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Showing 19 results for Type of Study: Applied Research
Reza Safdari, Abdorreza Naser Moghadasi, Sahar Khenarinezhad, Ehsan Ghazanfarisavadkoohi,
Volume 14, Issue 5 (1-2021)
Volume 14, Issue 5 (1-2021)
Abstract
Background and Aim: Taking a wide range of medications in Multiple sclerosis (MS) patients can lead to side effects and drug interactions. Therefore, the use of intelligent systems such as drug monitoring systems can help in the effective and timely treatment of MS disease. In this regard, the present study was conducted to design, development, and evaluation of the drug monitoring system for multiple sclerosis patients.
Materials and Methods: The present descriptive-developmental study was performed in four stages. In the first stage, by searching the library resources and valid guidelines, the minimum data set was determined and provided to neurologists and MS fellowships in the form of checklists for validation. Then the software was designed logically and coded based on the opinion of experts. In the last stage, the software was evaluated by end-users.
Results: The information elements in the software design were categorized into patient demographic information, medical history, clinical signs, imaging procedures, laboratory tests for ocrelizumab and fingolimod drugs, counseling, and treatment data. Finally, the performance of the drug monitoring system was evaluated with an average of 7.9 and was approved by users.
Conclusion: The results of software evaluation showed that the drug monitoring system can help general practitioners, neurologists, and MS fellowships in monitoring and follow-up of patients and lead to increased patient safety.
Materials and Methods: The present descriptive-developmental study was performed in four stages. In the first stage, by searching the library resources and valid guidelines, the minimum data set was determined and provided to neurologists and MS fellowships in the form of checklists for validation. Then the software was designed logically and coded based on the opinion of experts. In the last stage, the software was evaluated by end-users.
Results: The information elements in the software design were categorized into patient demographic information, medical history, clinical signs, imaging procedures, laboratory tests for ocrelizumab and fingolimod drugs, counseling, and treatment data. Finally, the performance of the drug monitoring system was evaluated with an average of 7.9 and was approved by users.
Conclusion: The results of software evaluation showed that the drug monitoring system can help general practitioners, neurologists, and MS fellowships in monitoring and follow-up of patients and lead to increased patient safety.
Marjan Ghazi Saeedi, Gholam Reza Esmaeili Javid, Niloufar Mohammadzadeh, Hamide Asadallah Khan Vali,
Volume 14, Issue 5 (1-2021)
Volume 14, Issue 5 (1-2021)
Abstract
Background and Aim: Diabetes is one of the most common metabolic diseases in the world, of which one of the most common and painful complications is diabetic foot ulcer. The accuracy and comprehensiveness of the contents of electronic medical record is effective in improving the quality of treatment and the care of diabetic foot ulcer patients. The aim of this study is to determine the minimum data set (MDS) essential for diabetic foot patients' electronic medical records.
Materials and Methods: In this descriptive-analytical study, authoritative internet and library resources were studied to collect diabetic foot ulcer information elements. Fourteen physicians and nurses working and collaborating with the Wound Healing Center affiliated to Academic Center for Education, Culture and Research (ACECR) were selected for clinical survey, and 5 health information technology specialists of Tehran University of Medical Sciences (TUMS) were chosen for demographic information survey. The study tools were a researcher-made questionnaire, CVR content validity method and test-retest method for reliability.
Results: Out of 23 information elements surveyed in demographic section, cases above 99% of the agreement were selected. Also, out of 86 information elements of the clinical section, more than 51% of the cases were selected. Clinical experts included 6 wound specialists, 4 general practitioners and 6 nurses. In the demographic information section, the lowest agreement was related to the element of identity and Education level with 20% agreement. In clinical information, the lowest agreement was related to surgery, leech therapy and MRI of the foot with 0% and PRP, G-CSF, Sono-Doppler liver with 14%.
Conclusion: The minimum information elements of diabetic foot ulcer electronic medical record were divided into history, wound information, lower limb information, paraclinical results, wound management, and follow-up in clinical section; and in demographic information section, they were divided into identity, admission, finance, reporting, and system capability. The proposed model for manual and electronic medical records is available.
Materials and Methods: In this descriptive-analytical study, authoritative internet and library resources were studied to collect diabetic foot ulcer information elements. Fourteen physicians and nurses working and collaborating with the Wound Healing Center affiliated to Academic Center for Education, Culture and Research (ACECR) were selected for clinical survey, and 5 health information technology specialists of Tehran University of Medical Sciences (TUMS) were chosen for demographic information survey. The study tools were a researcher-made questionnaire, CVR content validity method and test-retest method for reliability.
Results: Out of 23 information elements surveyed in demographic section, cases above 99% of the agreement were selected. Also, out of 86 information elements of the clinical section, more than 51% of the cases were selected. Clinical experts included 6 wound specialists, 4 general practitioners and 6 nurses. In the demographic information section, the lowest agreement was related to the element of identity and Education level with 20% agreement. In clinical information, the lowest agreement was related to surgery, leech therapy and MRI of the foot with 0% and PRP, G-CSF, Sono-Doppler liver with 14%.
Conclusion: The minimum information elements of diabetic foot ulcer electronic medical record were divided into history, wound information, lower limb information, paraclinical results, wound management, and follow-up in clinical section; and in demographic information section, they were divided into identity, admission, finance, reporting, and system capability. The proposed model for manual and electronic medical records is available.
Mohammad Zarbi, Reza Safdari, Nahid Einollahi,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Medical diagnostic laboratories are among the most important centers in the treatment cycle of patients. Today, the conscious choice of such laboratories is one of the challenges that patients face in the treatment process. This study was conducted with the aim of improving the knowledge of software users in the field of laboratory sciences and also facilitating the conscious and intelligent selection of the laboratory required by users.
Materials and Methods: This is a descriptive-developmental research with an applied approach. The steps consisted of library studies, questionnaire-based needs assessment, collection of knowledge and identity data, design through drawing UML diagrams, implementation using Java programming language, and software evaluation.
Results: A comprehensive system of laboratory information and experiments can be performed in all laboratories in Tehran, based on factors such as location access, types of laboratories and types of tests, a system was designed that allows users to access the most appropriate laboratory centers with high speed and less mobility, sufficient information, and in accordance with their needs. The evaluation was done using a researcher-made questionnaire whose validity and reliability were confirmed. The target population consisted of eleven specialists and forty ordinary users. According to the Likert criterion, the results obtained from the answers of all participants in the study to the questions of the questionnaire were higher than 4.05.
Conclusion: The software showed that the factors that had priority in the need assessment significantly increased user satisfaction and also provided ease of use of laboratory services in accordance with users' needs.
