Payavard Salamat

Survey the Effect of Virtual Network on the Knowledge and Clinical Skills of Surgical Technologist Students

nazanin sarraf shahri

Background and Aim: Virtual networks have become one of the most influential tools in people’s lives, affecting various aspects of life. In medical sciences, with numerous advancements, the use of virtual networks is increasing. However, virtual networks can lead to wastage of students’ time and a reduction in study hours, which negatively impacts their knowledge and practical skills. Therefore, this study aimed to investigate the impact of using virtual networks on the knowledge and practical skills of surgical technologist students.
Materials and Methods: This descriptive-analytical study was conducted on 60 students in the 6th and 8th semester of operating room technology at Iran University of Medical Sciences in 2020-2021. At the end of the semester, the students underwent a comprehensive 40-question theoretical exam to assess their theoretical knowledge. To evaluate the level of virtual network usage, the students filled out a researcher-designed questionnaire. The practical skills of the students were measured based on their internship grades. Normality of the data was assessed using the Kolmogorov-Smirnov, and Pearson correlation coefficient test. Data analysis was performed using SPSS software.
Results: According to the findings of this study, there was a significant negative relationship between the level of virtual network usage and theoretical knowledge (P<0.05). This means that with an increase in virtual network usage, the level of students’ knowledge decreased. On the other hand, there was a significant positive relationship between theoretical knowledge and practical skills. This means that as the scores of the comprehensive exam increased, the scores of practical skills (internship) also increased. However, no significant relationship was found between the level of virtual network usage and students’ practical skills (P>0.21).
Conclusion: Based on the findings of this study, virtual networks lead to a weakening of students’ theoretical knowledge, as evidenced by the decrease in scores on the researcher-designed questionnaire (level of virtual network usage) and the comprehensive exam scores. Another result of the study was the significant positive relationship between theoretical knowledge and practical skills, indicating that as the comprehensive exam scores increased, the scores obtained in internships also increased.

Investigating the Effect of Virtual Professional Ethics Training on the Communication Skills of Operating Room Staff

Fatemeh Kazemi Najafabadi

Background and Aim: Communication skills are considered as the most important feature required for health care workers and provide the basis for the development of professional ethics. Since working in the operating room requires team effort and establishing communication between team members, the importance of communication skills in operating room nurses is more visible. Therefore, in the present study was performed, with the aim of determining the effect of virtual training on the principles of professional ethics on communication skills of operating room staff of Ayatollah Kashani and Hajar hospitals of Shahrekord University of Medical Sciences.
Materials and Methods: A quasi-experimental study with a single-group plan before and after in 2020 was performed on 35 operating room staff of Kashani and Hajar teaching hospitals in Shahrekord who were selected by random sampling. Demographic information questionnaire and Queen Dam communication skills questionnaire were used to collect the data. Data analysis was performed by SPSS software using independent t test, Analysis of variance, paired t-test and ANOVA statistics.
Results: Paired t-test showed that the mean of communication skills after the intervention was significantly different from before (P<0.001). The mean of communication skills before the intervention was 65.85±24.52 and after the intervention was 139.77±5.70. No significant relationship was reported between communication skills and age, service history and number of working hours (P>.0.05). Also, there was no significant difference in the average of communication skills according to the variables of gender, marital status, field of study and degree (P>0.05).
Conclusion: The present study showed that professional ethics training was able to improve the communication skills of employees. Therefore, it seems necessary to compile virtual professional ethics training for health care providers and other groups providing health services who do not have enough time to participate in face-to-face classes. According to the results obtained, managers of health systems are recommended to use strategies such as holding workshops on the principles of professional ethics to develop communication skills in their employees.

The Frequency of Growth Deviations of Children Under 5 Years from Standard Curves and Its Related Factors in Zahedan

Mostafa Peyvand

Background and Aim: Children’s health is important as the future builders of society. Many children under 5 years of age around the world and in Iran have growth disorders. Due to the importance of growth disorder and its impact on the development, learning and future of the child, the present study was conducted with the aim of determining the frequency of deviations from the growth curves of children under 5 years of age and related factors in Zahedan city.
Materials and Methods: This case-control study was conducted in 2020 in Zahedan. The study population included all children under 5 years old, born in Zahedan between 2013 and 2020 that 784 of whom were selected by random sampling method. To determine the factors related to growth disorder multiple logistic regression analysis was used and to check the significance level, chi-square test and Pearson correlation were used. In this research, the data were analyzed with SPSS software.
Results: The results of this research showed that 54% of the boys and 51.20% of the girls had growth disorders. Between child growth disorder and maternal chronic disease (P<0.05), maternal body mass index (P<0.05), Maternal weight gain during pregnancy (P<0.05), distance between births (P<0.05) maternal urinary tract infection during pregnancy (P<0.05), mother’s age (P=0.006), mother’s education (P<0.05), birth weight (P<0.001), birth order (P<0.05), father’s occupation (P<0.05) and father’s education (P<0.05) a significant association was found. In the present study, the average birth weight in children with growth disorders was 2.75±0.58 and in healthy children was 2.95±0.57, and this difference was statistically significant (P=0.001). The average age of mothers of children with growth disorders was 29.19±6.07 and the average age of mothers of healthy children was 27.98±6.10, this difference was statistically significant (P=0.006).
Conclusion: Growth disorder is a multi-causal complication. Risk factors can be corrected and prevented by developing health education and increasing mothers’ awareness and knowledge. Also, the father’s job and literacy are effective in the child’s growth disorder, so Increasing community health literacy and encouraging fathers’ learning and literacy can partially prevent growth disorders in children.

