COMMONITY HEALTH
Year:2019 | Volume:6 | Issue:2|Papers Count:14

Manpower is undoubtedly the key element of sustainable development in every country. Accordingly, comprehensive plan and preparation for training, empowerment, and manpower provision are essential toward development goals. With a brief look around the world, one will find that progress has been made everywhere with the use of efficient and productive manpower. Fertility behavior in the past determines the current population and age distribution; therefore, the present fertility behavior will determine population and age distribution in the future. Accordingly, demography is a science that enables planners to anticipate the future, and based on its requirements, make long-term population policies for the country. Although this science dates back to at least 200 years, there has been little interest in using it in our country. While population policies are multi-generational they have been changed four times in Iran during less than 40 years: (1) Restrictive policy in the 70s, (2) Hasty and unjustified expansive policy in the 80s, (3) Reintroduction of the restrictive policy in 90s and 2000s, and finally (4) Return to wisdom, the replacement policy with the increase in fertility announced in 2014. Analyzing these four policies, it seems that the adoption of restrictive policy to deal with the abrupt and sharp decline in mortality after 1950 was inevitable and the reintroduction of the restrictive policy in stage 3 was a kind of confrontation with the expansive policy of stage 2. However, the policy of stage 2 was hasty and without regard to its consequences. In stage 4, or returning to rationalism, we witness the definitive knowledge of demography, the least goal of which is the replacement level. The particular significance of this policy in the development of the country is obvious and its contents are self-evident wisdom and prosperity. It is expected that the scientific community and scholars also try to play a role in proportion to their scientific position in the objective accomplishment of its contents. . .

Fertility levels have fallen drastically to a below-replacement level (under two children per woman required to maintain the population) in most developed and some developing countries, including Iran. Over the past two decades, the total fertility rate of Iran (the average number of children per woman) has remained under the replacement level, dropping from 2. 0 children per women in 2000 (1) to 1. 8 in 2005 and then to 1. 6 in 2018 (2, 3). The persistent low fertility rate is an increasing concern for countries with low fertility, as it accelerates population ageing and declining labor force, with the prospect of severe consequences for economic development. As a result, increasing attention is being paid to policies to reduce the socioeconomic burdens of low fertility. . .

Background and Objective: Over the past two decades the total fertility rate has remained the belowreplacement level (two children per woman), which can lead to aging population and hence shortage of labor forces required for the development of the country. This research aimed to study reasons behind the intention to have no children. Materials and Methods: This descriptive study uses data from the 2012 Tehran Survey of Fertility Intentions (n= 2267), conducted among married men and women under aged 36 living in 22 districts of the city of Tehran. The samples were selected by a two stage cluster random sampling method, and a structured questionnaire was used to collect data by interviewing respondents face-to-face at the door of their residence. Using SPSS version 24 and descriptive statistics, reasons for not wanting children were examined according to respondents’ socio-economic characteristics. Results: Overall, 40% (902) of respondents reported that they intend not to have any children in the future. Number of living children was negatively related to the intention to have children. About 9% (67) of childless respondents reported that they intend to remain childless forever, and 34% (302) of respondents with one child and 81% (443) of those having two children stated that they intend to stop childbearing. “ Not being able to afford the cost of raising children” (27%), “ having the desired number of children” (25%), “ being worry about the future of their children” (15%) as the most important reasons for not wanting any (more) children. The other reason for intending not to have children was “ conflict of childbearing with own personal life, plans and interests” (16%), which was reported largely by men, and those with higher levels of education and income, and those with one or no child. Respondents also reported “ spouse’ s opposition” 6%) and “ problems in spousal relationships” (2%) as the other reasons for wanting no more children. Conclusion: The study showed that beyond of economic reasons, uncertainty about children’ s future and childbearing-personal life conflict are two other important cultural and social reasons for low fertility intention, which are required to be considered by policy makers developing or tailoring the country’ s population policies.

