Ghaseminejad, Tavafian, Heidarnia,
Volume 14, Issue 1 (6-2015)
Abstract
Introduction: Low back pain is a common problem among nurses. the purpose of this study was to assess effectiveness of physical health educational program on the quality of life of nursing staff with chronic low back pain working in hospitals in yazd.
Methood: This semi experimental study was carried over 119 employees with chronic low back pain working in hospitals in yazd in both intervention (n=60)and control (n=59) groups. The intervention group participated in a training program included a - 180 minutes education session. Data were collected through using the 36-item Short-Form Health Survey questionnaire (SF-36) at base line and 3- month follow up and analyzed using descriptive and analytical statistics.
Conclusion: This study showed the physical dimensions of quality of life including physical functioning , role physical , bodily pain and general health in the intervention group with mean age of 72/32,58/18,59/96,69/10 respectively were improved in compare with the same dimensions in control group with mean age of 60/50,47/88,38/05,51/27 at 3- month follow up (P<0/0001). There were no significant improvement in terms of mental component of quality of life in intervention (P=0/855).
Results: The results indicated the educational program could be effective on physical functioning, role physical, bodily pain and general health.
Shima Naderi, Mohammad Amiri, Leila Riahi,
Volume 14, Issue 2 (8-2015)
Abstract
Background: Hospitals are best places to provide preventive and health promotion services along with healthcare services. These studies aimed at determine the effect of establishing health promoting hospitals’ standards on hospitals indicators in Fatemieh hospital.
Materials and Methods: This is a comparative study which was conducted in Fatemieh (case) and Khatamolanbia (control) hospitals in 2013. The standards of health promoting hospitals as an independent variable were established in Fatemieh hospital. Data related to indicators of leaving hospital with personal satisfaction, Cardio pulmonary Resuscitation (CPR) and neonatal mortality were collected in both hospitals in second half of 2012 and first half of 2013. SPSS version 16 used for data analysis and Chi-square and Fisher exact tests were utilized. The results were shown by comparative tables.
Results: The neonatal mortality rate before and after the intervention was 7.28 and 14.03 in case hospital, while this rate was 5.26 and 10.83 in control hospital respectively. The percentage of leaving hospital with personal satisfaction before and after interventions was 3.43% and 2.93% respectively in case hospital and success of cardiopulmonary resuscitation in this group was 56.1% and 61.3% correspondingly. There was no significant relation between establishing standards of health promoting hospitals and indicators of leaving hospital with personal satisfaction and neonatal mortality in Fatemieh hospital, while significant relation was obtained between promoting of cardiopulmonary resuscitation indicator and standards of health promoting hospital in mentioned hospital(P=0.001).
Conclusion: Initial results revealed that establishment of health promoting hospitals’ standards had positive effects in Fatemieh hospital and lead to improve a number of indicators.
Neda Asadi, Zahra Royani,
Volume 14, Issue 2 (8-2015)
Abstract
Background: Depression is a common disorder with incremental trend among patients with hemodialysis. This study conducted in order to determine correlation between social support and depression among patients undergoing hemodialysis of Kerman city.
Materials and Methods: This study was a cross-sectional one. 182 hemodialysis patients referred to health centers of Kerman were selected by census sampling method. data was collected Using questionnaires including demographic information, Beck's Depression Questionnaire (BDI) and Social Support Questionnaire (ESSI: Enriched Social Support Instrument) and analyzed by SPSS software version 17 utilizing descriptive statistics (mean and standard deviation) and Pearson Correlation Coefficient test.
Results: 68.1% of the subjects had some degree of depression. Also, 83% of participants reported good social support. Furthermore, Assessing the relation between depression and social support revealed an inverse relationship between depression and social support (P =0.005), increasing social support occurred decreasing depression as well.
Conclusion: Study results indicated high prevalence of depression among the patients. It seems special attention in should be paid to psychological issues in hemodialysis wards. Nurses can prevent depression incidence by recognizing high risk individuals in term of perceiving social support among these patients.