Reasons for Induced Demand in the Health System: A Scoping Review

Parvaneh Isfahani

Background and Aim: Induced demand is the provision of healthcare services to patients by the influence of healthcare providers. Induced demand causes excessive use of health services, increases the waiting time for receiving health services, increases the price of health services, increases the costs and reduces the efficiency of the health system. Policymakers and health managers should take measures to reduce induced demand. Hence, they should understand the reasons for induced demand in the health system. Therefore, this research aimed to identify the reasons for induced demand in the health system.
Materials and Methods: This research was carried out using the scoping review method. All published articles and documents about the reasons for induced demand in the health system until June 21, 2023 were searched in nine databases and Google Scholar search engine. Finally, 38 articles were selected and reviewed. The data were analyzed by thematic analysis method and using MAXQDA10 software.
Results: Thirty-eight studies about the reasons of induced demand in the health system were published between 1974 and 2021. The number of researches in this area has been growing since 2011. Overall, 32 reasons for induced demand in the health system were identified and grouped into three categories: macro (health system), meso (health care organization) and micro (provider and receiver of health services). The most frequent reasons for healthcare induced demand in the literature include inappropriate policies, insufficient monitoring, inappropriate payment system, large number of physicians, lack of attention to clinical guidelines, financial motivation of healthcare providers, patient insurance coverage, unreasonable patients’ expectations, inappropriate price of health services, the complexity of the health service and patients’ inadequate medical knowledge.
Conclusion: Induced demand has negative effects on the health system and will lead to an increase in health costs, waste of health resources, a decrease in the efficiency of the health system, and finally, a decrease in people’s access to essential health services. Several factors at different levels of the health system lead to induced demand for health services. Therefore, interventions should be systematically applied at three levels of the health system, healthcare organizations, and providers and recipients of health services to prevent and reduce healthcare induced demand.

Identifying the Components of Providing Health Information Services to Patients in Hospital Libraries in Health Disasters by Meta-Synthesis Method

Alireza Noruzi

Background and Aim: It is not possible to provide health information services in health crises without a comprehensive understanding of these services and how to provide them due to the health crisis. Based on this, the aim of the current research was to obtain comprehensive information about the components of providing health information services in health crises.
Materials and Methods: The current research was conducted with a qualitative approach and a meta-combined method, using the seven-step method of Sandelowski and Barroso. The statistical population consisted of articles and theses published in persian and international databases between 1991 to 2022 AD and 1370 to 1400 solar. Out of a total of 8363 resources identified based on the critical skills assessment program, 40 resources were approved. Extracted information was coded and coding reliability was measured and confirmed using Kappa coefficient.
Results: From the results of the research, 74 codes were extracted in 21 concepts and 6 categories in the field of providing health information services to patients. which categories and codes include health information needs assessment (disease, health, health information sources, patients); accessibility and dissemination of health information (health information, access ways); Awareness and notification of health information (information, tools); Education (patients, managers and staff of hospital libraries, methods); Planning (health crisis, resources, budget, infrastructure, patients, librarians and Medical Information Specialists) and obstacles and limitations (expert force, budget, facilities and infrastructure and resources) were categorized.
Conclusion: Dealing with the issue and components of providing health information services to patients in health Disasters in hospital libraries can cause policymakers in this field to know more about the dimensions, concepts, and consequences of providing these services in order to provide access to health information for everyone, especially patients. According to the identified components, efforts can be made to prepare the necessary infrastructure in order to plan to strengthen the strengths and eliminate the existing weaknesses and make appropriate policies in order to play the role of health counseling and launch the health information service department in hospital libraries.

Design and Usability Evaluation of Chronic Obstructive Pulmonary Disease Self-Care Application Based on Android