Materials and Methods: This is a descriptive-developmental research with an applied approach. The steps consisted of library studies, questionnaire-based needs assessment, collection of knowledge and identity data, design through drawing UML diagrams, implementation using Java programming language, and software evaluation.
Results: A comprehensive system of laboratory information and experiments can be performed in all laboratories in Tehran, based on factors such as location access, types of laboratories and types of tests, a system was designed that allows users to access the most appropriate laboratory centers with high speed and less mobility, sufficient information, and in accordance with their needs. The evaluation was done using a researcher-made questionnaire whose validity and reliability were confirmed. The target population consisted of eleven specialists and forty ordinary users. According to the Likert criterion, the results obtained from the answers of all participants in the study to the questions of the questionnaire were higher than 4.05.
Conclusion: The software showed that the factors that had priority in the need assessment significantly increased user satisfaction and also provided ease of use of laboratory services in accordance with users' needs.
Marjan Ghazi-Saeedi, Roya Riahi, Rasool Nouri,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: In this study, in order to increase the visibility of articles in Scopus journals of Tehran University of Medical Sciences (TUMS), selective dissemination of information (SDI) service was presented and its impact on some citation indices was investigated.
Materials and Methods: This is a semi-experimental study of two groups (pretest-posttest design with a control group). In this study, TUMS Scopus indexed journals (20 titles) were randomly divided into test and control groups and their citation indices were assessed. Then, the SDI services for test group journals were designed based on PubMed's Alert system and presented to the university's top researchers for one year. Finally, the citation indices of the journals of test and control groups were reassessed and compared. For data analysis, independent t-test, paired t-test and, covariance analysis were used.
Results: Comparison of mean citations as well as SJR, SNIP and CiteScore indices before and after the intervention showed no significant difference between the test and control groups. But the average CiteScore in both groups after the intervention was significantly higher than the average before the intervention.
Conclusion: The results showed that the provision of the aformentioned services in the time period defined in this study had no significant effect on the citation indices. However, the valuable experiences gained in this study will undoubtedly be applicable to future research as well as services to researchers, librarians, and journal managers.
Materials and Methods: This is a semi-experimental study of two groups (pretest-posttest design with a control group). In this study, TUMS Scopus indexed journals (20 titles) were randomly divided into test and control groups and their citation indices were assessed. Then, the SDI services for test group journals were designed based on PubMed's Alert system and presented to the university's top researchers for one year. Finally, the citation indices of the journals of test and control groups were reassessed and compared. For data analysis, independent t-test, paired t-test and, covariance analysis were used.
Results: Comparison of mean citations as well as SJR, SNIP and CiteScore indices before and after the intervention showed no significant difference between the test and control groups. But the average CiteScore in both groups after the intervention was significantly higher than the average before the intervention.
Conclusion: The results showed that the provision of the aformentioned services in the time period defined in this study had no significant effect on the citation indices. However, the valuable experiences gained in this study will undoubtedly be applicable to future research as well as services to researchers, librarians, and journal managers.
Niloofar Mohammadzadeh, Ziba Mosayebi, Hamid Beigy, Mohammad Shojaeinia,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Sepsis is the most important disease in the first 28 days of life and one of the main causes of infant mortality in the intensive care unit. Its definitive diagnosis is possible by performing blood culture. Neonatal sepsis can be a clinical sign of nosocomial infections that are often resistant to antibiotics. Therefore, the purpose of this study was to create and evaluate a hospital sepsis prediction model and present its results to health care providers.
Materials and Methods: In this descriptive-applied study, the research population includes neonates admitted to the intensive care unit of Valiasr Hospital in Tehran and the research sample is the data of 4196 neonates admitted to this ward from 2016 to August, 2020. The initial features for creating a predictive model of sepsis were prepared by examining the relevant information sources and under the supervision of professors and officials of Valiasr Hospital's mother and fetus research center and its validity was confirmed by 5 neonatal professors of this hospital. In this research, machine learning algorithms have been used to create a sepsis prediction model.
Results: Accuracy and AUROC(area under the ROC curve) parameters were used to evaluate the generated models. The highest values of Accuracy and AUROC are related to Adaptive Boosting and random forest algorithms, respectively.
Conclusion: Learning curves show that using different training examples and more complex selection of combination features improves the performance of the models. Further research is needed to evaluate the clinical effectiveness of machine learning models in a trial.
Materials and Methods: In this descriptive-applied study, the research population includes neonates admitted to the intensive care unit of Valiasr Hospital in Tehran and the research sample is the data of 4196 neonates admitted to this ward from 2016 to August, 2020. The initial features for creating a predictive model of sepsis were prepared by examining the relevant information sources and under the supervision of professors and officials of Valiasr Hospital's mother and fetus research center and its validity was confirmed by 5 neonatal professors of this hospital. In this research, machine learning algorithms have been used to create a sepsis prediction model.
Results: Accuracy and AUROC(area under the ROC curve) parameters were used to evaluate the generated models. The highest values of Accuracy and AUROC are related to Adaptive Boosting and random forest algorithms, respectively.
Conclusion: Learning curves show that using different training examples and more complex selection of combination features improves the performance of the models. Further research is needed to evaluate the clinical effectiveness of machine learning models in a trial.
Niloofar Mohammadzadeh, Dr Seyed Hadi Sajjadi, Seyed Hasan Sajjadi,
Volume 15, Issue 1 (3-2021)
Volume 15, Issue 1 (3-2021)
Abstract
Background and Aim: Social networks that provide users with health data not only educate them but also play an active role in the health decision-making process. Health social networks, in addition to being a good tool for better patient communication with health care providers, can play an effective role in connecting similar patients with each other to receive social support. Social networking is one of the biggest achievements of Web 2, which facilitates communication between people. Despite the spread of social networks, their use in the field of health is still at its early levels. To implement an information system, it is first necessary to identify, design and model the related processes. The main purpose of this study was to provide technical documentation for the development of social networks in the field of health in order to facilitate future developments.
Materials and Methods: This study was an applied research. Due to the review of texts in the first phase, this research was descriptive. It is also a developmental research due to its technological dimensions in modeling and pattern model presentation. First, extracted features were confirmed based on experts’ opinions. Then, according to the identified features, social network modeling was performed at three levels of data, functional and process. Based on the modeling, a prototype model was designed and evaluated.
Results: In this research, technical documents were prepared for the development of social networks in the field of health in the three axes of data modeling, functional modeling and process modeling. In the usability assessment by Nielsen model, the created prototype based on modeling was evaluated. Finally, the number of problems in each case of the Nielsen model was determined. The case of "Visibility of system status" with 26.31 and "Consistency and standards" with 5.27 were associated with the highest and lowest problems, respectively.
