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Sharareh Mirsaeidi Farahani, Ahmad Vedadi, Ali Rezaeian,
Volume 15, Issue 2 (5-2021)
Volume 15, Issue 2 (5-2021)
Abstract
Background and Aim: Due to the importance and position of the health sector in society and consideration of industry 4.0 during these days, we witness an increase in the spread of state-of-the-art (smart) technologies in various fields, on one hand, and an evolutionary development by integrating healthcare and technology, on the other hand. Thus, the application of smart technologies can help to overcome many of the healthcare sector limitations. This study aimed to propose an appropriate model for deploying smart services in the Iranian healthcare system.
Material and Methods: This was a qualitative research study based on thematic analysis in 2020. The required data were extracted by literature review and expert interviews. A sample of 15 experts were selected using purposive sampling. Sampling was continued until full data saturation was reached. The data were collected using semi-structured interviews. The interviews were implemented and analyzed in MAXQDA. Finally, a qualitative method was developed.
Results: Based on the findings of this research, 202 open codes were extracted and 23 basic themes (sub- themes) were identified to design the model of deployment smart services in the Iranian health sector which categorized in seven organizing themes (main themes) consist deployment planning, execution management, task organization frame work, national preparedness, stage-setting, organizational interventions, and resistance management. Then, according to the above themes, the thematic model was provided which has a suitable model fitness (IFI: 0.934, NFI: 0.959, RMSEA: 0.080).
Conclusion: Providing the model for deploying smart health care and use of these technologies help to significantly improve the quality of health services, improve access to these services, reduce costs and thus improve health of society.
Material and Methods: This was a qualitative research study based on thematic analysis in 2020. The required data were extracted by literature review and expert interviews. A sample of 15 experts were selected using purposive sampling. Sampling was continued until full data saturation was reached. The data were collected using semi-structured interviews. The interviews were implemented and analyzed in MAXQDA. Finally, a qualitative method was developed.
Results: Based on the findings of this research, 202 open codes were extracted and 23 basic themes (sub- themes) were identified to design the model of deployment smart services in the Iranian health sector which categorized in seven organizing themes (main themes) consist deployment planning, execution management, task organization frame work, national preparedness, stage-setting, organizational interventions, and resistance management. Then, according to the above themes, the thematic model was provided which has a suitable model fitness (IFI: 0.934, NFI: 0.959, RMSEA: 0.080).
Conclusion: Providing the model for deploying smart health care and use of these technologies help to significantly improve the quality of health services, improve access to these services, reduce costs and thus improve health of society.
Seyed Hassan Emami Razavi, Mahboubeh Shali, Samaneh Mirzaei, Ali Reza Nikbakht Nasrabadi, Zahra Khazaeipour,
Volume 15, Issue 3 (8-2021)
Volume 15, Issue 3 (8-2021)
Abstract
Background and Aim: Implementation of a program to support physicians’ working long in deprived areas is one of the most important programs of the Health System Transformation Plan in response to the challenge of the shortage of expert staff, particularly physicians. Numerous factors affect the persistence of physicians in different regions, especially in deprived ones. This study aims to explain the experiences of physicians in relation to the challenges of working long in deprived areas.
Materials and Methods: The present research is a qualitative study that was conducted in 2020 in Tehran, Iran. To achieve information saturation, 16 physicians and specialists were chosen using purposive sampling method. Then, for data collection, semi-structured interviews were used. Moreover, data analysis was performed using Graneheim and Lundman contractual content analysis method, and data management was done with MAXQDA software version 12. Furthermore, Lincoln and Guba reliability criteria were applied to achieve data accuracy and reliability.
Results: Three female and 13 male physicians with a mean work experience of 45.4±7.8 years and an average work experience in deprived areas of 8±6.3 years participated in the study. Six participants were native to the region and the rest were non-native. Twelve participants in the study were the faculty members of the university. When the data were analyzed, 286 initial codes were extracted. The information was divided into four main categories and eleven subcategories. Welfare, motivation, justice and security were the main categories of this study.
Conclusion: Providing individual and social welfare for physicians, and fair treatment in financial payments and educational justice along with establishing security provide the necessary motivation for physicians to stay in a deprived area. Besides by combining several solutions at the same time, the presence of doctors in deprived areas can be guaranteed.