Kobra Darabiyan

Background and Aim: Despite the continuous progress in medicine, COPD (Chronic Obstructive Pulmonary Disease) is still a progressive, incurable and chronic respiratory condition that limits the patients’ functions in various dimensions, and significantly reduce their quality of life. In this way, self-care of patients and the use of related tools have a significant effect in disease control and treatment. The purpose of this research was design and development of an android-based application for COPD.
Materials and Methods: This research was a descriptive developmental type with a practical approach. Initially, based on the study of library resources, guidelines, and the examination of the medical records of COPD inpatients in Firouzabadi Hospital, a questionnaire was designed to identify the information requirements, data items and features of the application. Then it was reviewed and finalized by a sample of 10 (randomized and convenience sampling) internal and lung specialist doctors in Firouzabadi and Hazrat Rasool hospitals affiliated to Iran University of Medical Sciences. The data was analyzed using descriptive statistics, and then scenario tables and UML diagrams were illustrated to show the overall flow of the application. The application was designed and developed using the Java programming language in the Android Studio 2021 platform. After installing the application on the mobile phones of ten COPD patients of the internal and pulmonary clinic of Firouzabadi Shahre Rey Hospital, and using it for a week, the opinions of the patients about the usability of the application were collected through the QUIS questionnaire, and analyzed.
Results: Application sections were determined following experts’ survey, personal information items, clinical information, disease management, reporting, and training points, which were provided to patients after design for use and evaluation. At the end of the research, the results of the evaluation of the usability and satisfaction level of the application showed that from the patients’ point of view, the application is at a good level with an average score of 1.8 (out of 10 points).
Conclusion: The developed self-care application can be used to increase awareness, help to manage the disease, increase the level of quality of life, and reduce the complications and disease burden for patients with COPD.

Evaluation of Documentation and Coding Requirements of Medical Records in the Implementation of a Payment System Based on Diagnosis-Related Groups (DRG) in Medical Education Centers of Urmia University of Medical Sciences

Farid Khorrami

Background and Aim: In the health system, reimbursement methods are an important criterion for the allocation of resources and the performance of service providers. The use of diagnosis-related groups (DRG) system reduces the length of stay and additional costs of the patient, prevents unnecessary treatment, increases resource efficiency and transparency of health care services. The development of the DRG system focuses on the accurate documentation of medical records and the correct coding of diagnoses and procedures. The purpose of this research is to evaluate the documentation and coding requirements of medical records in the implementation of a payment system based on diagnosis-related groups in Iran.
Materials and Methods: This research was descriptive-cross-sectional and was conducted in 2022. The data collection tool was a researcher-made checklist, the validity of which was confirmed based on the opinion of experts (health information management health economics) and its reliability was obtained by calculating Cronbach’s alpha (0.83). The research population consisted of 418 medical records in five medical training centers affiliated to Urmia University of Medical Sciences, which were selected through stratified-proportional sampling. Data were analyzed using SPSS software.
Results: The results of the evaluation of the documentation and coding requirements of medical records for the implementation of the DRG system showed that the demographic/administrative variables including age, sex, type of admission, length of stay, health insurance, and doctor’s expertise were completely recorded. Evaluation of clinical variables also showed that the main diagnosis, main procedure, secondary diagnosis and other procedures were documented in medical records in 98%, 97%, 88% and 75% respectively. Regarding the coding of the main diagnosis and the main procedure, 100%, secondary diagnosis 68% and other procedures 80% have been done.
Conclusion: Considering that some essential clinical variables for the implementation of DRG, especially co-morbidities, complications and other procedures are not recorded separately and completely, therefore it is necessary to define separate information elements in medical records and HIS for accurate recording of these variables and proper interaction between coders and doctors is established to increase the possibility of correct coding. It is also suggested that the DRG system be implemented in our country in a phased and gradual approach so that necessary changes are made in the documentation process and hospital information systems.

A Systematic Review of the Performance of Persian Language Mobile Applications in the Covid-19 Pandemic

Azita Yazdani

Background and Aim: With the spread of the Corona pandemic, the statistics of the number of mobile health applications have grown significantly. This research was conducted with the aim of evaluating the content of Persian language applications in the management of Covid-19.
Material and Methods: In this review research, a systematic search for Persian language programs in the field of Covid-19 management was conducted in four mobile application markets including Myket, Bazzar, Google Play and App Store. The content of the programs was evaluated based on a researcher-made checklist, which was verified according 3 specialist comments, in the five axes of ease of use, education, monitoring, privacy and data sharing. Programs that received more than 50% of the evaluation score were introduced as selected programs. By removing duplicate programs, 119 programs were extracted, of which 21 programs entered the final stage of quality evaluation based on the inclusion and exclusion criteria and after a complete review of the content and capabilities.
Results: Based on the total points of the program, Safiran Salamat received the most score (31), Ac19 and mask were ranked next with 27 and 22 points, respectively. These three programs along with Corona Amar Tashkhis as fourth program received more than 50% of the content review and 17 other programs received less than 50% of the total score. Government has a great role in programs development (three program were government and one was non- government base). All 4 programs, had acceptable score in ease of use but none of them develop for user tracking. Pearson’s correlation test was used to test the relationship between the quality (total scores of apps) and the popularity (amount of downloads), and no significant correlation was observed.
Conclusion: The results of the present study showed that Iranian mobile applications have an acceptable performance in the fields of education and information sharing, but their low popularity makes the achievement of these goals far from expected. Marketing strategies can be effective as one of the useful policy in increasing the use of mobile health programs. Also, the inclusion of capabilities such as contact tracing and online consultations can be fruitful in the pursuit of goals.