Conclusion: The growing need and expansion of the use of social networks has created a good platform for using this tool in the field of health and exploiting its benefits. The present study focuses on providing technical documentation for the development of health social networks and to facilitate the development of social networks in the field of health.
Materials and Methods: This study was an applied research. Due to the review of texts in the first phase, this research was descriptive. It is also a developmental research due to its technological dimensions in modeling and pattern model presentation. First, extracted features were confirmed based on experts’ opinions. Then, according to the identified features, social network modeling was performed at three levels of data, functional and process. Based on the modeling, a prototype model was designed and evaluated.
Results: In this research, technical documents were prepared for the development of social networks in the field of health in the three axes of data modeling, functional modeling and process modeling. In the usability assessment by Nielsen model, the created prototype based on modeling was evaluated. Finally, the number of problems in each case of the Nielsen model was determined. The case of "Visibility of system status" with 26.31 and "Consistency and standards" with 5.27 were associated with the highest and lowest problems, respectively.
Conclusion: The growing need and expansion of the use of social networks has created a good platform for using this tool in the field of health and exploiting its benefits. The present study focuses on providing technical documentation for the development of health social networks and to facilitate the development of social networks in the field of health.
Emel Hoveyzi, Jila Najafpoor, Mehrdad Sharifi, Mansour Zahiri,
Volume 15, Issue 5 (1-2022)
Volume 15, Issue 5 (1-2022)
Abstract
Background and Aim: The growing health care needs of students actuated world Health Organization to develop School-based health projects in the last decades. The most important plan that has received worldwide attention and in Iran for nearly one decade is Health Promoting School (HPS) program which being implemented with collaboration of Ministries of Health and Education. Present qualitative study was conducted to evaluate this program implementation in Ahvaz education organization (District 1).
Materials and Methods: In this qualitative study data was collected by semi-structured interview. The study population consisted of school health experts affiliated with Ahvaz West Health Center and health deputy, health experts affiliated with education organization (District 1 and school headmasters and expert staffs in HPS (22 persons). The sampling was purposeful and the interviews continued until saturation of data. Content analysis was used for analysis of the data.
Results: Data analysis showed that most components of the HPS program in schools belong to education organization were not implemented properly. The major barriers were categorized into 5 and 47 main and subsidiary themes respectively. Poor stewardship and authority, policymaking and legislation, weaknesses in motivation, attitude and awareness of managers and experts, inadequacy in resources and infrastructure, ineptitude in program implementation and finally inappropriate evaluation system was specified as the main themes. According to results, some of the most important reasons for failure in HPS program consisted of, lack of functions definiteness between health deputy in ministry of health and education organization, job dissatisfaction in school health experts, not being a priority behalf education organization, insufficient delegation of authorized budget, lack of interpectoral cooperation between trustee organizations and indifference about program evaluation.
Conclusion: The most important challenge in the HPS program is the implementation barriers that make the establishment and implementation of this program almost ineffective. The serious and committed interaction between the ministry of Health and Education and between their respective provincial and county districts can provide the foundation for the implementation of this valuable program. A review of the organizational structure and executive framework of the program is also necessary.
Materials and Methods: In this qualitative study data was collected by semi-structured interview. The study population consisted of school health experts affiliated with Ahvaz West Health Center and health deputy, health experts affiliated with education organization (District 1 and school headmasters and expert staffs in HPS (22 persons). The sampling was purposeful and the interviews continued until saturation of data. Content analysis was used for analysis of the data.
Results: Data analysis showed that most components of the HPS program in schools belong to education organization were not implemented properly. The major barriers were categorized into 5 and 47 main and subsidiary themes respectively. Poor stewardship and authority, policymaking and legislation, weaknesses in motivation, attitude and awareness of managers and experts, inadequacy in resources and infrastructure, ineptitude in program implementation and finally inappropriate evaluation system was specified as the main themes. According to results, some of the most important reasons for failure in HPS program consisted of, lack of functions definiteness between health deputy in ministry of health and education organization, job dissatisfaction in school health experts, not being a priority behalf education organization, insufficient delegation of authorized budget, lack of interpectoral cooperation between trustee organizations and indifference about program evaluation.
Conclusion: The most important challenge in the HPS program is the implementation barriers that make the establishment and implementation of this program almost ineffective. The serious and committed interaction between the ministry of Health and Education and between their respective provincial and county districts can provide the foundation for the implementation of this valuable program. A review of the organizational structure and executive framework of the program is also necessary.
Hamzeh Amin-Tahmasbi, Hossein Nasirzadeh,
Volume 15, Issue 6 (3-2022)
Volume 15, Issue 6 (3-2022)
Abstract
Background and Aim: Inattention of hospital waste management has caused many problems. As a consequence, it has put the environment and human health at serious risk. Medical centers are one of the important health institutions which in recent years, population growth, increasing clients and service populations has led to significant growth in waste production in them. The quality and quantity of medical centers waste is becoming more and more problematic and is considered as a dangerous toxic substance. The purpose of this article is to evaluate, prioritize and explain the management plan for treatment and disposal of medical centers waste.
Materials and Methods: Important criteria in choosing the method of waste disposal of medical centers were extracted from previous studies. Then, the importance of these criteria was determined using the Fuzzy Analytic Hierarchy Process (Fuzzy AHP) and at the end, the best disposal method was selected using the Fuzzy Weighted Aggregated Sum Product Assessment (Fuzzy WASPAS).
Results: Among the main criteria, environmental issues was the first priority with 0.517 weight and the criteria of cost and volume of waste with the points of 0.317 and 0.166 were ranked second and third, respectively. Also, between the sub-criteria, the air pollution was ranked first with 0.256 weight. Finally, among the disposal methods, the sanitary landfill method with 0.317 weight was ranked first and the microwave methods, waste incineration and autoclave with the points of 0.265, 0.253, and 0.173 scored second to fourth respectively.
Conclusion: Considering the obtained results and prioritizing, it is possible to achieve more risk reduction, reduction of environmental pollution and reduction of costs by disposing of waste in health centers. Accordingly, the most appropriate method for disposing of waste in medical centers in the country is the “sanitary landfill” method. Of course, sanitary landfilling of waste should be done in an appropriate and standard way to prevent groundwater pollution and damage to the environment. Solving the problems caused by hospital waste is a complex and multidimensional issue that requires the cooperation and assistance and integration of community facilities (government, private and public institutions).