Masoumeh Saeedian, Mohammadmehdi Sepehri, Hassan Aghajani, Toktam Khatibi,
Volume 14, Issue 3 (9-2015)
Abstract
Background: Myocardial Infarction (MI) is the most common cause of death in developed and developing countries. Based on World Health Organization prediction, MI will be the leading cause of death in the world up to 2020. The main goal of acute myocardial infarction therapy is reperfusion which is performed by two treatment approaches, although these two methods use for unique complication treatment but they are different in treatment cost and quality; Since the costs of health care is growing, this study aimed at identifying affected differentiated costs among patients with acute MI with the purpose of providing a framework to compare two treatment methods.
Materials and Methods: In presented model in current study, with the purpose of select affecting cost attributes utilized hybrid of Genetic algorithm and decision tree approach as a new method and compare its result using random method.
Results: Study result presented classifies error reduction up to 0.2 compare with random method error. Then, based on selected attributes, presented a framework comparing two treatment methods. Also, in the majority of direct cost and total cost, Primary Angioplasty was cost effective more than Thrombolytic Therapy, but in indirect cost, we achieved some results dissimilar to physicians' expected results such as kidney failure.
Conclusion: Suggested approach in this research can be a guidance to physicians and insurances institutes in acute myocardial infarction treatment policies.
Zohreh Kalani, Zahra Pourmovahed, Ali Akbar Vaezi, Seyede Felor Vaziri,
Volume 14, Issue 3 (9-2015)
Abstract
Background: Using vein by Peripheral Catheter is one of the important ways to provid water, electrolytes, medications and nutrients to patients in hospitals and other therapeutic centers. Phlebitis is an important complication of using peripheral cannula. This study performed to determine the incidence of phlebitis related to peripheral cannulae, and its effecting factors.
Materials and Methods: This prospective and analytical study was conducted in adult's medical- surgical units of Shahid Sadoughi Yazd. Two hundred ninety seven cannulae of 297 patients were assessed. Phlebitis was identified by the presence of at least two following symptoms including local pain, redness, swelling, warmth and palpable venous cord.
Results: The mean of patients' age was 40.82±19.48 (12-91 yrs.). The phlebitis incidence rate was 14.1%. Some factors such as smoking (P=0.007), diabetes (P=0.001) had positive and significant association with phlebitis incidence rate. Odd Ratio for smoking and diabetes were 3.107(CI=1.310-7.372, 95%) and 3.736(CI=1.736-8.039, 95%) respectively.
Conclusion: Study findings revealed that overall incidence rate of phlebitis compare with other similar studies was low. Study results indicated high phlebitis incidence in smokers, diabetic patients, and elder patients which can be prevented by considering phlebitis incidence in impatiens.
Faramarz Pourasghar, Jafarsadegh Tabrizi, Nesa Kavakebi, Ahad Banagozar Mohammadi,
Volume 14, Issue 3 (9-2015)
Abstract
Background: Patient transfer requires the wide variety of functions such as collaboration, appropriate communication and coordination between hospitals and the Center for Treatment Guidance and Information (CTGI). This study aimed at determining the influencing factors in the coordination of patient transfer and also explaining the situation of the CTGI in patient transfer process coordination.
Materials and Methods: This study was a qualitative study (phenomenology) conducted using three Focus Group Discussions (FGD) and thirty interviews with participants who were involved in the process of patient transfer in a referring hospital, six patient receiver hospitals and CTGI in Tabriz. Purposive sampling was used to select study participants. Data was analyzed using content analysis.
Results: The effective factors of the patient transfer coordination were categorized in four main themes including weakness in the exchange of clinical information, data constraints, legal protections weakness and guidelines implementation and lack of clinical empowerment in managing patient. Eighteen sub-themes were identified which include legal protections weakness and guidelines implementation in center for treatment guidance as sector problems.
Conclusion: There are some problems in coordination of patient transfer process which is relate to non adherence a specific procedure for admission , ineffective interactions and information exchange. In order to achieve uninterrupted medical treatment, the patient transfer coordination should be improved. The center for treatment guidance and information should be obtained its position as a supervising authority.