Materials and Methods: The present research is a qualitative study that was conducted in 2020 in Tehran, Iran. To achieve information saturation, 16 physicians and specialists were chosen using purposive sampling method. Then, for data collection, semi-structured interviews were used. Moreover, data analysis was performed using Graneheim and Lundman contractual content analysis method, and data management was done with MAXQDA software version 12. Furthermore, Lincoln and Guba reliability criteria were applied to achieve data accuracy and reliability.
Results: Three female and 13 male physicians with a mean work experience of 45.4±7.8 years and an average work experience in deprived areas of 8±6.3 years participated in the study. Six participants were native to the region and the rest were non-native. Twelve participants in the study were the faculty members of the university. When the data were analyzed, 286 initial codes were extracted. The information was divided into four main categories and eleven subcategories. Welfare, motivation, justice and security were the main categories of this study.
Conclusion: Providing individual and social welfare for physicians, and fair treatment in financial payments and educational justice along with establishing security provide the necessary motivation for physicians to stay in a deprived area. Besides by combining several solutions at the same time, the presence of doctors in deprived areas can be guaranteed.
Maryam Azimi, Davoud Haseli, Hossein Dehdarirad, Farzaneh Fazli, Nahid Einollahi,
Volume 15, Issue 4 (10-2021)
Volume 15, Issue 4 (10-2021)
Abstract
Background and Aim: Transgenic species are the ones whose genomes are genetically modified. The transgenic field is one of the areas that has a high importance and position in the world. Therefore, the aim of the present research is to draw and analyze the co-authorship network of researchers in transgenic subject area.
Materials and Methods: The type of this research is descriptive and was carried out using scientometric techniques such as co-authorship network and social network analysis indices. In this study, 23,456 articles by transgenic researchers indexed in the Web of Science database during the period 2010-2019 were retrieved. VOSviewer and UCINET software were used to draw the co-authorship map and analyze the network indicators.
Results: The scientific cooperation network of transgenic researchers was studied and analyzed using macro and micro indicators of the social network. The status of macro indicators was not appropriate and the network was poorly cohesive. So that, the network density was 0.027, the clustering coefficient was 0.834, the diameter was 15 and the average distance was 4.155. In terms of micro-indicators, the status of researchers in the network was determined in such a way that David Ayares had the most cooperation with other members and also Nam-Hai Chua played the most important role in communicating with people from different clusters of the network, finally, Yan Zhang had the shortest distance with other members of the network.
Conclusion: Based on the findings, it can be concluded that the co-authorship network of transgenic researchers has low cohesion and information is transmitted among members at a low speed. With respect to this, status of different researchers in this study was determined, the results of this study can be used to guide future collaborations, and encourage universities and scientific institutes to develop their interactions with each other and further strengthen collaborations. It should also be noted that according to the findings of the study in this field, Iranian researchers were not identified as key individuals in this network, which requires research on the status and position of Iranian researchers in the field of transgenics.
Materials and Methods: The type of this research is descriptive and was carried out using scientometric techniques such as co-authorship network and social network analysis indices. In this study, 23,456 articles by transgenic researchers indexed in the Web of Science database during the period 2010-2019 were retrieved. VOSviewer and UCINET software were used to draw the co-authorship map and analyze the network indicators.
Results: The scientific cooperation network of transgenic researchers was studied and analyzed using macro and micro indicators of the social network. The status of macro indicators was not appropriate and the network was poorly cohesive. So that, the network density was 0.027, the clustering coefficient was 0.834, the diameter was 15 and the average distance was 4.155. In terms of micro-indicators, the status of researchers in the network was determined in such a way that David Ayares had the most cooperation with other members and also Nam-Hai Chua played the most important role in communicating with people from different clusters of the network, finally, Yan Zhang had the shortest distance with other members of the network.
Conclusion: Based on the findings, it can be concluded that the co-authorship network of transgenic researchers has low cohesion and information is transmitted among members at a low speed. With respect to this, status of different researchers in this study was determined, the results of this study can be used to guide future collaborations, and encourage universities and scientific institutes to develop their interactions with each other and further strengthen collaborations. It should also be noted that according to the findings of the study in this field, Iranian researchers were not identified as key individuals in this network, which requires research on the status and position of Iranian researchers in the field of transgenics.
