Showing 355 results for SH
Mahnaz Shoghi, Khadijeh Yahyavi, Raheleh Mohammadi,
Volume 20, Issue 2 (Vol.20, No.2, Summer 2024)
Abstract
Background and Objectives: The use of modern and technology-based educational methods can play a significant role in enhancing nurses' capabilities in stress management and improving their responses to stressful situations. Therefore, this study aims to determine the impact of stress management on the stress responses of nurses working in pediatric departments of educational hospitals affiliated Iran University of Medical Sciences through a multimedia software intervention.
Methods: In this quasi-experimental study, a random sampling method was employed to select 102 nurses (51 individuals in the intervention group and 51 in the control group) working in general hospital departments. The inclusion criteria for evaluating the effectiveness of stress management training on the stress responses of nurses included having at least a bachelor’s degree, a minimum of 6 months of work experience in pediatric wards, no reported psychological disorders, and no use of psychiatric medications based on self-reports. Additionally, participants were required to have access to a computer capable of running DVDs and familiarity with its operation, with no prior experience or readiness to participate in a stress management workshop within the last 6 months. Conversely, the exclusion criteria were participant dissatisfaction, change of department, and hospital relocation. This assessment is shared in improving the skills and response to the stress of nurses in pediatric department of medical centers. To measure the stress responses, the Inventory Response Stress questionnaire was utilized, which was completed by both groups prior to the intervention. Subsequently, the educational content regarding stress management was provided to the intervention group for duration of 8 weeks. At the end of the eighth week, both groups completed the stress response questionnaire again. Data analysis was performed using SPSS version 22 software, with statistical tests including Fisher's exact test, Mann-Whitney U test, Kruskal-Wallis H test, and Analysis of Variance (ANOVA).
Results: No significant difference was observed in the mean of stress response in the intervention (29.69 ± 23.66) and control (33.20 ± 27.95) groups before the intervention (p = 0.661). The average stress response score in the intervention group (19.65 ± 16.74) was significantly lower than the control group (32.67 ± 28.17) after the intervention (p < 0.001).
Conclusion: These data demonstrated the positive effect of the stress management program on nurses' stress response who participated in this study.
Tahereh Tiemori, Marjan Ajami, Sareh Shakerian, Morteza Abdollahi,
Volume 20, Issue 2 (Vol.20, No.2, Summer 2024)
Abstract
Background and Objectives: Evidence shows that blood lipid disorders in people are influenced by their unhealthy diet. This study was conducted with the aim of investigating the dietary pattern of people with lipid disorders and the status of non-communicable diseases in the studied population.
Methods: A cross-sectional study was conducted on 300 patients with lipid disorders. The participants were selected among people with lipids who referred to comprehensive health service centers in Alvand city by multistage sampling method. The data were collected using a semi-quantitative food frequency questionnaire (FFQ). The findings were analyzed by SPSS software.
Results: Three dietary patterns including healthy, unhealthy and average were identified in the research participants. Most people (66.3%) followed a moderate dietary pattern. Also, 85% of people were overweight or obese. The results of the logistic regression analysis showed that an unhealthy eating pattern increases the likelihood of developing diseases by 2.267 times compared to a healthy eating pattern. It also showed that with increasing age, the probability of contracting the disease increases by 1.093. Also, there was a significant relationship between food pattern and education level (P<0.05). In this study, there was no significant relationship between age, marital status of people and their food pattern (P>0.05).
Conclusion: The results showed that people who follow an unhealthy food pattern have more non-communicable diseases. Therefore, it seems that modifying the food pattern through nutrition education is appropriate and can be effective in preventing other non-communicable diseases in the future.
Elham Davtalab Esmaeil, Ali Hossein Zeinalzadeh, Leila R. Kalankesh, Alireza Ghaffari, Saeed Dastgiri,
Volume 20, Issue 2 (Vol.20, No.2, Summer 2024)
Abstract
Background and Objectives: The present study aimed to assess the prevalence and familial aggregation pattern of alcohol consumption among father-offspring, mother-offspring, siblings, and spouses in Tabriz city, and to investigate the associated risk factors.
Methods: This cross-sectional study was conducted in 2023 on 860 individuals in Tabriz city. The heads of households were selected as proband individuals. Conveniently, probands were recruited from daily visitors, and upon agreeing to participate, their first-degree relatives (spouse and children) were also invited to join in. Data were collected using standard self-reported questionnaires. Generalized Estimating Equations (GEE) were employed to assess family aggregation among father- offspring, mother-offspring, and siblings.