Background and Objective: The key role of social determinants of health also applies to sexual function as a part of sexual health. Accordingly, this study aimed to determine the relation between social determinants of health and sexual function among women who were referred to health centers affiliated to Shahid Beheshti University of Medical Sciences. Materials and Methods: This descriptive analytic study was conducted with participation of 260 women who were referred to health centers affiliated to Shahid Beheshti University of Medical Sciences in 2016. Health centers were selected by random method and convenience sampling was conducted for selecting participants. Data were collected via demographic questionnaire, socio-economic questionnaire, Multidimensional Scale of Perceived Social Support and Female Sexual Function Index. Data were analyzed using SPSS software-version 23, and Kolmogorov-Smirnov, Independent T-Test, Pearson’ s correlation and Linear Regression with Enter and Step-Wise method. Significance level was considered 0. 05 in all tests. Results: The mean (SD) total score of sexual function was 25. 7 (5. 8). Increased level of couples' education, finance Index with the mean (SD) of 85. 3 (13. 3), and social support with the mean (SD) of 60. 1 (13. 5) were associated with improved sexual function (p<0. 05). Couple’ s occupation didn’ t have significant relationship with sexual function of women (p>0. 05). The analysis of stepwise regression showed that social support, husband's education and Finance Index could directly predict the sexual function of women. Conclusion: The study showed that higher levels of social support, husband's education and Finance Index were associated with better female sexual function scores.

Background and Objective: Work-family conflict is a friction of roles in which the pressures from the field of work as well as family are in some ways incompatible which negatively affects the well-being of employed women. The purpose of this study was to determine the effectiveness of reality group therapy on work-family conflict and psychological well-being of married women working in Telecommunication Company. Materials and Methods: The present study was had a quasi-experimental design with pre-test-post-test with control group. The statistical population of this study included all married female workers of Tehran Telecommunication Company in 2017, from whom 60 were selected by convenience sampling and randomly divided into two groups: experimental and control. The intervention was conducted for the experimental group. Data were collected by Scale of Psychological Well-being and Work-Family Conflict Questionnaire. Data analysis was performed using single-variable covariance analysis by SPSS-22 software. Results: The mean (SD) age of participants in the experimental group was 38. 7 (4. 4) and the control group 37. 2 (4. 6). The mean (SD) work-family conflict score in the experimental group was 17. 1 (1. 9) in pre-test, which was reduced to 14. 9 (2. 3) in post-test (P<0. 01); however, the mean (SD) score of the control group was 16. 5 (1. 6) in the pre-test and varied to 16. 1 (1. 4) in the post-test, which was not statistically significant. The mean (SD) psychological well-being score of the experimental group was 41. 6 (7. 7) in pre-test, which increased to 47. 4 (7. 9) in post-test (P<0. 001); however, the mean (SD) score in the control group was 41. 5 (4) in the pretest and 42. 8 (3. 9) in post-test, which was not statistically significant. Conclusion: The study showed that reality group therapy led to a reduction of work-family conflict and an increase in the psychological well-being of married women working in the Telecommunication Company.

Background and Objective: Emotional regulation strategies form crucial parts of one’ s life and excitementdisturbance and regulation can cause psychological damage. The aim of this study was to determine therelationship between emotional regulation, resiliency and self-efficacy with the emotional creativity ofpainter artists in Ahwaz. Materials and Methods: The method of this research was correlational. The study population included allpainter artists in Ahwaz, among whom 200 were selected by convenience sampling method. For datacollection, Granfsky Emotion Regulation Questionnaire, resiliency scale, self-efficacy questionnaire &Emotional Creativity Inventory were used. Data were analyzed by using Pearson correlation and multipleregressions by SPSS-22. Results: The mean (SD) age of participants was 36. 7 (7. 5), which included the age range of 23 to 41 years. The mean (SD) score of positive emotional regulation was 22. 4 (7. 7), self-efficacy 31. 4 (6. 9), resiliency 48. 7(10. 2) which had a positive correlation with emotional creativity with a mean (SD) of 28. 8 (2. 7) (P=0. 001)which meant that increased positive emotional regulation increased emotional creativity. Resiliency, selfefficacy, positive emotional regulation, and negative emotional regulation predicted 33% of emotionalcreativity variance (P<0. 0001) and resiliency and self-efficacy were the strongest predictors of emotional creativity. Conclusion: Resiliency, self-efficacy, positive emotional regulation increased emotional creativity andnegative emotional regulation decreased emotional creativity of painter artists.