Mr Kasra Dolatkhahi, Adel Azar, Tooraj Karimi, Mohammad Hadizadeh,
Volume 15, Issue 4 (10-2021)
Volume 15, Issue 4 (10-2021)
Abstract
Background and Aim: Cancer and in particular Breast cancer are among the diseases that have the highest mortality rate in Iran after heart disease. The accurate prognosis for Breast cancer is important, and the presence of various symptoms and features of this disease makes it difficult for doctors to diagnose. This study aimed to identify the factors affecting Breast cancer, modeling and ultimately diagnosing the risk of Breast cancer.
Materials and Methods: In the present study, first, by content analysis and library studies, the effective factors in Breast cancer were identified, then with the help of a team of experts consisting of physicians and subspecialists in Breast oncology and Breast surgery; With the help of the Delphi method, the factors were adjusted and 26 final factors that were numerically correct and string based on local and climatic conditions were approved. Then, according to the final factors and based on the medical records of 5208 patients in the Cancer Research Center of Shahid Beheshti University of medical sciences, to diagnose cancer, Decision Tree, Random Forest, and Support Vector Machine methods were used as machine learning methods.
Results: In the first step, by content analysis method, 29 effective factors in Breast cancer were identified. Then, taking into account the indigenous and climatic conditions and using the Delphi method and also using the opinions of 18 Experts during three years, 26 factors were finalized. In the final step, using the medical records of the patients and the results obtained from the three methods mentioned, random forest, had the highest accuracy of 94.75% and precision of 97.26% in diagnosing Breast cancer. It has been noted that, compared to other similar studies, indigenous databases have been exploited, the accuracy obtained has been very close to previous studies, and in many cases much better.
Conclusion: Using the random forest method and taking advantage of the factors affecting Breast cancer, the ability to diagnose cancer has been provided with greatest accuracy.
Materials and Methods: In the present study, first, by content analysis and library studies, the effective factors in Breast cancer were identified, then with the help of a team of experts consisting of physicians and subspecialists in Breast oncology and Breast surgery; With the help of the Delphi method, the factors were adjusted and 26 final factors that were numerically correct and string based on local and climatic conditions were approved. Then, according to the final factors and based on the medical records of 5208 patients in the Cancer Research Center of Shahid Beheshti University of medical sciences, to diagnose cancer, Decision Tree, Random Forest, and Support Vector Machine methods were used as machine learning methods.
Results: In the first step, by content analysis method, 29 effective factors in Breast cancer were identified. Then, taking into account the indigenous and climatic conditions and using the Delphi method and also using the opinions of 18 Experts during three years, 26 factors were finalized. In the final step, using the medical records of the patients and the results obtained from the three methods mentioned, random forest, had the highest accuracy of 94.75% and precision of 97.26% in diagnosing Breast cancer. It has been noted that, compared to other similar studies, indigenous databases have been exploited, the accuracy obtained has been very close to previous studies, and in many cases much better.
Conclusion: Using the random forest method and taking advantage of the factors affecting Breast cancer, the ability to diagnose cancer has been provided with greatest accuracy.
Soheila Khoeini, Ali Reza Noruzi, Zeinab Jozi, Esmaeil Mostafavi,
Volume 15, Issue 6 (3-2022)
Volume 15, Issue 6 (3-2022)
Abstract
Background and Aim: Bibliotherapy is a useful treatment for the prevention and treatment of mental disorders and has led to the formation of many scientific publications in this field. The purpose of this study was to investigate the publication trends in the field of bibliotherapy and visualize the structure of its scientific collaborations based on the Web of Science database during the period 1975 to 2020.
Materials and Methods: The present scientometric study was conducted by citation analysis and social network analysis. The statistical population includes 1032 documents published. HistCite, VOSveiwer, Pajek and UciNet software were used to analyze the data. The co-authorship networks were analyzed and drawn by the VOSviewer software.
