Advances in Nursing & Midwifery

Introduction: Successful sexual relationships and intimacy would improve marital adjustment in couples, acting as a significant predictor of marital satisfaction. The present study aimed to investigate the effectiveness of emotionally-focused couples therapy (EFCT) on marital violence, marital adjustment, and sexual intimacy of couples visiting counseling centers of Ahvaz.

Methods: This study adopted a single-case research design with the noncurrent multiple baseline approach. The statistical population included all the volunteer couples with lack of marital adjustment visiting the counseling centers of Ahvaz, Khuzestan Province (Iran) in 2021. Purposive sampling was employed to select two couples (i.e., four individuals). The therapy protocols were administered to all participants in two phases: an 18-session intervention and four baseline steps including a first 45-day follow-up and a later 3-month follow-up. Research questions were employed to analyze the participants before the therapy in sessions 4, 8, 12, 16, and 18 as well as the 45-day and 3-month follow-ups. The Dyadic Adjustment Scale (DAS), Couples' Sexual Intimacy Questionnaire and the Violence Against Women Questionnaire were used to collect data. The visual analysis method, the reliable change index (RCI), and the recovery percentage formula were used for data analysis.

Results: According to the results, the EFCT managed to significantly improve sexual intimacy, mitigate marital violence, and improve poor marital adjustment among participants at the end of the therapy and during the 45-day and 3-month follow-ups.

Conclusions: This study achieved promising results concerning the applicability of EFCT. Hence, the EFCT can alleviate both marital violence and poor marital adjustment in addition to enhancing sexual intimacy among couples.

Abstract
Introduction: Given the considerable negative effects of diabetes, improving health literacy can play a deciding role in preventing and treating such diseases and in saving resources. The present study aimed to investigate the relationship between women’s marital intimacy with health literacy and attitudes towards extramarital relations of husbands with diabetes in Ahvaz.
Methods: The statistical population of this descriptive correlational study included all the diabetes patients and their wives in Ahvaz in 2021. The sample of 141 men with diabetes and their wives was selected using convenience sampling. To collect data, the Marital Intimacy Scale, Health Literacy for Iranian Adults (HELIA), and Attitudes toward Infidelity Scale (AIS) were used. The Pearson correlation coefficient and regression were simultaneously used for data analysis.
Results: The results suggested that health literacy (r= 0.35) and attitudes towards extramarital relations (r= -0.27) in men with diabetes had significant positive and negative correlations with women’s marital intimacy, respectively. The regression results indicated that the variables of health literacy and attitudes towards extramarital relations in men had a significant multiple correlation with women’s marital intimacy (P<0.001).
Conclusions: The results illustrated that paying attention to health literacy and attitudes of men with diabetes towards extramarital relations for their wives’ marital intimacy was more important than ever before.

Abstract
Introduction: Reproductive and sexual health and its dimensions are important aspects of health in human life and the World Health Organization emphasizes to promote these section health indexes. Since a review study has not been conducted to identify an appropriate approach for intervention in this field. Therefore, this study was conducted with the aim of systematically reviewing the impact of educational and counseling interventions on sexual function of women.
Methods: A comprehensive electronic search was carried out with no time limit until 6 August 2022. All published studies with inclusion criteria by 2021 were searched in Embase, Cochrane library, Web of Sciences, Google Scholar, Pubmed, Scopus, SID, and Magiran. The literature search was performed using PRISMA instructions. Cochrane Quality Assessment Scale [adapted for evaluating RCT, interventional studies] was used to evaluate the quality of the articles.
Results: From a total of 93 articles obtained from the search in databases, by removing duplicate titles and checking the titles and summaries of the articles, 40 articles were obtained, and finally, after the final review of the full text of the articles, 21 articles were included in the present review. Due to the variety of interventional types in the studies, it was not possible to categorize counseling approaches. Studies showed that interventions based on sexual education and counseling were effective on the outcomes including marital satisfaction, sexual knowledge, sexual satisfaction, marital relationship quality and sexual performance.
Conclusions: Designing a comprehensive educational program with an appropriate approach focusing on various aspects of reproductive and sexual health can be an important role in promoting sexual and reproductive health. Therefore, interventional studies are necessary to identify an appropriate intervention approach to enhance reproductive and sexual literacy of couples.

Background: Among the types of cancers, colorectal cancer is more likely to occur in the elderly; It is known as one of the most common causes of death in the world. Cancer and living with an ostomy affect different aspects of the elderly life and increase stress in them. Religious coping strategies are methods based on spirituality and religion that help a person deal with stressful issues so that patients can adapt to the situation by increasing acceptance.

Objectives: The aim of this study was to investigate the correlation between religious coping strategies and quality of life in elderly patients with ostomy colon cancer Methods: This study was a descriptive_correlational which was carried out on 85 elderly patients with colon cancer who referred to colorectal clinics of Shahid Beheshti University of Medical Sciences hospitals in 2019. The inclusion criteria were the diagnosis of colon cancer by the oncologist, having an abdominal ostomy, age of sixty years and older, lack of cognitive impairment by MMES (Mini Mental Examination Status) and passing at least six-month of ostomy. Sampling method was convenience. The data collection tool was  persian version of Pargament's Brief religious coping Scale and the City of Hope quality of life-ostomy questionnaire. Chi-square, independent t-test, Pearson correlation and linear regression models were used to analysis.

Results: The results showed that the mean age of patients was 65.28 years. The mean score of quality of life was 232.58 with standard deviation of 41.17. The mean score of religious coping was 30.55 with standard deviation of 3.19 . The correlation between quality of life and religious coping was seen and there were positive and significant correlation between religious coping  and spiritual of quality of life (r=0.269, p=0.001). Conclusion: There was a direct and significant correlation  between health dimentional of quality of life and religious coping strategies. Healths care providers with focus on coping skills training and strengthening religious coping styles in routine care can  improve the quality of life of these patients.

Abstract
Introduction: As a clinical setting, the operating room (OR) is also a complicated system; there are a lot of contrasts and complexities between the OR environment and other clinical areas regarding the teaching and learning process. Effective teaching in the operating room is clearly one of the most important and yet most challenging and difficult-to-define tasks for any educator. There is no instructional model for operating room students. This study was aimed at developing a clinical education model for OR students, in accordance with ADDIE model.
Methods: The ADDIE model was used to guide the development of clinical education in five University of Medical Sciences. The ADDIE model includes five steps of Analysis, Design, Development, Implementation, and Evaluation. Qualitative method, literature review and curriculum assessment was used to generate five step ADDIE model.
Results: Conceptual model “gaining of clinical competence and approval” was appeared in analysis step ADDIE model. Presenting educational objectives, learning communication skills and teamwork, performing objective evaluation, administering a comprehensive test, as well as learning from surgical team members and peers were also specified.
Conclusions: The findings of the research, in relation to the clinical training of students in the operating room field, indicated the uniqueness of the clinical environment of the operating room and how the student copes with the different conditions of the environment and teamwork in the operating room. The present research led to the design of a model based on the general pattern of educational design(ADDIE model). ADDIE provides a model for common understanding of teamwork to increase aptitude and professional competence of operation room students. It also provides evidence the usefulness of ADDIE model on clinical education for OR students.