Dr. Farnaz Khatami, Dr. Mojtaba Sedaghat Siyahkal,
Volume 14, Issue 4 (1-2016)
Abstract
Background: This study investigated the Length of Stay (LOS) in the Intensive Care Unit (ICU) and its influential factors as a step toward revising hospital policies, more appropriate resources usage and improving health system performance.
Materials and Methods: this cross-sectional study was conducted on 246 patients, among nine general ICUs of Tehran University of Medical Sciences. Variables such as age, type of disease, existing nosocomial infection and APACHE II (Acute Physiology and Chronic Health Evaluation) score were studied. SPSS software utilized for statistical analysis using Mann Witney U and regression.
Results: The mean and median of LOS was 8.6±19.2 and 2 (1-7) days, respectively. Mortality rate was 19.9% (N=49). The mean age was 52.7±22.07 yrs which LOS enhanced with increasing age (r=0.35, p<0.001). The mean of APACHE II score was 14.2±6 and it raised with increasing patients LOS (r=0.19, p=0.01). Average length of stay in patients with surgical diagnosis was 6.71 days less than others. Among effecting factors, nosocomial infection (p<0.001), need for mechanical ventilation in the first 24 hours of hospitalization (p<0.001) and a past medical history (p=0.012) which prolonged LOS significantly.
Conclusions: In this study, type of disease, hospital infection and age were the most important affecting factors on the length of stay. Thus, implementing effective interventions in order to maintain patients' health and safety is recommended. Since, half of the patients were hospitalized less than two days, providing protocols are necessary to make better use of ICU resources for patients who really need.
Jafar Sadegh Tabrizi, Yeganeh Partovi, Amir Bahrami, Mohammad Asghari,
Volume 14, Issue 4 (1-2016)
Abstract
Background: Type 2 diabetes is a chronic disease which has incremental prevalence regarding to unhealthy lifestyle. Based on the significant gap between received and standard care in patients with type 2 diabetes, this condition occurred high costs to health system. In order to eliminate this gap, this study aimed at measuring the technical quality of perceived care among patients with type 2 diabetes.
Materials and method: A cross-sectional study was carried out among 180 people with two type of diabetes in diabetes clinic using convenience sampling method. A three part questionnaire includes demographic information, disease statue and the technical quality questions was that the validity and reliability of it was approved. The data were analyzed using SPSS13software.
Results: Total technical quality score was 2.9 which was lower than bench mark 5. The main indices related to diabetic control (HbA1c, blood pressure, LDL) were acceptable regarding Iranian diabetic guideline and they were controlled well.
Conclusion: According to notable gap between existing standards and perceived care in type 2 diabetic patients, there is a good opportunity to promote quality of services.
Ali Asghar Ayatollahi, Reza Kazemi Darsanaki, Abolfazl Amini, Somayeh Rahimi, Mohammad Ali Vakili, Sara Hoseinzadeh,
Volume 15, Issue 2 (6-2016)
Abstract
Background:Nosocomial infections due to mortality and economic costs are one of the main challenges in current century. Gram-negative bacilli infections acquired in hospitals and hospital environment is one of the most important places of residence and publication of these types of bacteria. This study aimed to investigate the prevalence of gram-negative bacilli from the equipment of hospital in Western region of Golestan province in 2015.
Materials and Methods: During this descriptive study, 1210 devices were examined with sterile swab of environment and equipments which used in various wards of seven teaching hospitals of Golestan province using census sampling. After identification of the isolated colonies based on biochemical standard tests, results analyzed using SPSS version 22.
Results:Based of isolated samples, 352 positive microbial cultures (29.1%) contaminated with gram-negative bacilli which the highest bacterial contamination was related to Enterobacter (10.7%). among different hospital wards the highest bacterial contamination observed in ICUs (19.32%) and among assessed equipment, the highest contamination was related to laryngoscope blades (10.51%), phone (7.1%) , ECG sensor device and monitoring interface (6.25%).