Materials and Methods: Important criteria in choosing the method of waste disposal of medical centers were extracted from previous studies. Then, the importance of these criteria was determined using the Fuzzy Analytic Hierarchy Process (Fuzzy AHP) and at the end, the best disposal method was selected using the Fuzzy Weighted Aggregated Sum Product Assessment (Fuzzy WASPAS).
Results: Among the main criteria, environmental issues was the first priority with 0.517 weight and the criteria of cost and volume of waste with the points of 0.317 and 0.166 were ranked second and third, respectively. Also, between the sub-criteria, the air pollution was ranked first with 0.256 weight. Finally, among the disposal methods, the sanitary landfill method with 0.317 weight was ranked first and the microwave methods, waste incineration and autoclave with the points of 0.265, 0.253, and 0.173 scored second to fourth respectively.
Conclusion: Considering the obtained results and prioritizing, it is possible to achieve more risk reduction, reduction of environmental pollution and reduction of costs by disposing of waste in health centers. Accordingly, the most appropriate method for disposing of waste in medical centers in the country is the “sanitary landfill” method. Of course, sanitary landfilling of waste should be done in an appropriate and standard way to prevent groundwater pollution and damage to the environment. Solving the problems caused by hospital waste is a complex and multidimensional issue that requires the cooperation and assistance and integration of community facilities (government, private and public institutions).
Ahmad Siar Sadr, Roohollah Tavallaee, Mohammad Ali Afshar Kazemi,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: Enterprise Architecture based on laboratory needs, and by using of the commons of valid and existing enterprise architecture frameworks, leads to the aligns of needs with organizational strategies and goals and information technology infrastructure. The aim of this study was the investigation of the effect of enterprise architecture model implementation on laboratory information management systems.
Materials and Methods: In this quantitative study in 2020, proposed enterprise architecture model which was based on the compilation of Zachman and service-oriented architecture models was investigated by the maturity of enterprise architecture at Sharif University. The statistical community of this study was 100 laboratory specialists based on Morgan sample determination table CCM (Capacity Maturity Model), which was designed based on the Likert spectrum, was used as a questionnaire assessment tool. For data analysis, descriptive indicators such as frequency, percentage and one-sample t-test to compare the mean in SPSS software was used.
Results: Assessing the maturity of enterprise architecture including four areas of IT (Information Technology) planning and organization, IT development and implementation, IT service and support, and IT monitoring and evaluation. Among the various dimensions of enterprise architecture maturity, the lowest average was related to the field of monitoring and evaluation and the highest average was related to the field of service and support. Dimensions in terms of status were: service and support dimension, planning and organizing dimension, development and implementation dimension, monitoring and evaluation dimension, respectively. The test results were significantly different in the areas related to the maturity of enterprise architecture, including the planning and organization areas, development and implementation, service and support (P<0.0001). There was no significant difference in monitoring and evaluation.
Conclusion: The use of enterprise architecture specific to laboratory management systems causes the optimal use of resources and ease of interaction. Evaluation of the implementation of the proposed architectural framework in the laboratory environment showed that the proposed model has matured in the three areas of planning and organization, development and implementation, service and support. In order to improve the maturity of enterprise architecture, more attention should be paid to the field of monitoring and evaluation and the reform program should start from this field.
Materials and Methods: In this quantitative study in 2020, proposed enterprise architecture model which was based on the compilation of Zachman and service-oriented architecture models was investigated by the maturity of enterprise architecture at Sharif University. The statistical community of this study was 100 laboratory specialists based on Morgan sample determination table CCM (Capacity Maturity Model), which was designed based on the Likert spectrum, was used as a questionnaire assessment tool. For data analysis, descriptive indicators such as frequency, percentage and one-sample t-test to compare the mean in SPSS software was used.
Results: Assessing the maturity of enterprise architecture including four areas of IT (Information Technology) planning and organization, IT development and implementation, IT service and support, and IT monitoring and evaluation. Among the various dimensions of enterprise architecture maturity, the lowest average was related to the field of monitoring and evaluation and the highest average was related to the field of service and support. Dimensions in terms of status were: service and support dimension, planning and organizing dimension, development and implementation dimension, monitoring and evaluation dimension, respectively. The test results were significantly different in the areas related to the maturity of enterprise architecture, including the planning and organization areas, development and implementation, service and support (P<0.0001). There was no significant difference in monitoring and evaluation.
Conclusion: The use of enterprise architecture specific to laboratory management systems causes the optimal use of resources and ease of interaction. Evaluation of the implementation of the proposed architectural framework in the laboratory environment showed that the proposed model has matured in the three areas of planning and organization, development and implementation, service and support. In order to improve the maturity of enterprise architecture, more attention should be paid to the field of monitoring and evaluation and the reform program should start from this field.
Zahra Vahedpoor, Mohammad Javad Azadchehr, Taha Baghbani, Tayebeh Felfelian Fini, Mehdi Nazeri,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: Vulvovaginal candidiasis (VVC) is a vaginal fungal infection that mainly caused by Candida albicans. Among various treatments and their controversial outcomes, oral fluconazole has been accepted as a common and efficient treatment for acute and chronic cases. The aim of this study is about therapeutic effect of fluconazole and evaluation of its antifungal susceptibility.
Materials and Methods: In this cross-sectional study Samples were collected from 107 suspected patients to vulvovaginal candidiasis who went to the gynecology clinic of Kashan University of Medical Sciences in (2020-2022). At first consent and then demographic registrations were obtained. All samples were collected and cultured on Chromagar and Sabouraud’s dextrose agar and incubated at 30°C for 72 h. Yeast colonies were identified based on their colors and morphologic criteria.
All patients were treated by a single dose of fluconazole (150 mg/ml) or two continuous additional doses, depending on the absence or history of recurrence. Improvement of clinical and mycological symptoms in patients were followed for 30-35 days. Antifungal susceptibility to fluconazole was determined by microdilution method (CLSI, document M27-A3).
Results: A total of 107 patients were diagnosed with vulvovaginal candidiasis. Candida albicans (79.4%) was the most common identified species. total response to fluconazole treatment based on mycological findings (negative culture and direct smear) was 62.6% (P=0.012), there was no significant difference between candida species, albicans (64.7%) and non-albicans (54.5%), type of vaginal candidiasis forms (recurrent and non-recurrent) and antifungal susceptibility to fluconazole (MIC≤8)(P>0.05). Consideration of MICs≤1 and MICs>1 as a cutoff point there was a significant difference between failure and response to treatment (P=0.014).
Conclusion: According to empiric treatment of Vulvovaginal candidiasis, concurrent Laboratory diagnosis with anti-fungal susceptibility could help us in selecting the appropriate treatment protocol and prevent the emergence or increase of resistant species.