Background and Objective: One of the main issues to be considered in solving couples’ conflicts is the acquisition of communication skills towards each other. The aim of this study was to determine the effectiveness of schema and commitment therapy (not mentioned in Farsi version), compassion-based therapy and dialectical behavioral therapy (DBT) on marital conflicts among women referred to Social Emergency Services in cities of Tonekabon and Ramsar. Materials and Methods: This applied research was a methodological perspective of a semi-experimental research project including pre-test and post-test with control group. The statistical population of this study included all women who were referred to Tonekabon and Ramsar Social Emergency Services during spring and summer of 2017. Of the 100 respondents who answered the Marital Conflict Questionnaire, 60 were selected purposefully and randomly assigned into two experimental and control groups. Data were analyzed using SPSS. 22 software and multivariate analysis of covariance analysis. Results: The mean (SD) age of participants was 37. 2 (5. 5) years. The coordination score of the experimental group varied from 16. 5 (3. 1) in pre-test to 11. 4 (2. 7) in post-test; sexual intercourse score 10. 8 (4. 1) to 6. 7 (3. 7); emotional reactions score 53. 3 (12. 3) to 36. 2 (11); children’ s protection score from 19. 8 (4. 8) to 24. 6 (4. 6), score of relationships with the spouse’ s relatives 36. 2 (6) to 29. 9 (6. 3); the score for the separating finances from each other 24. 2 (4. 8) to 18. 3 (4. 2), P <0. 001. The mean (SD) score for subscales of marital conflicts in the control group was not significantly different in pre-test and post-test. Conclusion: The study showed that the combination of schema therapy, compassion-based therapy, and dialectical behavioral therapy reduced marital conflicts.

Background and Objective: Having disabled children imposes mental stress on family members and especially mother, considering her main responsibility in raising children. The purpose of this study was to compare the quality of life, intolerance of uncertainty, and parenting stress among mothers with mentally retarded children and their peers. Materials and Methods: This study was of causal-comparative design. The statistical population included all mothers aged 25 to 35 who had children less than 12 years of age living in Bardaskan city, in Razavi Khorasan Province located in north-eastern Iran, in 2018. Two groups including 64 mothers with mentally retarded children and peers, who were mothers with normal children, were selected by convenience sampling. Data were collected using the World Health Organization's Quality of Life Questionnaire-Short Form, Intolerance of Uncertainty Questionnaire and Parenting Stress Questionnaire. Data were analyzed by multivariate analysis of variance analysis using SPSS software version 16. Results: The mean (SD) age was 32. 6 (8. 9) among mothers with mentally retarded children and 31. 8 (7. 6) among peers. The mean (SD) quality of life score among peers was 106. 4 (10. 7) which was higher than mothers with mentally retarded children with a mean (SD) of 84. 9 (14. 4) (P<0. 001). The mean (SD) intolerance of uncertainty score among mothers with mentally retarded children was 73. 6 (15. 4) which was higher than peers with a mean (SD) of 56. 5 (23. 2) (P<0. 001). The mean (SD) parental stress score among mothers with mentally retarded children was 111. 61 (19. 4) which was higher than peers with a mean (SD) of 65. 3 (15. 5) (P<0. 001). Conclusion: The study showed that intolerance of uncertainty and stress of parenting among mothers with mentally retarded children was higher while their quality of life was lower than peers.

Background and Objective: Reduced marital intimacy disrupts family function, durability and sustainability of marriage. Low intimacy leads to a rise in inappropriate interactions, reduced satisfaction and happiness in marriage, and leads to a desire to get a divorce among couples. Therefore, the present study aimed to define the effect of emotional schema therapy on marital intimacy among couples on the brink of divorce. Materials and Methods: This study was of semi-experimental design with pre-test, post-test, follow-up and control group. Among all couples at the Justice Department in cities of Shahin Shahr and Meymeh in 2017 and applied for a divorce, 54 couples who had a standard deviation below the average of Bagarozzi's marital intimacy questionnaire, were selected by purposeful sampling method, and randomly divided into three groups: experimental, consulting and control. Then, the experimental group participated in the emotional schema therapy and the counulting group in the public conversation course. One month after the completion of the training courses, the groups completed the questionnaire by post-test and three months later they completed the questionnaire again. Data were analyzed by SPSS-22 using single and multivariate analysis of covariance. Results: Emotional schema therapy increased the mean (SD) of total marital intimacy of couples in the experimental group from 243. 8 (57. 7) in pre-test to 296. 3 (63. 5) in post-test and 306. 9 (63. 4) in follow-up (P<0. 05). The effect of the emotional schema therapy on components in post-test was 56. 6% for physical intimacy, 40. 6% mental intimacy, 38. 4% emotional intimacy, 43. 2% psycological intimacy, 31. 1% sexual intimacy, 27. 7% spiritual intimacy, 26. 2% scio-creational intimacy, 25% choronological intimacy, and 68. 1% aesthetic intimacy. The effect of the emotional schema therapy in follow-up was 68. 1% for physical intimacy, 61. 3% spiritual intimacy, 60. 4% scio-creational intimacy, 51. 2% psycological intimacy, 49. 5% emotional intimacy, 49. 3% mental intimacy, 49. 3% sexual intimacy, 48. 5% choronological intimacy, and 45. 4% aesthetic intimacy (P<0. 05). In addition, there was a significant difference between the increase in the scores of marital intimacy and all its components among the couples of the cosulting group compared to the control group (P<0. 05), but there was no significant difference between the two groups in the follow-up. Conclusion: The study showed that emotional schema therapy resulted in increased marital intimacy of couples on the brink of divorce.

