Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making
Abstract Background Women’s empowerment is a process wherein females are afforded power over their own lives as well as their participation in the communities and larger societies to which they belong. An important aspect of such empowerment is the right to make decisions regarding fertility—an enti...
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doaj-cd2fff7365a345bb99640a3e8a3518742021-02-07T12:20:34ZengBMCBMC Women's Health1472-68742020-02-012011910.1186/s12905-020-0893-0Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision makingZahra Kiani0Masoumeh Simbar1Mahrokh Dolatian2Farid Zayeri3Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical SciencesMidwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical SciencesDepartment of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical SciencesProteomics Research Center and Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical SciencesAbstract Background Women’s empowerment is a process wherein females are afforded power over their own lives as well as their participation in the communities and larger societies to which they belong. An important aspect of such empowerment is the right to make decisions regarding fertility—an entitlement affected by the social health determinants that contribute to the social conditions under which humans live and work throughout their lives. As one such determinant, psychosocial factors play an essential role in the development of women’s empowerment. Correspondingly, this study conducted a structural equation modeling of these determinants to examine the empowerment of Iranian women in reproductive decision making. Methods This cross-sectional study involved 400 women who were referred to clinical centers of the Shahid Beheshti University of Medical Sciences in Tehran, Iran. Data were collected using six questionnaires, namely, demographic, socioeconomic, and social support questionnaires, the Rosenberg self-esteem scale, a marital satisfaction questionnaire, and an empowerment survey. The data were analyzed using SPSS software version 17, and the structural equation modeling was carried out using EQS software version 6.1. Results The Iranian women had an average level of empowerment with respect to reproductive decision making, and such empowerment was related to all the psychosocial factors examined (p = 0.001). The final model appropriately fit the data (comparative fit index = 0.92, root mean square error of approximation = 0.06). The psychosocial factors served as intermediate social determinants of the women’s empowerment in reproductive decision making (β = 0.78, p = 0.001). This empowerment was indirectly affected by socioeconomic situation as a structural factor (β = 0.44, p = 0.001). Conclusions Socioeconomic factors, through the mechanism of psychosocial determinants, may significantly affect women’s empowerment in making decisions regarding reproductive health. Conditions associated with these factors should be improved to ensure that women claim and exercise their right to have mastery over their reproductive health.https://doi.org/10.1186/s12905-020-0893-0Decision makingReproductiveSocial determinants of health |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zahra Kiani Masoumeh Simbar Mahrokh Dolatian Farid Zayeri |
spellingShingle |
Zahra Kiani Masoumeh Simbar Mahrokh Dolatian Farid Zayeri Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making BMC Women's Health Decision making Reproductive Social determinants of health |
author_facet |
Zahra Kiani Masoumeh Simbar Mahrokh Dolatian Farid Zayeri |
author_sort |
Zahra Kiani |
title |
Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making |
title_short |
Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making |
title_full |
Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making |
title_fullStr |
Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making |
title_full_unstemmed |
Structural equation modeling of psychosocial determinants of health for the empowerment of Iranian women in reproductive decision making |
title_sort |
structural equation modeling of psychosocial determinants of health for the empowerment of iranian women in reproductive decision making |
publisher |
BMC |
series |
BMC Women's Health |
issn |
1472-6874 |
publishDate |
2020-02-01 |
description |
Abstract Background Women’s empowerment is a process wherein females are afforded power over their own lives as well as their participation in the communities and larger societies to which they belong. An important aspect of such empowerment is the right to make decisions regarding fertility—an entitlement affected by the social health determinants that contribute to the social conditions under which humans live and work throughout their lives. As one such determinant, psychosocial factors play an essential role in the development of women’s empowerment. Correspondingly, this study conducted a structural equation modeling of these determinants to examine the empowerment of Iranian women in reproductive decision making. Methods This cross-sectional study involved 400 women who were referred to clinical centers of the Shahid Beheshti University of Medical Sciences in Tehran, Iran. Data were collected using six questionnaires, namely, demographic, socioeconomic, and social support questionnaires, the Rosenberg self-esteem scale, a marital satisfaction questionnaire, and an empowerment survey. The data were analyzed using SPSS software version 17, and the structural equation modeling was carried out using EQS software version 6.1. Results The Iranian women had an average level of empowerment with respect to reproductive decision making, and such empowerment was related to all the psychosocial factors examined (p = 0.001). The final model appropriately fit the data (comparative fit index = 0.92, root mean square error of approximation = 0.06). The psychosocial factors served as intermediate social determinants of the women’s empowerment in reproductive decision making (β = 0.78, p = 0.001). This empowerment was indirectly affected by socioeconomic situation as a structural factor (β = 0.44, p = 0.001). Conclusions Socioeconomic factors, through the mechanism of psychosocial determinants, may significantly affect women’s empowerment in making decisions regarding reproductive health. Conditions associated with these factors should be improved to ensure that women claim and exercise their right to have mastery over their reproductive health. |
topic |
Decision making Reproductive Social determinants of health |
url |
https://doi.org/10.1186/s12905-020-0893-0 |
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