Results: U.S., UK, and Australia were ranked first to third with 369, 148, and 91 documents respectively. The documents published by researchers from these three countries have received 10547, 3459, and 3041 citations, respectively. The Universities of Alabama, Nevada, and the Karolinska Institutet in Sweden published the most in this field, with 29, 26, and 21 documents. Scogin F, Cuijpers P, and Rohde P were the most prolific authors with 29, 21, and 17 documents, respectively. Miller WR, Cuijpers P, and Andersson G received the most citations with 2441, 2298, and 1750, citations respectively. UK with 63 degree centrality, U.S. the most influential country with a betweenness centrality of 191.450 and the closeness centrality of the 80 were the most influential countries, and Vrije Universiteit Amsterdam with a betweenness centrality of 1416.755 and a closeness centrality of 658 and the Karolinska Institute with a degree centrality of 43 was the most influential organizations. Rohde P with 39-degree centrality and Cuijpers P with 314.500 betweenness centrality and 821 closeness centrality were the most active author in the co-authorship networks in bibliotherapy. Journal of Clinical Counseling and Psychology was the most cited and the Journal of Poetry Therapy published the most documents.
Conclusion: Paying more attention than before to the cooperation of countries, universities and active authors in the field of bibliotherapy can lead to more knowledge and experience exchange in developed and developing countries.
Materials and Methods: The present scientometric study was conducted by citation analysis and social network analysis. The statistical population includes 1032 documents published. HistCite, VOSveiwer, Pajek and UciNet software were used to analyze the data. The co-authorship networks were analyzed and drawn by the VOSviewer software.
Results: U.S., UK, and Australia were ranked first to third with 369, 148, and 91 documents respectively. The documents published by researchers from these three countries have received 10547, 3459, and 3041 citations, respectively. The Universities of Alabama, Nevada, and the Karolinska Institutet in Sweden published the most in this field, with 29, 26, and 21 documents. Scogin F, Cuijpers P, and Rohde P were the most prolific authors with 29, 21, and 17 documents, respectively. Miller WR, Cuijpers P, and Andersson G received the most citations with 2441, 2298, and 1750, citations respectively. UK with 63 degree centrality, U.S. the most influential country with a betweenness centrality of 191.450 and the closeness centrality of the 80 were the most influential countries, and Vrije Universiteit Amsterdam with a betweenness centrality of 1416.755 and a closeness centrality of 658 and the Karolinska Institute with a degree centrality of 43 was the most influential organizations. Rohde P with 39-degree centrality and Cuijpers P with 314.500 betweenness centrality and 821 closeness centrality were the most active author in the co-authorship networks in bibliotherapy. Journal of Clinical Counseling and Psychology was the most cited and the Journal of Poetry Therapy published the most documents.
Conclusion: Paying more attention than before to the cooperation of countries, universities and active authors in the field of bibliotherapy can lead to more knowledge and experience exchange in developed and developing countries.
Tahereh Abolghasem, Maryam Nakhoda, Dr Sepideh Fahimifar, Dr Mohammad Khandan,
Volume 15, Issue 6 (3-2022)
Volume 15, Issue 6 (3-2022)
Abstract
Background and Aim: Knowledge management and employee engagement are the key factors for organizations to achieve competitive advantage, increase productivity and improve performance. The purpose of this study was to identify the relation of effective factors on employee engagement and healthcare knowledge management in the organization.
Materials and Methods: This research was applied in terms of systematic review and was done by meta-analysis-quantitative method. The statistical population included external research. Data collection tools are researcher-made checklist and EBL critical appraisal checklist (Glynn). For this purpose, comprehensive meta-analysis software version 2.0 was used.
Results: Findings showed that at 95% confidence level, employee engagement has a significant relation on healthcare knowledge management and was able to explain 37% of knowledge management. Leadership (0.349), Reward (0.616), Organizational Culture (0.655), Job Satisfaction (0.674), Innovation (0.493), productivity (0.411), organizational performance (0.775) and organizational learning (0.548) are factors that was affecting employee engagement and healthcare knowledge management. The results of heterogeneity tests showed that the studies were heterogeneous and therefore the random effect size was used. The funnel diagram shows high standard error and high bias. In other words, the distribution of research was not normal and random.