Conclusion:The study findings confirmed that microbial contamination with gram-negative bacilli of hospitals equipment is highly considerable in West of Golestan province. Periodic assessments can be effective in nosocomial infections prevention.
Dr Roohollah Askari, Naeimeh Keyghobadi, Fateme Jafari Nodoushan, Dr Sima Rafiei,
Volume 16, Issue 3 (11-2017)
Abstract
Background: One of the main principles in comprehensive care giving in nursing is spirituality and spiritual care which has been addressed to have a crucial role in providing more effective treatment in patients. This study aimed to assess nurses’ attitude toward spirituality and spiritual care in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016.
Materials and Methods: This descriptive, cross-sectional study was conducted among 133 nurses employed in three selected teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016. Data collection was performed through a two- section standard SSCRS questionnaire (The Spirituality and Spiritual Care Rating Scale) including spirituality (n=15 items) and spirituality care (n=8 items). To data analyze SPSS software version 22 was utilized. Significance level was set less than 0.05.
Results: The mean score of attitude toward spirituality and spiritual care were calculated relatively 31.15±7.89 and 21.05±5.5, respectively. Furthermore, there was a significant statistical association between nurses’ attitude with gender (p=0.01) and job category (p=0.03). given that, there was no significant association between age, educational level, employment and marital status.
Conclusion: Based on study findings, attitude toward spirituality were more desirable compare to spiritual care among nurses. Thus, more training and awareness can have affecting effects on clinical care and treatment quality potentially in spite of positive attitude toward spirituality.
Dr Abdolreza Shaghaghi, Hassan Mahmoodi, Hossein Shahriari,
Volume 17, Issue 3 (11-2018)
Abstract
Background: The Health Promoting Hospitals (HPH) initiative emphasizes on changes in traditional hospitals’ approach in care provision. This study aimed to provide scientific evidence required for successful planning and implementation of the HPH in the country’s educational hospitals.
Materials and Methods: In this descriptive-analytical study, opinions of 300 frontline health professionals working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences were examined using validated tools in 2016. Descriptive data analysis procedures and logistic regression analysis (using Enter method) were applied by SPSS software version 22. The level of significance was considered less than 0.05.
Results: The mean scores and SD for applicability of the HPH standards were 66.06±17.51. Gender (OR=3.19 95%CI: 1.33- 8.40), occupation type (OR= 1.50 95% CI: 0.65- 0.70), hospital type (general vs. specialized) (OR= 1.59 95%CI: 1.10- 1.25), number of active beds (OR=3.84 95% CI: 1.56-9.42) and having prior knowledge about the HPH program (OR=2.81 95% CI: 1.31-4.80) were identified as significant predictors of the HPH standards’ feasibility in the studied hospitals.
Conclusion: Given that study findings, at least the baseline subjective inclination to adapt the HPH standards in the educational hospitals do not exist through the Iranian health care providers’ points of view. As the first step in progress towards preparation for implementing the HPH standards, planning of tailor-made educational programs for hospitals’ staff in Iran is recommended.
Sara Bigdeli, Dr Maryam Tajvar, Dr Mohammad Arab,
Volume 18, Issue 1 (5-2019)
Abstract
Background: Visual disorders in old age is one of the most important factors in decreasing quality of life of older people. This study aimed to access the vision-related quality of life of older people in Tehran and to examine some of the underlying factors.
Materials and Methods: This was a population-based cross-sectional study among 566 older people aged 60 years and over, living in Tehran. A multistage cluster randomized sampling method was used to select study population, data was gathered using interviewing them at their home. NEI-25 VFQ (Visual-Functioning Questionnaire) was used to measure the vision-related quality of life of the participants. Multi-level linear regression analysis was used to data analysis.
Results: The average score of the vision-related quality of life was 80 out of 100. Among 12 dimensions of Visual-Functioning Questionnaire, the dimensions of color vision (CV), vision specificsocial functioning (VSSF) and peripheral vision with the scores of 96.8, 96.7 and 95 gained the highest and the dimensions of driving and vision specific dependency (VSD) with the scores of 42.6 and 50.3 had the lowest scores, respectively. Significant associations were observed between being a women, older, and having a lower education with poorer vision-related quality of life.