Results: No significant of familial aggregation alcohol consumption was observed between spouses (OR=0.54 (0.16-1.8)). Although familial aggregation was observed between mothers and children, this was not statistically significant (OR=1.54 (0.8-2.94)). There was a significant familial aggregation of alcohol consumption between fathers and children (OR=1.98 (1.08-2.5)). Among siblings, familial aggregation was not statistically significant (OR=1.38 (0.41-4.63)).
Conclusion: Based on the findings of this study, family members play an important role in influencing the alcohol consumption behaviors of other family members. Additionally, individuals with lower socioeconomic status, those who are divorced, and singles may be more appropriate targets for alcohol consumption screening programs.
Ashraf Saber, Maryam Omidi, Fereshteh Eidy, Mahdis Mehrabi Bardar, Rahman Panahi, Zahra Moghadasi, Shiva Pouraliroudbaneh, Ahmadreza Shamsabadi,
Volume 20, Issue 2 (Vol.20, No.2, Summer 2024)
Abstract
Background and Objectives: Violence against pregnant women is a clear violation of women's rights associated with many consequences and complications both for the mother and fetus. In this study, we aimed to determine factors affecting the severity of domestic violence against pregnant women.
Methods: This cross-sectional descriptive-analytical study was carried out between July 2020 and September 2021. The participants were 234 women with low-risk pregnancies (28-40 weeks) who were transferred to the maternity ward of Bentolhoda Hospital in Bojnurd City. Mothers were selected by the convenience sampling method. A two-part questionnaire was used in this study, which included demographic and midwifery information questionnaires and a domestic violence questionnaire created by Tabrizi in 2013. Subsequently, the data were analyzed using logistic regression.
Results: The prevalence rate of violence against pregnant women (experiencing at least one type of domestic violence from the husband) was 64.6%. Among those who had experienced violence, 36.1% of the participants experienced low to very mild violence during pregnancy and 63.9% experienced moderate violence. However, severe violence was not experienced by any of the research units. Also, there was a significant relationship between babies' gender and the severity of violence (P=0.03). Pregnant women with male fetus (OR = 3.14, CI95%:1.093–9.069) were 3.14 times more exposed to violence with moderate severity.
Conclusion: In this study, most women suffered domestic violence with moderate severity. Among pregnant women with male fetuses, the severity of violence was even higher. Thus, it is necessary to pay a proper attention to the design and implementation of educational and support programs for these women to prevent domestic violence and reduce its adverse impacts.
Aliakbar Haghdoost, Samira Emadi, Azam Bazrafshan,
Volume 20, Issue 2 (Vol.20, No.2, Summer 2024)
Abstract
The migration of elites has become a major challenge worldwide. In Iran, in recent years, there has been a remarkable increase in the number of immigrants. Migration often occurs in different ways including educational migration within geographical borders, field migration, experts avoiding professional activities, and forced or semi-forced migration. Due to the fact that each form of migration can lead to diverse problems, it is imperative to pay attention to the nature and complications of each type of migration in the discussion of human resources management.
Marzieh Fattahi-Darghlou, Hamid Gheibipour, Neda Mahdavi, Fatemeh Shahbazi,
Volume 20, Issue 3 (Vol.20, No.3, Autumn 2024)
Abstract
Background and Objectives: More than 12 types of cancer are caused by contact with environmental factors and occupational carcinogens. Therefore, this study aimed to evaluate the trend of mortality and disability-adjusted life years (DALYs) rates attributed to occupational carcinogens in Hamedan province, Iran, from 1990 to 2021.
Methods: In this ecological study, the Global Burden of Diseases database was used to collect the required data. The trend of changes in the mortality and disability-adjusted life years rates was examined using joinpoint regression analysis and the Join Point Regression software.
Results: The years of life lost (YLLs) due to premature death and disability attributed to occupational carcinogens in Hamadan Province increased from 10.31 per 1,000 population in 1990 to 23.33 per 1,000 population in 2021. The average annual percent change (AAPC) in DALYs was 3.79% for women and 2.57% for men. The all-cause mortality rate attributed to occupational carcinogens rose from 0.31 per 100,000 population in 1990 to 0.74 per 100,000 in 2021 (AAPC = 2.78%; 95% CI: 2.68% to 2.90%).