Conclusion: Managers can increase the level of engagement and management of organizational knowledge by focusing on the identified factors and its implementation in the organization and increase the level of desire and participation of employees in knowledge management processes.
Materials and Methods: This research was applied in terms of systematic review and was done by meta-analysis-quantitative method. The statistical population included external research. Data collection tools are researcher-made checklist and EBL critical appraisal checklist (Glynn). For this purpose, comprehensive meta-analysis software version 2.0 was used.
Results: Findings showed that at 95% confidence level, employee engagement has a significant relation on healthcare knowledge management and was able to explain 37% of knowledge management. Leadership (0.349), Reward (0.616), Organizational Culture (0.655), Job Satisfaction (0.674), Innovation (0.493), productivity (0.411), organizational performance (0.775) and organizational learning (0.548) are factors that was affecting employee engagement and healthcare knowledge management. The results of heterogeneity tests showed that the studies were heterogeneous and therefore the random effect size was used. The funnel diagram shows high standard error and high bias. In other words, the distribution of research was not normal and random.
Conclusion: Managers can increase the level of engagement and management of organizational knowledge by focusing on the identified factors and its implementation in the organization and increase the level of desire and participation of employees in knowledge management processes.
Sousan Rabihavy, Zhila Najafpour,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: Operation rooms have several specialty processes, a higher level of technology, complicated treatment protocols, and the need for skillful human recourses, which is one of the highest risk wards in the hospital. Therefore, this study was initiated to identify and evaluate potential errors by using the Failure Mode, Effects, and Criticality Analysis (FMECA) approach to recognize the potential errors in operation rooms of Golestan hospital of Ahvaz.
Materials and Methods: This research was done with a qualitative approach in seven stages and it was based on the FMECA protocol. Data were obtained through direct observation, assessment of documents and interviews with the related staff. In this regard, surgical processes were extracted from the beginig of the surgical planning to discharge patient from the post-anesthesia care unit, after that the potential errors associated with each process were identified. Finally, the risk priority number of each of them was calculated according to the indicators of Occurrence (O), Severity (S), and Detectability (D). Score analysis was performed using descriptive statistics and SPSS software.
Results: In the present study, during the analysis of processes related to surgical care, 17 primary surgery processes and 75 sub processes (from surgical planning to discharg from the post-anesthesia care unit) were identified. Seventy failure modes were identified. Ultimately, after analyzing the failure modes in the risk matrix, among the 70 identified failure modes, two failure modes had unacceptable risk, including no proper cleaning of the operation theatre and marking the surgical site, and there was Seven other failure modes with moderate risk, including unappropraite hand hygiene and environmental and operating room fixed equipment disinfection, central oxygen disconnection, lack of equipments in night shift, delay in delivery of prostheses to the surgical site, transfer of patient who requires intensive care to the ward, were identified. Human and organizational causes contributed the most to the occurrence of potential errors.
Conclusion: Analysis of failure modes showed that the highest probability of error occurs in the processes during surgery and due to human and organizational factors. Identification of 70 potential errors in 17 processes of the Operating Room indicates the integrity of FMECA’s preventive approach in identifying and prioritizing the high-risk areas of the processes, insensitive parts such as the operating room.
Materials and Methods: This research was done with a qualitative approach in seven stages and it was based on the FMECA protocol. Data were obtained through direct observation, assessment of documents and interviews with the related staff. In this regard, surgical processes were extracted from the beginig of the surgical planning to discharge patient from the post-anesthesia care unit, after that the potential errors associated with each process were identified. Finally, the risk priority number of each of them was calculated according to the indicators of Occurrence (O), Severity (S), and Detectability (D). Score analysis was performed using descriptive statistics and SPSS software.
Results: In the present study, during the analysis of processes related to surgical care, 17 primary surgery processes and 75 sub processes (from surgical planning to discharg from the post-anesthesia care unit) were identified. Seventy failure modes were identified. Ultimately, after analyzing the failure modes in the risk matrix, among the 70 identified failure modes, two failure modes had unacceptable risk, including no proper cleaning of the operation theatre and marking the surgical site, and there was Seven other failure modes with moderate risk, including unappropraite hand hygiene and environmental and operating room fixed equipment disinfection, central oxygen disconnection, lack of equipments in night shift, delay in delivery of prostheses to the surgical site, transfer of patient who requires intensive care to the ward, were identified. Human and organizational causes contributed the most to the occurrence of potential errors.