Materials and Methods: In this cross-sectional study Samples were collected from 107 suspected patients to vulvovaginal candidiasis who went to the gynecology clinic of Kashan University of Medical Sciences in (2020-2022). At first consent and then demographic registrations were obtained. All samples were collected and cultured on Chromagar and Sabouraud’s dextrose agar and incubated at 30°C for 72 h. Yeast colonies were identified based on their colors and morphologic criteria.
All patients were treated by a single dose of fluconazole (150 mg/ml) or two continuous additional doses, depending on the absence or history of recurrence. Improvement of clinical and mycological symptoms in patients were followed for 30-35 days. Antifungal susceptibility to fluconazole was determined by microdilution method (CLSI, document M27-A3).
Results: A total of 107 patients were diagnosed with vulvovaginal candidiasis. Candida albicans (79.4%) was the most common identified species. total response to fluconazole treatment based on mycological findings (negative culture and direct smear) was 62.6% (P=0.012), there was no significant difference between candida species, albicans (64.7%) and non-albicans (54.5%), type of vaginal candidiasis forms (recurrent and non-recurrent) and antifungal susceptibility to fluconazole (MIC≤8)(P>0.05). Consideration of MICs≤1 and MICs>1 as a cutoff point there was a significant difference between failure and response to treatment (P=0.014).
Conclusion: According to empiric treatment of Vulvovaginal candidiasis, concurrent Laboratory diagnosis with anti-fungal susceptibility could help us in selecting the appropriate treatment protocol and prevent the emergence or increase of resistant species.
Leila Shahmoradi, Niloofar Kheradbin, Ahmad Reza Farzanehnejad, Niloofar Mohammadzadeh, Atefeh Ghanbari Jolfaei,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Identifying risk factors is recommended as the first step for depression management in children and adolescents. This study aims to determine the data elements required for developing a clinical decision support system for screening major depression in young people.
Materials and Methods: This research was a descriptive-analytical study. The research population included a variety of mental health specialists that were both psychologists and students in psychiatry and guidance & counseling majors as well as electronic databases including Scopus, Pubmed, Embase, PsychInfo, WOS and Clinical key. The data collection tool was a questionnaire designed in three main sections which was answered by a convenient sample of 8 people who were specialists in the field. To analyze the extracted data Content Validity Ratio (CVR) and Mean measures were calculated for each item in questionnaire. Content Validity Index (CVI) and Cronbach’s Alpha (using SPSS software) were calculated which were equal to 0.74 and 0.824 respectively which confirmed validity and reliability of the research tool.
Results: According to Lawshe’s table, data elements with CVR between 0 and 0.75 and Mean less than 1.5, like “Ethnicity and race” (CVR=-0.25, Mean=1.125), were rejected. Items such as “Gender” (CVR=0.5) with a CVR equal to or less than 0.75, as well as items with a CVR between 0 and 0.75 and a Mean equal to or more than 1.5, like “Marital status” (CVR=0.5, Mean=1.625) were retained and considered to be included as the minimum data set for screening major depression in ages 10 to 25 years. Data elements were categorized in three categories: Demographic, Clinical and Psychosocial
Conclusion: Clinical decision support systems can facilitate providing healthcare at different levels such as screening major depression. These systems can be used for screening major depression risk factors to improve accessibility to mental health practitioners, assure the implementation of guidelines and provide a common language between different levels of healthcare. Determining the minimum data set for screening major depression in ages 10 to 25 years, is the first step toward developing a clinical decision support system for screening individuals for major depression.
Materials and Methods: This research was a descriptive-analytical study. The research population included a variety of mental health specialists that were both psychologists and students in psychiatry and guidance & counseling majors as well as electronic databases including Scopus, Pubmed, Embase, PsychInfo, WOS and Clinical key. The data collection tool was a questionnaire designed in three main sections which was answered by a convenient sample of 8 people who were specialists in the field. To analyze the extracted data Content Validity Ratio (CVR) and Mean measures were calculated for each item in questionnaire. Content Validity Index (CVI) and Cronbach’s Alpha (using SPSS software) were calculated which were equal to 0.74 and 0.824 respectively which confirmed validity and reliability of the research tool.
Results: According to Lawshe’s table, data elements with CVR between 0 and 0.75 and Mean less than 1.5, like “Ethnicity and race” (CVR=-0.25, Mean=1.125), were rejected. Items such as “Gender” (CVR=0.5) with a CVR equal to or less than 0.75, as well as items with a CVR between 0 and 0.75 and a Mean equal to or more than 1.5, like “Marital status” (CVR=0.5, Mean=1.625) were retained and considered to be included as the minimum data set for screening major depression in ages 10 to 25 years. Data elements were categorized in three categories: Demographic, Clinical and Psychosocial
Conclusion: Clinical decision support systems can facilitate providing healthcare at different levels such as screening major depression. These systems can be used for screening major depression risk factors to improve accessibility to mental health practitioners, assure the implementation of guidelines and provide a common language between different levels of healthcare. Determining the minimum data set for screening major depression in ages 10 to 25 years, is the first step toward developing a clinical decision support system for screening individuals for major depression.
Miss Maryam Eslami, Javad Jahangirzadeh,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: The curriculum as the heart of the educational system is one of the effective factors in achieving the goals and mission of the university and its evaluation is of particular importance. Since medical education deals with human life and clerkships also play an essential role in shaping the professional abilities of medical students, this research was conducted with the aim of determining the desirability of clerkship programs from the point of view of medical students of Tehran University of Medical Sciences during the Covid-19 pandemic based on the nine elements of Francis Klein.
Materials and Methods: In this study, a descriptive-survey method was used. The statistical population was 487 medical students of Tehran University of Medical Sciences, who were undergoing the clerkship stage at the time of the research, and the questionnaire was provided to them in the form of a census. The number of samples was determined based on Morgan’s table of 215 people. The research tool was a standard questionnaire, the validity of which was confirmed by professors in the field of educational sciences, and its reliability was calculated using the Cronbach’s alpha method of 0.794. Descriptive statistics (including statistical tables, graphs, central and dispersion indices) and inferential statistics (including one-sample t-tests and independent two-sample t-tests) were used for data analysis.
Results: The results showed that clerkship programs from the point of view of medical students of Tehran University of Medical Sciences during the covid-19 disease, considering that the t-statistic of all research variables is less than 1.96 (educational objectives t=-4.735, educational content t=0/666, learning activities t=-7.812, teaching strategies t=-4.246, educational materials and resources t=-0.970, grouping of learners t=-5.223, learning space (place) t=-4.029, learning time t=-5.043, and learning evaluation t=-7.348) were not desirable in terms of all elements. It was also found that there is no significant difference in attitudes between male and female students regarding the desirability of these programs except for the element of educational goals.