Conclusion: The trend of mortality and disability-adjusted life years due to occupational carcinogens in Hamadan province had an increasing trend overally. Periodic screenings for workers in high-risk occupations are essential to mitigate the burden of occupational cancers.
Ali Alami, Hassan Eshaghiyan Farimani, Farnaz Sharifi Mood,
Volume 20, Issue 3 (Vol.20, No.3, Autumn 2024)
Abstract
Background and Objectives: Suicide is a major health concern worldwide, and there is a strong association between the presence of suicidal ideation and suicide attempt in the future. This study aimed to determine the epidemiological status of suicidal thoughts among university students and its correlation with some of their personal, family, and social factors.
Methods: An analytic cross-sectional study was conducted on 556 students of Gonabad University of Medical Sciences (GMU) who met the inclusion criteria and were selected by multi-stage sampling in 2023. To collect data, a checklist and the Beck Scale for Suicidal Ideation (BSSI) were used. The collected data were analyzed using independent t-tests, chi-square, Fisher's exact test, and logistic regression.
Results: The prevalence (95% confidence interval) of suicide ideation among students of GMU was estimated at 20.5% (17.2-23.8%), with 11.5% of the students having high-risk (High and very high risk) suicidal thoughts. The prevalence of suicidal ideation was significantly higher among female compared to male students (P=0.016). Moreover, single students had more suicidal thoughts compared to married ones (P=0.019). In contrast, there was no statistically significant association between suicidal ideation and age, native status, place of residence and faculty of study of students.
Conclusion: The prevalence of suicide ideation and high-risk suicide ideation among the students was found to be relatively high. Thus, attention to state of mental health of students, especially female and single students, as well as creating suitable conditions for living and studying for them is recommended.
Mahla Iranmanesh, Milad Ahmadi Gohari, Aliakbar Haghdoost, Maryam Yazdanpanah, Abbas Kamyabi, Simin Salehinejad, Vahid Yazdi-Feyzabadi,
Volume 20, Issue 4 (Vol.20, No.4, Winter 2025)
Abstract
Background and Objectives: In the field of medicine, job satisfaction holds significant importance, as it plays a vital role in the quality of healthcare services. This study aimed to assess physicians' job satisfaction levels and identify the related factors.
Methods: This cross-sectional survey study was conducted online in 2023 among 1,100 Iranian physicians using a respondent substitution method. Physicians answered the questions regarding themselves and their closest physician friend, with whom they maintain regular contact and interactions. Satisfaction was categorized using a Likert scale into two scales: sufficient satisfaction (very high and high) and insufficient satisfaction (very low, low, and moderate). Factors affecting job satisfaction among physicians were determined using multivariable logistic regression.
Results: Among the 2,200 physicians, 24.9% (547 individuals) of the physicians were satisfied with their profession, while 75.1% (1,653 individuals) had low or moderate (insufficient) satisfaction. The odds of male physicians being satisfied with their profession were 1.54 times higher than female physicians. Factors including interest in medicine, the amount of time spent practicing medicine, sufficient income, low occupational stress, high job stability, no reduction in professional autonomy compared to the past, migration status, time dedicated to practicing medicine in public and private sectors as well as in academic activities, pursuing further education, and the physician’s income were all positively and significantly correlated to job satisfaction (p<0.05).
Conclusion: Job satisfaction among Iranian physicians is significantly influenced by various factors such as interest in medicine, adequate income, job stability, and reduced job stress. The highest level of satisfaction was observed among male physicians. Improving working conditions and reducing job stress are essential to improving job satisfaction and the quality of healthcare services.
Fereshteh Eidy, Razieh Jafarizadeh, Fatemeh Shoghi, Amirhossein Moradian, Fatemeh Sadat Dolatabadi, Samira Rabiei,
Volume 20, Issue 4 (Vol.20, No.4, Winter 2025)
Abstract
Background and Objectives: Overweight and obesity are serious public health problems that have increased significantly among adolescents in recent decades. This condition can affect various aspects of adolescents' quality of life. A questionnaire based on IWQOL-kids was used to assess the quality of life among overweight and obese adolescents in Iran for the first time.