Background and Objective: The rapid growth of cutting-edge technologies in the field of electronics and behavioral addiction to it may unconsciously have negative effects on real life. This study aimed to determine the relationship between addiction to mobile-based social networks and the social relations of nursing students. Materials and Methods: The study was of cross-sectional correlational design, where 273 students from all nursing students were selected by random sampling in the academic year 2017-2018. Data were collected via Social Networks Addiction Standard Questionnaires and the Power of Communication which were competed after confirmation of validity and reliability and obtaining written consent from participants. Data were analyzed by SPSS version 18 software and independent t-test and Pearson correlation coefficient. Results: Participants included 129 (47. 3%) female, 144 (52. 7%) of male students with the mean (SD) age of 21. 7 (2. 75) years. 266 (97. 4%) of whom used social networks; 256 (93. 8%) and 173 (63. 4%) used Telegram and Instagram respectively. The total score of virtual network addiction with the mean (SD) of 63 (20. 5) negatively correlated with dimensions of addiction to virtual networks including the personal performance with the mean (SD) of 23. 8 (8. 9); time management 17. 1 (6. 2); and power of communication 79. 8 (13. 3), P<0. 001. In addition, increasing score of two other dimensions of addiction to virtual networks including self-control with the mean (SD) of 10. 5(4. 2) and social relations 12. 4 (4. 1) negatively correlated with the score of power of communication P<0. 001. Conclusion: The study showed that increased addiction to social networks decreases students’ communication skills.

Background and Objective: Suicide is one of the social harms and it is essential to identify risk and protective factors in order to prevent and reduce suicide. The purpose of this study was to determine the predictive role of meaning in life and early maladaptive schemas in suicidal ideation among university students. Materials and Methods: This descriptive-analytical study was conducted with participation of 240 university students from different majors in Iran University of Medical Sciences. Participants were selected by using a multi-stage cluster sampling method. To collect data, Beck Scale for Suicide Ideation (BSSI), Meaning in Life Questionnaire (MLQ) and the short form of Yang's early maladaptive schemas questionnaire (YSQ-SF) were employed. Data were analyzed in SPSS-23 Software using Pearson correlation coefficient and regression analysis. Results: The early maladaptive schemas, with a mean (SD) score of 173. 77 (51. 8), negatively and the meaning in life, with a mean (SD) score of 52. 97 (11), positively correlated with suicidal ideations, with a mean (SD) score of 3. 43 (5. 7), P<0/05. Meaning in life, vulnerability to harm and social isolation/alienation significantly could predict suicidal ideations, P<0. 01. Thus, the more meaning in life the less the probability of suicidal ideations. In addition, the probability of suicidal ideations increases with increasing vulnerability to harm and social isolation. Conclusion: The study showed that presence of meaning in life lead to a decrease in suicidal ideations, while early maladaptive schemas lead to an increase in suicidal ideations. Therefore, meaning in life is a protective factor and early maladaptive schemas are a risk factor for suicide ideations among university students.