Conclusion: According to the results of the research, the medical clerkship programs of Tehran University of Medical Sciences are facing challenges during the Covid-19 pandemic. Therefore, it is necessary to provide a program that is compatible with the conditions and can meet the educational needs of the learners.
Materials and Methods: In this study, a descriptive-survey method was used. The statistical population was 487 medical students of Tehran University of Medical Sciences, who were undergoing the clerkship stage at the time of the research, and the questionnaire was provided to them in the form of a census. The number of samples was determined based on Morgan’s table of 215 people. The research tool was a standard questionnaire, the validity of which was confirmed by professors in the field of educational sciences, and its reliability was calculated using the Cronbach’s alpha method of 0.794. Descriptive statistics (including statistical tables, graphs, central and dispersion indices) and inferential statistics (including one-sample t-tests and independent two-sample t-tests) were used for data analysis.
Results: The results showed that clerkship programs from the point of view of medical students of Tehran University of Medical Sciences during the covid-19 disease, considering that the t-statistic of all research variables is less than 1.96 (educational objectives t=-4.735, educational content t=0/666, learning activities t=-7.812, teaching strategies t=-4.246, educational materials and resources t=-0.970, grouping of learners t=-5.223, learning space (place) t=-4.029, learning time t=-5.043, and learning evaluation t=-7.348) were not desirable in terms of all elements. It was also found that there is no significant difference in attitudes between male and female students regarding the desirability of these programs except for the element of educational goals.
Conclusion: According to the results of the research, the medical clerkship programs of Tehran University of Medical Sciences are facing challenges during the Covid-19 pandemic. Therefore, it is necessary to provide a program that is compatible with the conditions and can meet the educational needs of the learners.
Reza Saadat Mehr, Aram Karimian, Kamel Abdi, Fereshteh Bakhshian, Mehran Zarghami,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Burned patients experience a high level of anxiety during dress changing. The use of complementary medicine is one of the methods of anxiety management that many studies have conducted about it in recent years. The purpose of this study was to compare the effectiveness of progressive relaxation with abdominal respiration technique on pain anxiety of burn dressing.
Materials and Methods: This study was a randomized clinical trial with a control group. We selected forty-five patients referred to Zare Hospital in Sari through simple sampling and assigned into three groups. The first group received relaxation intervention, the second group received respiratory technique intervention, and no intervention was performed in the control group. Burn Specific Pain Anxiety Scale (BSPAS) was used to measure pain-related anxiety. SPSS software version 20 was used to analyze the data. Descriptive statistics, ANOVA and Tukey’s post hoc test were used for data analysis.
Results: Based on the results, 28% of the participants in the study were single and 72% were married. In terms of age, most of the participants were between 31 and 40 years old. The findings showed that there was no significant difference between the mean pain anxiety levels in the three groups before the intervention. There was a significant difference in the average burn dressing pain anxiety after the intervention between the relaxation group and the control group (P<0.001) and the breathing techniques group and the control group (P<0.000), so that the average burn dressing pain anxiety in the group Relaxation was reduced by 8.60 units as compared to the control group and in the breathing techniques group by 11.60 units as compared to the control group.
Conclusions: The use of relaxation “techniques” and respiratory techniques, which are non-pharmacological methods, are recommended during dress changing in the burned patient. These methods are simple and inexpensive and can reduce the effects of pain anxiety during dress changing.
Materials and Methods: This study was a randomized clinical trial with a control group. We selected forty-five patients referred to Zare Hospital in Sari through simple sampling and assigned into three groups. The first group received relaxation intervention, the second group received respiratory technique intervention, and no intervention was performed in the control group. Burn Specific Pain Anxiety Scale (BSPAS) was used to measure pain-related anxiety. SPSS software version 20 was used to analyze the data. Descriptive statistics, ANOVA and Tukey’s post hoc test were used for data analysis.
Results: Based on the results, 28% of the participants in the study were single and 72% were married. In terms of age, most of the participants were between 31 and 40 years old. The findings showed that there was no significant difference between the mean pain anxiety levels in the three groups before the intervention. There was a significant difference in the average burn dressing pain anxiety after the intervention between the relaxation group and the control group (P<0.001) and the breathing techniques group and the control group (P<0.000), so that the average burn dressing pain anxiety in the group Relaxation was reduced by 8.60 units as compared to the control group and in the breathing techniques group by 11.60 units as compared to the control group.
Conclusions: The use of relaxation “techniques” and respiratory techniques, which are non-pharmacological methods, are recommended during dress changing in the burned patient. These methods are simple and inexpensive and can reduce the effects of pain anxiety during dress changing.
- Zeinab Hashemzadeh, Farhad Habibi, Hossein Dargahi, Mohammad Arab,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Home care is an alternative method of hospitalization, especially for chronic patients and is an innovative approach to improve care and reduce the costs of hospital readmissions. The present study was conducted with the aim of investigating the benefits and challenges of implementing the home care plan after being discharged from the hospital considering the perspective of health service recipients and providers at Tehran University of Medical Sciences in 2021.
Material and Methods: The present study is an applied research that was conducted qualitatively using structured and semi-structured interviews. The research sample was those responsible for the implementation of this project at the ministry and university level, the implementers of this project in 4 hospitals, 5 institutions providing home care services, and family of patients. Twenty-eight people from the research community were included in the study using the purposeful and snowball sampling method. Content analysis method was used to analyze the interview data. MAXQDA2020 software was used for data classification.
Results: The results were classified into two categories: benefits and challenges of the home care plan after discharge. A total of 61 open codes were extracted from the analysis of research interviews, so that 27 codes led to the identification of 5 themes (Including improving service delivery, reducing costs, achieving health goals, cultural and social benefits, providing the necessary infrastructure) in the benefits and 34 codes led to the identification of 7 themes (including policy-making, legal and ethical, economic, manpower, cultural-social-communication, service provision limitations and time and place limitations) in the challenges.
Conclusion: The result of this research showed that home care services after being discharged from the hospital play an important role in completing the provision of healthcare services. Home care services after being discharged from the hospital improves service delivery, reduces costs, and helps in achieving health goals. It also benefits patients, society and the government in various cultural and social fields. On the other hand, it seems that there are challenges in the political, legal, economic and cultural fields in the way of the optimal implementation of this plan. Therefore, planning to evaluate and solve the problems facing these services is essential.