Methods: This study was conducted on 170 overweight and obese adolescents (both boys and girls) aged 11 to 18 years educating in schools of North Khorasan Province. Using a cluster sampling method, data collection was conducted. Data were collected using the IWQOL-kids, a quality of life questionnaire for adolescent obesity, and satistical analyses were conducted using R software version 4.3.2 through univariable and multivariable regression models.
Results: The mean of total score of IWQOL-kids for overweight and obese girls and boys was 82.1 ± 16 and 86.4 ± 15.5, respectively. A significant correlation was found between age and the number of siblings with physical functioning, self-esteem, and overall quality of life scores (p < 0.05). Additionally, age and the number of siblings were significantly associated with social life and family relationships (p < 0.05).
Conclusion: Given the impact of weight on adolescents' quality of life, future studies are recommended to include body composition assessments to more accurately examine the impact of gender differences on the quality of life of this age group.
Rahman Panahi, Armin Baleshzar, Ali Zahmatkesh,
Volume 20, Issue 4 (Vol.20, No.4, Winter 2025)
Abstract
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A review of studies has revealed that the concept of traffic literacy in Iran has not been investigated so far, and there is no valid and reliable tool to measure traffic literacy. In addition, there is a relationship between health literacy in one hand, and managing diseases and accidents, the number of traffic injuries and prevention of road traffic injuries in other hand. Also, considering the relationship between health literacy and the management of diseases and accidents, the rate of traffic injuries, and its role in preventing road traffic injuries, and considering the potential impact of health literacy in promoting safer practices for pedestrians and for having a healthier and safer society, it seems necessary to design a tool to measure traffic literacy in the country. |
Farahnoosh Farnood, Elnaz Faramarzi, Aysouda Ghanizadegan, Seyyedeh Mina Hejazian, Sepideh Zununi Vahed, Mohammadreza Ardalan,
Volume 21, Issue 1 (Vol.21, No.1, Spring 2025)
Abstract
Background and Objectives: Sleep disorders are common issues in people's health and can be related to metabolic and kidney diseases. Studies have shown that the relationship between proteinuria and sleep disorders can be modified. Since this relationship has not been investigated in Iranian populations, this study examined the relationship between proteinuria and sleep in the Azar cohort population.
Methods: This cross-sectional study used data from the Azar cohort study with a population of 15,000. Based on the study's inclusion and exclusion criteria, 105 patients with proteinuria were selected. After age and sex matching, 420 patients without proteinuria were included in the control group. The patients' sleep patterns were assessed based on a designed questionnaire, and the results were compared between the two groups.
Results: None of the sleep factors significantly differed between the two groups with and without proteinuria (P>0.05). Moreover, the mean weight, waist circumference, systolic blood pressure, diastolic blood pressure, and body mass index (BMI) were significantly different in the two groups (P<0.001).
Conclusion: There was no significant relationship between proteinuria and sleep in the Azar cohort population. However, the weight, BMI, waist circumference, and systolic and diastolic blood pressure significantly differed between people with and without proteinuria.
Zainab Al-Sadat Alavizadeh, Maryam Farjamfar, Shahrabano Goli, Omid Garkaz, Sahar Paryab, Mahbobeh Pourheidari, Mehdi Fathi,
Volume 21, Issue 1 (Vol.21, No.1, Spring 2025)
Abstract
Background and Objectives: Healthy sexual relations, as one of the basic components of human life, are one of the signs of physical and mental health that have a significant impact on the quality of individual and marital life.
The present study aimed to investigate the effectiveness of cognitive behavioral sleep therapy on the sexual function of married women of reproductive age in Sabzevar city in 2021-2022.
Methods: This study was conducted as a simple randomized clinical trial before and after intervention and one-month follow-up with intervention and control groups. The sample included 70 eligible women. The intervention group (N = 35) received four individual counseling sessions of cognitive-behavioral hypnotherapy, while the control group (N = 35) received no intervention. The research tool included a demographic questionnaire, Hypnotic Induced Profile (HIP), and Female Sexual Function Index (FSFI). Data were analyzed using SPSS version 22 software.
Results: Based on the results of sexual function, there was a significant difference between the intervention and control groups after cognitive behavioral hypnotherapy intervention (p<0.001) and one month after the intervention (p<0.001). The analysis of the components of sexual function (sexual desire, arousal, lubrication, orgasm, satisfaction, and pain) indicated that all components except for pain and satisfaction had significant differences between the intervention and control groups after the intervention and follow-up. The satisfaction component had a significant difference just one month after the intervention (p=0.010).