Conclusion: This study results provides an evidence for policymakers in prioritizing visual health services based on more impaired visual function and also at risk older people.
Shima Tasharoei, Dr Ali Jahan, Dr Kamran Ghods,
Volume 18, Issue 2 (8-2019)
Abstract
Introduction: Intensive Care Unit (ICU) in hospitals is one of the most sensitive and costly units which is really important due to safety and health of patients during their stay in these units. Hence, considering the potential risks in this unit, treatment operations for eliminating or decreasing risks are very important. Among these intensive care units, the most important one is the open-heart surgery unit which may have irreparable damages due to vulnerability of these patients in the process of their transfer, care, and discharge. The present study aims to identify the potential risks and offer solutions for eliminating or decreasing them.
Method: In this research, we used Failure Mode and Effect Analysis (FMEA) method, which is a very useful method for evaluating and managing the risks, to prioritize risk factors. Due to some limitations of the method, fuzzy FMEA and fuzzy TOPSIS methods were also used in order to have more precise results and then the results were compared with each other.
Results: The suggested approach was implemented in ICU-OH (open-heart) unit of Kowsar hospital in Semnan. Finally, nineteen factors were recognized as major risk factors. Also, corrective actions were determined for all detected risks that can be pursued according to their priorities.
Conclusions: Factors including not observing hemodynamic signs, not considering patient safety and security, and inability to interpret arterial gas valve abnormalities are the three top risk factors that can be addressed through training and having more control on nurses.
Fatemeh Khazaei, Hasan Mirza Hosseini, Mostafa Nokani,
Volume 19, Issue 2 (8-2020)
Abstract
Introduction: Hemodialysis is one of the effective therapies in patients with chronic renal failure. Along with increasing life expectancy as a benefit of this treatment; this type of service can threaten the quality of life of recipients. Therefore, the present study was conducted to investigate the effectiveness of emotional schema-based therapy on improving the quality of life of dialysis patients.
Materials and Methods: The current semi-experimental, applied study was designed and implemented as pretest-posttest research with a control group. All outpatients treated with dialysis instrument in medical centres affiliated to Tehran University of Medical Sciences in 2009-2010 were the statistical population of the study and the quality of life questionnaire related to kidney patients used for data collection. After the research team performed the treatment protocol in 8 sessions of 90 minutes in the intervention group, the research data were analyzed using SPSS24.
Results: The results of the study showed that the treatment protocol based on emotional schema therapy influence all aspects of quality of life and increase the mean score compared to the pretest. Also, there is a significant difference between the groups, both in the general dimension and specific dimension of dialysis patient's quality of life.
Conclusion: As the study findings show, it can be stated that emotional schema therapy is effective in improving the quality of life of dialysis patients and can be used as a useful intervention to improve the quality of life of patients.
Fariba Salahi, Nastaran Farajpour,
Volume 20, Issue 2 (9-2021)
Abstract
Background and Aim: Today we are witnessing tremendous advances in medical data mining. The data, by analyzing and discovering the relationships between them, can lead to algorithms that help us prevent or treat many diseases. Meanwhile, genetic diseases have attracted a large part of the attention of the medical world because the birth of children with genetic disorders imposes a great financial, psychological and emotional burden on society. Therefore, the aim of this study is to present an algorithm as a secondary screening test before performing cell and molecular tests.
Material and Methods: In this study, 1000 cases of pregnant women who were in moderate or high risk group after screening tests were studied. Their clinical information was stored, missing data was deleted, and records were integrated. Then, using Clementine software, data mining and data correlation were performed, and finally a suitable algorithm for diagnosing the disease was performed. Genetic mutations were identified.
Results: By applying five algorithms, neural networks, support vector machine, binary decision tree, multiple decision tree and logistic regression on the data, it was found that the neural network algorithm with 97.522% accuracy has the highest success rate in Diagnosis of genetic-chromosomal diseases before birth.
