant between-group differences during the first two days and nights (P > 0.05); however, pain scores were significantly lower in the intervention group from day 3 to day 7 and from night 3 to night 7 (P < 0.05). Conclusion: The findings suggest that Roy’s Adaptation Model may contribute to pain reduction among ICU patients, supporting the potential value of theory-based nursing care in critical care settings. Incorporating this model into routine ICU practice may enhance pain management and facilitate patient adaptation.