Conclusion: Cognitive behavioral sleep therapy counseling is efficacious in improving women's sexual function and most of its components. This approach is recommended to be used to enhance women's sexual function. Additionally, conducting more comprehensive studies can be beneficial.
Seyed Aria Nejadghaderi, Mohammad Khalili, Aliakbar Haghdoost, Abbas Aghaei-Afshar, Hamid Sharifi,
Volume 21, Issue 1 (Vol.21, No.1, Spring 2025)
Abstract
Background and Objectives: Dengue fever is a viral disease transmitted by Aedes aegypti and Aedes albopictus mosquitoes, seriously threatening public health. Therefore, prevention and control strategies are critical, given the lack of effective treatment. This study aimed to combine international guidelines for controlling Aedes mosquitoes and managing dengue fever.
Methods: This narrative review focused on international guidelines for preventing and controlling dengue fever and Aedes mosquitoes. Reputable international sources were reviewed, and the selection criteria included the credibility of the issuing organization, focus on vector-borne diseases, and adaptability to different environmental conditions. Key data from each guideline, including objectives, main messages, and recommendations, were extracted. The search timeframe was extended to 2024 and conducted on international websites.
Results: International guidelines emphasized an integrated approach to vector control. Environmental strategies include sustainable water system management, stagnant water elimination, and safe waste disposal. Chemical controls stress the cautious use of larvicides and insecticides while strictly adhering to resistance management protocols. Biological interventions, such as introducing predator species into water bodies, were recommended in specific conditions. The guidelines also highlighted community engagement and education and advocate for intersectoral collaboration. Innovative tools such as insecticide-treated materials, lethal traps, and disease trend prediction technologies were also endorsed. Social mobilization and intersectoral cooperation were key elements for long-term success.
Conclusion: International dengue control strategies combine a multifaceted approach, integrating environmental management, chemical and biological control, and community engagement. Implementing these guidelines as well as technological advancements, and international collaboration can significantly reduce the global burden of dengue fever.
Aliasghar Fakhri-Demeshghieh, Hesameddin Akbarein, Rouzbeh Bashar, Mohammad Reza Shirzadi, Zahra Boluki, Narges Ghasemzadeh,
Volume 21, Issue 1 (Vol.21, No.1, Spring 2025)
Abstract
Background and Objectives: Rabies is a public health threat worldwide. This study aimed to determine the amount and trend of the costs of anti-rabies serum and rabies vaccine in Iran between 2015 and 2022.
Methods: Using national data from March 2015 to March 2022, the cost of anti-rabies serum, human rabies vaccine, and the total cost of both were determined. The annual trend of the serum, vaccine, and total cost was determined using Joinpoint regression with a maximum of one.
Results: The highest rabies serum and vaccine costs were observed in 2021 and 2020 (58.3 and 6.874 US million dollars), respectively. Average Annual Percent Change was statistically significant (p<0.001) and indicated an increasing trend in the costs of anti-rabies serum. The trend in vaccine costs between 2015 and 2020 was increasing, and the annual percent change between 2015 and 2020 (p˂0.001) and 2021 (p˂0.001) were statistically significant. The average annual percentage change was statistically significant for the total costs of anti-rabies serum and rabies vaccine (p˂0.001) and indicated an increasing trend in Iran.
Conclusion: The lowest rabies vaccine costs were observed in 2021, which might be due to the COVID-19 pandemic. To reduce rabies losses, the domestic production of anti-rabies serum, implementing rabies control measures in unowned dogs, and increasing public awareness about animal bites, particularly dog bites, are recommended.
Shima Shadkam Farrokhi, Amir Hossein Nekouei, Saeedeh Haji Maghsoudi, Hamid Sharifi, Aliakbar Haghdoost,
Volume 21, Issue 2 (Vol.21, No.2, Summer 2025)
Abstract
Background and Objectives: Abortion is a significant health and social issue in Iran, which affects women's physical and mental health, as well as population growth rates. This study evaluated and compared direct and indirect estimates of abortion incidence and its associated factors among women of reproductive age in Kerman, Iran.
Methods: This cross-sectional study estimated the incidence of abortion using direct and indirect methods (Proxy network Scale-Up Method). In the direct method, 471 women aged 18-54 were interviewed about their personal experiences with abortion. In the indirect method, 450 women provided information about abortions within their close social networks. The number of abortions reported by each individual was divided by the corresponding person-time to estimate the incidence rate using the direct method. The number of abortions reported within the social network was divided by the size of each individual’s close network population for the indirect abortion incidence estimation.