Material and Methods: The present study is an applied research that was conducted qualitatively using structured and semi-structured interviews. The research sample was those responsible for the implementation of this project at the ministry and university level, the implementers of this project in 4 hospitals, 5 institutions providing home care services, and family of patients. Twenty-eight people from the research community were included in the study using the purposeful and snowball sampling method. Content analysis method was used to analyze the interview data. MAXQDA2020 software was used for data classification.
Results: The results were classified into two categories: benefits and challenges of the home care plan after discharge. A total of 61 open codes were extracted from the analysis of research interviews, so that 27 codes led to the identification of 5 themes (Including improving service delivery, reducing costs, achieving health goals, cultural and social benefits, providing the necessary infrastructure) in the benefits and 34 codes led to the identification of 7 themes (including policy-making, legal and ethical, economic, manpower, cultural-social-communication, service provision limitations and time and place limitations) in the challenges.
Conclusion: The result of this research showed that home care services after being discharged from the hospital play an important role in completing the provision of healthcare services. Home care services after being discharged from the hospital improves service delivery, reduces costs, and helps in achieving health goals. It also benefits patients, society and the government in various cultural and social fields. On the other hand, it seems that there are challenges in the political, legal, economic and cultural fields in the way of the optimal implementation of this plan. Therefore, planning to evaluate and solve the problems facing these services is essential.
Akram Hemmatipour, Ali Hatami, Azam Jahangirimehr, Foruzan Jelodari, Zahra Mehri,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: There is a correlation between disease and quality of life in patients with chronic disease and physical disorders have a direct effect on all aspects of quality of life. Therefore, this study was conducted to determine the effect of family-centered empowerment model based on multimedia education on the quality of life of children with thalassemia.
Materials and Methods: In this experimental study, 120 patients along with their parents, who had medical records at the thalassemia center of Khatam al-Anbiya Hospital in Shoushtar, were selected according to the inclusion criteria and were divided into two groups of intervention and control (n=60) by random allocation. Subjects were matched in terms of age and gender. The data collection tools included Pediatric Quality of Life Inventory (Ped-SQL) and researcher-made questionnaires of awareness and self-efficacy in the area of thalassemia. The collected data were analyzed using SPSS and Mann-Whitney and Wilcoxon statistical tests and Pearson’s correlation coefficient.
Results: Out of 120 children who were included in the study, 87 were girls (72.5%), the mean age of these children was 9.74±2.25 years and disease duration was 5.35±4.47 years. In this study, in terms of children’s quality of life and its dimensions, after the implementation of the educational model, a significant increase was observed compared to pre-test phase only in the intervention group (P<0.001). After implementing this model, the level of knowledge (P<0.001) and self-efficacy of parents (P=0.003) was faced with a significant increase, and this significance was also observed compared to the control group (P<0.001). The variables of age, gender, disease duration and parents’ education level had no effect on parents’ self-efficacy and knowledge as well as children’s quality of life (P>0.05).
Conclusion: Based on the results of the present study, the implementation of family-centered empowerment programs based on multimedia education among parents of children with thalassemia improved the quality of life of these children by increasing the knowledge and self-efficacy of their parents. It is suggested that this program be implemented on a wider scale with better facilities for parents and the family members.
Materials and Methods: In this experimental study, 120 patients along with their parents, who had medical records at the thalassemia center of Khatam al-Anbiya Hospital in Shoushtar, were selected according to the inclusion criteria and were divided into two groups of intervention and control (n=60) by random allocation. Subjects were matched in terms of age and gender. The data collection tools included Pediatric Quality of Life Inventory (Ped-SQL) and researcher-made questionnaires of awareness and self-efficacy in the area of thalassemia. The collected data were analyzed using SPSS and Mann-Whitney and Wilcoxon statistical tests and Pearson’s correlation coefficient.
Results: Out of 120 children who were included in the study, 87 were girls (72.5%), the mean age of these children was 9.74±2.25 years and disease duration was 5.35±4.47 years. In this study, in terms of children’s quality of life and its dimensions, after the implementation of the educational model, a significant increase was observed compared to pre-test phase only in the intervention group (P<0.001). After implementing this model, the level of knowledge (P<0.001) and self-efficacy of parents (P=0.003) was faced with a significant increase, and this significance was also observed compared to the control group (P<0.001). The variables of age, gender, disease duration and parents’ education level had no effect on parents’ self-efficacy and knowledge as well as children’s quality of life (P>0.05).
Conclusion: Based on the results of the present study, the implementation of family-centered empowerment programs based on multimedia education among parents of children with thalassemia improved the quality of life of these children by increasing the knowledge and self-efficacy of their parents. It is suggested that this program be implemented on a wider scale with better facilities for parents and the family members.
Mouna Rafizadeh, Reza Safdari, Jaleh Shoshtarian Malak, Shaban Alizadeh,
Volume 17, Issue 2 (5-2023)
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: Simulation-based Mobile Education is one of the necessities of the new era as well as an escalating field to meet the needs of different educational systems and levels. Considering the increasing application of simulation-based technologies, and the popularity of Augmented Reality (AR) in the field of education, the present research aims to facilitate the initial steps in understanding the technical requirements and software used in developing these types of apps.
Materials and Methods: The data required for this research was collected by searching in library resources to identify the commonly used platform/software in designing and developing AR-based educational apps. At the same time, the included studies’ app features/sections were also extracted, and the total of this information was presented in a table. After indicating the mainly used software in the development of these types of apps, a simple app architecture and a how-to-develop model using the most practical software were illustrated.
Results: “3D Model display” and “multiple-choice questions” were identified as the minimum (basic) features of an AR-based educational app. To identify the most commonly used software in creating AR-based educational apps, articles were reviewed, required information was extracted, and gathered in form of a table. The results of the review showed that Unity 3D and Vuforia have the highest usage statistics in creating these types of apps. Finally, a simple model of the process of developing AR-based educational app and a sample output of this type of app were presented based on this information.
Conclusions: Simulation-based education is one of the prominent and growing topics worldwide. Augmented Reality is one of the most renowned and widely used technologies in this field. The results of this study encompass a set of basic features of an AR-based educational app as well as the software that can be used to create such apps. Therefore, this study can assist researchers interested in this field in navigating the simplest path to developing an AR-based educational app by providing them with an initial technical understanding of AR-based education.
Materials and Methods: The data required for this research was collected by searching in library resources to identify the commonly used platform/software in designing and developing AR-based educational apps. At the same time, the included studies’ app features/sections were also extracted, and the total of this information was presented in a table. After indicating the mainly used software in the development of these types of apps, a simple app architecture and a how-to-develop model using the most practical software were illustrated.