Conclusion: The use of genetic algorithm as a screening test causes less people to be candidates for costly and dangerous cellular and molecular tests and can be used as a tool to help detect the disease. To be used in the medical world.
Maryam Donyaei, Elnaz Yazdan Parast, Azadeh Arasteh,
Volume 21, Issue 2 (9-2022)
Abstract
Background and Aim: Anxiety is an unpleasant condition that occurs in the majority of people before surgery, and it can cause bleeding and complications after surgery and it can also affect the induction of anesthesia and recovery from it. Nowadays, due to the side effects of medications, non-pharmacological and non-invasive treatments are receiving a lot of attention.The purpose of this research is to determine the effectiveness of acupressure and recommended recitals on the patients’ anxiety before surgery in the hospitals of Ferdows city in 2019-2020.
Methods: This study was a double-blind clinical trial research that was conducted on 150 patients who were candidates for surgery. The samples were selected using convenience sampling. The participants were randomly assigned to one of the three acupressure groups (n=50), recommended recitals (n=50) and the control group (n=50). In order to apply acupressure, the third eye point (Yintang) was pressed for 10 minutes, and in the recommended recitals group, the patients listened to Surah Hamad and Zekr several times using an audio source and headphones. In the control group, pressure was applied to the false point for 10 minutes. The level of anxiety was measured using the VAS questionnaire in all three groups before, after and 30 minutes after the intervention respectively. Data were entered into SPSS software version 19 using descriptive and inferential statistical methods.
Results: In recommended recitals group, the average anxiety score before, after and 30 minutes after the intervention had a significant difference with each other (P<0.001). Also, the average anxiety score after the intervention was significantly lower than immediately and 30 minutes after the intervention in this group (P<0.001). Meanwhile, the average score of anxiety in the acupressure group (p=0.06) and the control group (p=0.10) did not show any significant difference with each other at three times.
Conclusion: Recommended recitals can reduce anxiety before surgery and can be used as a non-drug, safe and cheap method to reduce anxiety before surgery.
Elahe Amirahmadi, Mehdi Rezaie, Fatemeh Meshkini, Mohammad Hosseinikasnavieh,
Volume 21, Issue 3 (12-2022)
Abstract
Background and aim: Having weakness and lethargy and feeling the need for hospital emergency services is one of the most important reasons for patients to go to hospital emergency rooms. The aim of the present study was to investigate the relationship between morbidity and mortality of patients with weakness and lethargy.
Method: The present study was conducted in an observational and prospective manner in the emergency department of Rasool Akram and Firouzgar hospitals. The patients were divided into 5 groups by the evaluation team in the emergency triage unit using the international valid triage tool "Emergency Severity Index (ESI)". The patients were followed up for 2 months after the time of discharge and the patient's condition was examined in terms of illness, health or death.
Result: Between levels 1 and 2 (patients with high severity conditions) and 3 (patient needs two or more emergency facilities in case of no disturbance in vital signs), level 3 had the highest frequency of referrals (61.9%). 90.7% had an underlying disease and 66.1% of the patients were taking medication at the time of visit. 11% of patients died in the first visit. In the initial follow-up, 23.7% of people were still sick, 40.7% had recovered and 17.8% had died.
Conclusion: According to results in the final follow-up, 3.9% of people were still sick; the rate of recovered patients in the final follow-up was 44.1% and the percentage of deaths in the final follow-up was 24.6%. The high mortality rate indicates that the patients' concern was not due to weakness and lethargy, but due to a dangerous underlying disease that forced them to go to the hospital.
Seyed Mohammad Mehdi Baki Hashemi,
Volume 22, Issue 1 (5-2023)
Abstract
Background and purpose: Inter-hospital transfer refers to the transfer of patients to receive diagnostic, therapeutic and paraclinical services that can prevent more injuries or more effective treatment. The present study was designed with the aim of collecting and analyzing information related to sent patients and identifying the factors that cause the transfer of patients.