Results: The annual abortion incidence is estimated indirectly at 62 per 1,000 women of reproductive age (95% CI = 52, 73), with 57% attributed to spontaneous abortion and 43% to induced abortion. Factors such as more children, higher socioeconomic status, and an educated spouse were associated with increased abortion rates.
Conclusion: The occurrence of abortion in Kerman, as in the rest of the country, was a serious health issue. The underlying and root causes should be addressed to manage it more effectively. And it should be noted, more than half of these abortions are spontaneous, meaning that there are inherent limitations in reducing the number of abortions even with optimal management.
Fatemeh Gorji, Abolghasem Pourreza, Masud Yunesian, Simin Zahra Mohebi, Mahnaz Ashourkhani,
Volume 21, Issue 2 (Vol.21, No.2, Summer 2025)
Abstract
Background and Objectives: Timely use of dental services in early childhood plays an essential role in maintaining the health of primary teeth and preventing complications related to jaw development, nutrition, speech, and mental well-being. Regular dental visits help prevent early childhood caries and its consequences. This study aimed to evaluate factors influencing the use of dental services for primary teeth from parents’ perspectives, based on Andersen’s Behavioral Model.
Methods: This descriptive-analytical cross-sectional study was conducted in 2023 among 395 parents of children under six attending health centers in Semnan, Iran. Participants were selected using simple random sampling. Data were collected online via the Hackey questionnaire and analyzed using SPSS version 26 applying Chi-square tests and logistic regression.
Results: A minority of parents were aware of the appropriate timing for the first dental visit. Forty-five percent sought care only when problems occurred, while 36% attended regular check-ups. Overall, 62% reported moderate to good financial status, and 82% had basic insurance coverage. Key determinants of dental attendance included maternal education, service accessibility, insurance coverage, health information sources, and the characteristics of the healthcare providers as an educator. Larger family size and negative experiences with healthcare staff were associated with reduced utilization.
Conclusion: Interventions at individual and structural levels are needed to promote regular pediatric dental visits. Enhancing parental awareness, involving influential health personnel, expanding dental insurance, and fostering positive provider–parent interactions are recommended.
Haniyeh Salehi Sarbijan, Tanya Dehesh, Firuzeh Mirzaei, Armita Shahesmaeilinejad,
Volume 21, Issue 2 (Vol.21, No.2, Summer 2025)
Abstract
Background and Objectives: Declining fertility rates have become a significant demographic challenge in Iran. This study aimed to evaluate the extent of desire for childbearing and its associated factors among women in Jiroft, Iran, in 2022.
Methods: This cross-sectional study included 600 married women under 49 years of age who attended comprehensive health centers in Jiroft. Data were collected using a questionnaire that covered demographic information and questions related to the study objectives. Statistical analysis, such as frequency, percentage, and logistic regression, was performed using SPSS version 20 software.
Results: The current desire for childbearing was found to be 32.7%, while the future desire was 59.7%. The primary reasons cited for desiring children were the wish to be a mother (94.4%) and the love for children (93.9%). Conversely, the main reasons for not desiring children included concerns about securing the future of children (57.2%) and the increased economic burden of having another child (50%). Factors significantly associated with the desire for childbearing were the number of children (one child vs. no child: OR=5.23,95% CI: 2.03–13.49; two children vs. no child: OR=2.21,95% CI: 0.98–5.001), the subscale “Child as a Pillar of Life” (OR=1.02,95% CI: 1.008–1.04), the subscale “Postponing Childbearing to the Future” (OR=1.06,95% CI: 1.05–1.08), and the subscale “Childbearing Requires Prerequisites” (OR=1.01,95% CI: 1.002–1.03).
Conclusion: Overall, one-third of the women who participated in this study currently desired childbearing, and nearly two-thirds expressed a desire for it in the future. A positive attitude towards childbearing emerged as the most essential factor associated with this desire.
Marzieh Gharanjiki, Abdolhalim Rajabi, Taghi Amiriani, Gholamreza Roshandel, Mohammadali Vakili,
Volume 21, Issue 2 (Vol.21, No.2, Summer 2025)
Abstract
Background and Objectives: Colorectal cancer is the most common gastrointestinal malignancy worldwide, and its incidence is increasing in Iran. Competing risk analysis offers a refined approach to identify factors influencing Colorectal cancer-specific mortality. Therefore, This study was designed and conducted to determine the survival of patients with colorectal cancer and its associated factors.