Results: “3D Model display” and “multiple-choice questions” were identified as the minimum (basic) features of an AR-based educational app. To identify the most commonly used software in creating AR-based educational apps, articles were reviewed, required information was extracted, and gathered in form of a table. The results of the review showed that Unity 3D and Vuforia have the highest usage statistics in creating these types of apps. Finally, a simple model of the process of developing AR-based educational app and a sample output of this type of app were presented based on this information.
Conclusions: Simulation-based education is one of the prominent and growing topics worldwide. Augmented Reality is one of the most renowned and widely used technologies in this field. The results of this study encompass a set of basic features of an AR-based educational app as well as the software that can be used to create such apps. Therefore, this study can assist researchers interested in this field in navigating the simplest path to developing an AR-based educational app by providing them with an initial technical understanding of AR-based education.
Zahra Khaje, Kamran Yazdani, Ibrahim Abdollahpour, Mohsen Mohammadi, Saharnaz Nedjat,
Volume 17, Issue 5 (12-2023)
Volume 17, Issue 5 (12-2023)
Abstract
Background and Aim: Alzheimer’s is a chronic disease that causes cognitive disabilities, thinking, personality changes and disruptions in daily activities. Due to these disorders, patients need long-term care. Most care for Alzheimer’s patients is done at home by family members, which makes home caregivers mentally, physically, emotionally, socially and financially vulnerable. Health personnel have a key role to play in providing information and guidance and helping the family control these conditions. The purpose of this study was to examines the level of knowledge and attitude of health workers and determines the related factors.
Materials and Methods: This research is a cross-sectional study to evaluate the level of knowledge and attitude of health workers about Alzheimer’s disease and its related factors. All 260 health workers of Gorgan and Kordkuy districts were studied by census method to assess their knowledge and attitude about Alzheimer’s disease and its related factors. ANOVA and T-tests were used to determine the relationship between the independent variables and the dependent variable. Variables whose significant level of correlation with response variable was less than 0.2 in bivariate analysis were entered into the regression model and finally multiple linear regression was used to determine the factors related to level of knowledge and attitude.
Results: The mean level of knowledge was 46.73% (95% CI, 45.46 to 48.16) and the mean level of attitude was 55.61% (95% CI, 54.63 to 56.74). The results show that those with a history of previous education, a history of caring for Alzheimer’s patients, a higher level of work experience in the health care system, and having a female gender and be married have higher levels of knowledge and those with a history of previous education and Sistani descent had a higher attitude.
Conclusion: In general, the mean level of knowledge was 46.73(0-100) and the mean level of attitude was 55.61(0-100). Factors such as: gender, work history in the health system, history of participating in educational workshops, history of caring for sick patients, and marital status were related to the level of knowledge and factors such as ethnicity and history of participating in the training workshop were related to the level of attitude of the health care providers.
Soraya Sayar, Sara Noruzi, Seyed Mohammad Hossein Javadi, Mohammad Sabzi Khoshnami, Sanaz Dehghani, Maryam Pour Hosein, Mahnaz Zamyadi,
Volume 17, Issue 6 (2-2024)
Volume 17, Issue 6 (2-2024)
Abstract
Background and Aim: Considering the role of social workers in the health system, the success and stability of organ transplantation, prevention of re-hospitalization of patients and reduction of imposed costs, this study aims to design a protocol for the specialized interventions of social workers in Iran’s medical centers in the transplant process and to create uniformity in practice. Comprehensive services have been provided to patients and their caregivers.
Materials and Methods: The study was conducted in two phases of resource review and qualitative. In the resource review phase, reliable databases were examined, and in the qualitative phase, in order to collect information from Delphi techniques and focused group discussion with the presence of fifteen officials and social workers working in the country’s hospitals and experts and experts. The areas of health and treatment assistants of the Ministry of Health, university professors, medical staff and experts in the field of transplantation and organ donation were carried out. The protocol was sent to eight experienced experts for final review and evaluation, and they were asked to review the protocol in terms of the goal and scope of interventions, stakeholders, development steps, clarity of presentation, accessibility and non-dependence in writing according to the checklist to evaluate.
Results: In this study, the work process of social workers was drawn in three stages before, during and after transplantation. Also, various roles were considered for social workers in three stages of work, including the role of defender, supporter, case manager, resource mobilizer, trainer, consultant, evaluator and guidance. Interventions such as finding informational support, facilitating the patient hospitalization process, providing psychosocial support to the family with the aim of empowering them for post-transplant care, providing counseling to family members to deal with stress and improving mental health of the patient, providing economic support, Accomodation conditions are provided through hospital companions and communication and interaction with the treatment team, including the doctor, in order to respond to the needs of the family, facilitate treatment and on time discharging.
Conclusion: the protocol of specialized interventions of social workers in the transplantation process created a new step and a different look at psychosocial support in transplantation and coordination teams, so that social workers in the field of organ donation and transplantation and working with caregivers, families and the survivors of the patients arrived.
Miss Fariba Moalem Borazjani, Azita Yazdani, Reza Safdari, Seyed Mansoor Gatmiri,
Volume 17, Issue 6 (2-2024)
Volume 17, Issue 6 (2-2024)
Abstract
Background and Aim: Kidney failure is a common and increasing problem in Iran and worldwide. Kidney transplantation is recognized as a preferred treatment method for patients with end-stage renal disease (ESRD). Machine learning, as one of the most valuable branches of artificial intelligence in the field of predicting patient outcomes or predicting various conditions in patients, has significant applications. The purpose of this research was to predict kidney transplant outcomes in patients using machine learning.
Materials and Methods: Since CRISP is one of the strongest methodologies for implementing data mining projects, it was chosen as the working method. In order to identify the factors affecting the prediction of kidney transplant outcomes, a researcher-created checklist was sent to some of nephrologists nationwide to determine the importance of each factor. The results were analyzed and examined. Then, using Python language and different algorithms such as random forest, SVM, KNN, deep learning, and XGBoost the data was modeled.
Results: The final model was multilabel, capable of predicting various kidney transplant outcomes, including rejection probability, diabetic reactions, malignant reactions, and patient rehospitalization. After modeling the input data features, the model was able to predict the four kidney transplant outcomes such as rejection, diabetes, malignancy and readmission with an error rate of less than 0.01.
Conclusion: The high level of accuracy and precision of the random forest model demonstrates its strong predictive power for forecasting kidney transplant outcomes. In this study, the most influential factors contributing to patient susceptibility to the mentioned outcomes were identified. Using this machine learning-based system, it is possible to predict the probability of these outcomes occurring for new cases.
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