Background and Objective: Persons with personality disorders have characteristics that cause tension and conflict in their marital relationships and life and reduce sustainability of their marriage. The objective of this study was to determine the predictive role alexithymia in marital satisfaction and marital forgiveness among women with antisocial personality. Materials and Methods: The research method was descriptive-correlational. The statistical population of this study included women with divorce cases referred to the counseling department of municipality districts 1 and 2 of Tehran from October to December 2017. Participants included 123 women who were selected by convenience sampling method. Data were collected using Marital Forgiveness Questionnaire, Toronto Alexithymia Scale, marital satisfaction, and multivariate clinical trials of Million-3. Data were analyzed using Pearson correlation coefficient and multiple regression tests using SPSS-22 software. Results: The mean (SD) age of participants was 37. 2 (4. 13). The mean (SD) score of difficulty in identifying feelings was 14. 3 (2. 1), difficulty in describing emotions 12. 6 (3. 1), objective thinking 16. 4 (5. 9), lexithymia 44. 3 (11. 8), marital satisfaction 76. 7 (14. 1) and marital forgiveness 31. 5 (7. 6). Difficulty in identifying feelings (P<0. 001), difficulty in describing emotions (P<0. 05), objective thinking (P<0. 01), and alexithymia (P<0. 001) could negatively predict forgiveness and marital satisfaction. Higher scores of difficulty to describe feelings identify emotions and think objectively correlated with fewer score of forgiveness and marital satisfaction. Conclusion: The study showed that the components of emotional weakness significantly predicted forgiveness and marital satisfaction. It seems that the difficulty in identifying feelings, describing emotions and having objective thinking significantly affected and reduced marital satisfaction of women with antisocial personality.

Background and Objective: Women are potentially exposed to drug addiction in the community as half of the country's population and over the past years the extent of drug-related harm has spread to the population of women. The study aimed to identify predictors of addiction among women in Golestan province in northern Iran. Materials and Methods: The study was of descriptive-analytical design. The statistical population consisted of female addicts who were referred to private drug addiction centers in Gorgan and Azad-Shahr in Golestan Province, among whom 150 were selected by simple random sampling. Data were collected via of sociodemographic characteristics of substance abuse questionnaire. Data analysis was performed using descriptive statistics including statistical, mean, standard deviation and inferential statistics including multivariate regression analysis using SPSS-18 software. Results: The mean (SD) age of participants was 33. 7 (4. 2) and onset age of substance abuse 21. 8 (6. 9). As many as 61 (40. 7%) of participants had primary school education, 73 (48. 7%) were married, 41 (27. 3%) reported a history of substance abuse by their fathers, and 72 (48%) mentioned opium as the most abused substance. Family factors (P<0. 01), social factors (P<0. 05) and age (P<0. 01) were the strongest predictors of drug addiction among women. Psychosocial and psychological factors, education, marital status and economic status failed to predict drug addiction in women. Conclusion: The study showed that increased age, social scores, and scores of family factors were associated with increased drug addiction among women. In this study, marital status and economic factors including the occupational status and economic status did not predict the women's addiction.

Background and Objective: Adolescence is a period characterized by numerous social, psychological, behavioral and physical changes that can lead to some social problems such as delinquency. The purpose of this study was to compare the cognitive emotion regulation and identity styles among delinquent and nondelinquent adolescents. Materials and Methods: The present study was of causal-comparative design. The statistical population of this study included all delinquent and non-delinquent adolescents in the city of Rasht in northern Iran in 2017, among which 120 adolescents were selected by convenience sampling method. Data were gathered via questionnaires of cognitive-emotion regulation and identity styles for data analysis. Data were analyzed using multivariate analysis of variance by SPSS version 20. Results: The mean (SD) age of the delinquent group was 16. 9 (3. 5) and the normal group 17. 1 (4. 6). The mean (SD) score of the cognitive emotion adjustment components was higher among the delinquent group: 18. 1 (2. 2) vs. 15. 6 (3. 6) for rumination and 12. 1 (1. 5) vs. 8. 9 (2. 5) for blaming others (P<0. 05). However, the mean (SD) scores of focus on planning and self-blame were higher among the normal group: 36. 1 (2. 6) vs. 30. 1 (4. 5) and 9. 1 (1. 6) vs. 7. 1 (2. 6), respectively (P<0. 05). There was no significant difference between the two groups in terms of other components of cognitive emotion regulation and identity styles. Conclusion: The study showed that the rumination and blaming others was more frequent among the delinquent group, while self-blame was more frequent among the normal group. The delinquent and normal group did not differ significantly in terms of other components of cognitive emotion regulation and identity styles.