Methods: The study was a historical cohort. Data of patients diagnosed with colorectal cancer between 2013 and 2019 at Golestan University of Medical Sciences were collected, and patients were followed up until May 4, 2024. Patient survival was estimated, and the cumulative incidence function, as well as competing risk models of cause-specific hazards and subdistribution hazards, were applied for competing risk analysis. Model adequacy was assessed using the Akaike Information Criterion. Analyses were performed in STATA version 17 (α = 0.05).
Results: Of the 811 patients, 366 (45.13%) were women and the rest were men. The mean age and standard deviation were calculated as 58.54 ± 13.87 years. In the multivariable analysis of factors associated with colorectal cancer mortality in the presence of competing risks, variables including gender, age, literacy, ethnicity, and metastasis were statistically significant in both models. Findings indicated that the cause-specific hazard model provided a better fit for analyzing survival outcomes in colorectal cancer.
Conclusion: Competing risk analysis based on cause-specific hazards is recommended in the multivariable analysis of factors associated with colorectal cancer mortality, particularly in the presence of competing risks of death from other causes.
Mahboobeh Naroui, Parya Jangipour Afshar, Aliakbar Haghdoost,
Volume 21, Issue 3 (Vol.21, No.3, Autumn 2025)
Abstract
Background and Objectives: This study was conducted to determine the rate and examine factors associated with the migration of patients from Iranshahr to other regions of Iran for hospital care during 2023–2024.
Methods: This cross-sectional study employed an indirect approach. First, patients registered in the SIB system were asked about the size of their close family network. If the patient or their first-degree relatives had traveled outside Iranshahr to receive medical services, they were interviewed. Ultimately, 159 individuals were included. Factors and challenges associated with patient migration were scored on a scale from 0 to 20.
Results: The proportion of individuals who migrated from Iranshahr for hospital services in the past year was 5.9% (95% CI: 5.0, 6.7), equivalent to 6,785 people. The leading factor for migration was the type of illness, with a score of 19.1 (95% CI: 18.5, 19.5). Most patients traveled for gastrointestinal, cancer, and cardiac diseases, with referrals mainly to Kerman and Yazd provinces. Satisfaction with services received, with a score of 17.1 (95% CI: 16, 17.5), was the main reason for repeat referrals. The principal challenges were transportation costs (score 16.6) and accommodation costs (score 16.3).
Conclusion: Poor quality, limited effectiveness, and lack of diagnostic infrastructure were the main drivers of patient migration. To promote access and social equity, strengthening the healthcare infrastructure in this region must be prioritized.
Maryam Gholamarzaei, Marjan Ajami, Sareh Shakerian,
Volume 21, Issue 3 (Vol.21, No.3, Autumn 2025)
Abstract
Background and Objectives: Considering the importance of prevention and effective community-based interventions in reducing the psychological and economic burdens of cancers, and focusing on modifiable risk factors, the present study was designed and conducted with regard to several of these factors.
Methods: This case-control study included 211 patients with various types of cancer and 322 controls selected from the PARSA health system. Primary exposures of interest included fast food consumption, fruit and vegetable intake, and physical activity. The International Physical Activity Questionnaire (IPAQ) was used to assess physical activity levels, while the Food Frequency Questionnaire (FFQ) was used to measure fast food and fruit and vegetable consumption. Descriptive statistics and Chi-square tests, independent t-tests, and logistic regression were used for analysis.
Results: Logistic regression analysis indicated that inadequate fruit and vegetable consumption compared to adequate intake was associated with odds ratios of 4.49 and 4.042, respectively, for increased cancer risk. In addition, lower fast food consumption (OR = 0.466)] was associated with a 53% reduction in cancer risk. Physical activity [at the walking level] was statistically significant, although the effect size was very weak. Occupation, gender, education level, family history, and age showed statistically significant relationships with cancer, while other demographic variables showed no significant association.
Conclusion: Based on the findings of the current study and other evidence, as well as the fact that dietary patterns and physical activity are modifiable risk factors, appropriate interventions can play a preventive role in reducing the incidence of chronic diseases. This requires improving community awareness and designing and implementing effective interventions.