Methods: This cross-sectional study was conducted on 11,362 patient referral forms registered at Gilan University of Medical Sciences. Data were analyzed by Spss statistical software version 22 and Chisquer statistical test.
Results: The amount of patient transfer requests in 1401 compared to 1400 has increased by 9%. There is a relationship between the demand for transfer of patients with inappropriate distribution of specialized human resources, lack of demand feedback mechanisms, ineffective planning of nursing staff and residency of doctors in the hospital of origin, inefficient management of resources and equipment, lack of diagnostic, medical and pharmaceutical facilities, as well as with the seasons of the year. There is significant (p>0.05). There is a significant relationship between non-acceptance of patients and the lack or lack of beds needed by the patient in the destination hospital (p<0.05).
Conclusion: Improper distribution of specialized manpower according to the needs of the region, ineffective planning of resident guards, inefficient management have been identified as the main reasons for the demand for patient transfer. Forming a special working group to identify, evaluate, plan and monitor the removal of obstacles in a centralized manner and forming quality improvement circles can be a solution.
Elahe Totabi, Reza Mirzaei, Mohsen Najmaddini,
Volume 22, Issue 1 (5-2023)
Abstract
Background and purpose: The physical environment of the hospital includes elements and components that improve the quality of the treatment environment and also reduce the stress of the patients. Therefore, this research aims to improve the environmental quality of treatment spaces with the approach of reducing patients' stress.
Materials and methods: Based on the research approach, descriptive-analytical has been done. The selection of the research sample in the General Surgery Department (Imam Reza Birjand Hospital) is considered. To collect data, a questionnaire (patient, patient's companion, doctor and staff) was used to prioritize the variables. The validity of the questionnaire was checked by 3Smart PLS software, and the reliability was measured by Cronbach's alpha. Then the collected data was analyzed in SPSS 26 software.
Results: The results of this study showed that the prioritization of different criteria from the physical factors of the indoor environment of therapeutic spaces including: convenience, flexibility, nature, light, color, fresh air, sound, texture, furniture arrangement, works of art, and scent are different. It is meaningful. Based on the Kruskal-Wallis test, the most significant difference in the patient's stress reduction priority is the criteria of color, material and texture, fresh air, scent. Based on the Yeoman-Whitney test, gender has a significant difference in the variables of scent, color and fresh air.
Conclusion: The results of the research identified that flexibility, convenience, nature, according to the descriptive statistics, have the most influence in reducing the stress of the patients from the perspective of all the participant. Design solutions with the approach of reducing patient stress in medical centers are presented based on the significance of most variables.
Ahmad Arabkhani, Hossein Dargahi, Raheb Ghorbani, Israfil Rushdi,
Volume 22, Issue 1 (5-2023)
Abstract
Background: The development of the health system increases the health level of the society. The present study was carried out with the aim of development of "Health System Development Scale".
Methods: The study was qualitative-quantitative. For qualitative part, a semi-structured interview with 11 experts was conducted in a targeted manner with maximum diversity and the results were analyzed by open, central and selective coding method. For quantitative part, first the validity of the questionnaire was carried out through interviews with 10 experts. Finally, the construct validity was conducted according to the opinion of 220 experts by exploratory factor analysis (with the Kaiser-Meyer-Elkin scale) and confirmatory factor analysis (in the form of divergent, convergent validity and fit indices) using SPSS and Lisrel software. Reliability was also measured by calculating Cronbach's alpha coefficient and composite reliability.
Results: The scale was designed with 40 statements obtained from the findings of the qualitative study. In the quantitative part, the appearance and content validity ratio of the dimensions of the questionnaire was qualitatively confirmed (for all statements between 0.80 and 0.1). Construct validity was done by exploratory and confirmatory factor analysis and convergent validity was between 0.53 and 0.75 and divergent validity was between 0.54 and 1. The internal consistency of the tool was approved with Cronbach's alpha coefficient between 0.75 and 0.86 and composite reliability coefficient was between 0.72 and 0.80.
Conclusion: The validity and reliability of the scale was confirmed. It is suggested to use it to measure the level of development in the health system by experts in this field.