Conclusion: Analysis of failure modes showed that the highest probability of error occurs in the processes during surgery and due to human and organizational factors. Identification of 70 potential errors in 17 processes of the Operating Room indicates the integrity of FMECA’s preventive approach in identifying and prioritizing the high-risk areas of the processes, insensitive parts such as the operating room.
Zahra Aghasizadeh, Ali Reza Pouya, Nasser Motahari Farimani, Ali Vafeaa Najjar,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: Hospitals are the most important component of the health system and accurate evaluation of their performance is important. So far, much research has been done on the evaluation of hospitals using DEA models, but in these studies, organizations are considered as a black box and system processes and relationships between them are ignored. In this study, the efficiency of hospitals was evaluated using network envelopment analysis and its results were compared with simple envelopment analysis.
Materials and Methods: The method of the present research was ptactical and the nature of the survey was descriptive. The research population was all hospitals and educational centers affiliated to Mashhad University of Medical Sciences with a capacity of more than one hundred beds, which included twelve public hospitals and forty-eight sections. To collect information, methods of observing and studying documents, records and statistics of hospital activities have been used. For validation, by calculating Spearman correlation coefficient, it was found that the proposed model has a significant correlation with the Black Box DEA Model and the validity of the model was confirmed. SOLVER DEA and EXCEL software were used to implement the model.
Results: The results show that by considering the internal departments of the organization as well as the relations between the departments, a more accurate analysis of the efficiency of the hospitals would be done and we will have a better separation in the ranking between the organizations. Also, by using the network DEA model, the overall efficiency, the efficiency of each department and the rank of each department in comparison with similar departments in other hospitals are determined.
Conclusion: The framework presented in this study can be an appropriate criterion for measuring the efficiency of hospitals and their internal sections by determining the overall position of each hospital relative to other hospitals and by determining the efficiency of the section. By determining the efficiency of the internal departments of hospitals, a suitable priority is provided for allocating resources and investing in different departments in the direction of organizational improvement.
Materials and Methods: The method of the present research was ptactical and the nature of the survey was descriptive. The research population was all hospitals and educational centers affiliated to Mashhad University of Medical Sciences with a capacity of more than one hundred beds, which included twelve public hospitals and forty-eight sections. To collect information, methods of observing and studying documents, records and statistics of hospital activities have been used. For validation, by calculating Spearman correlation coefficient, it was found that the proposed model has a significant correlation with the Black Box DEA Model and the validity of the model was confirmed. SOLVER DEA and EXCEL software were used to implement the model.
Results: The results show that by considering the internal departments of the organization as well as the relations between the departments, a more accurate analysis of the efficiency of the hospitals would be done and we will have a better separation in the ranking between the organizations. Also, by using the network DEA model, the overall efficiency, the efficiency of each department and the rank of each department in comparison with similar departments in other hospitals are determined.
Conclusion: The framework presented in this study can be an appropriate criterion for measuring the efficiency of hospitals and their internal sections by determining the overall position of each hospital relative to other hospitals and by determining the efficiency of the section. By determining the efficiency of the internal departments of hospitals, a suitable priority is provided for allocating resources and investing in different departments in the direction of organizational improvement.
Mostafa Roshanzadeh, Mina Shirvani, Ali Tajabadi, Mohammad Hossein Khalilzadeh, Somayeh Mohammadi,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Clinical learning is an important part of the health field, where the student interacts with the environment and applies the learned concepts in practice. Clinical environments such as operating rooms are challenging for students due to their special complexity and can have a negative impact on their learning process. In order to identify students ‘learning challenges in the operating room environment, the present study was conducted to explain students’ experiences in the field of clinical learning challenges.
Materials and Methods: The present qualitative study was performed by contract content analysis method in 2022 in Shahrekord University of Medical Sciences. Fourteen surgical technology students were purposefully selected and data were collected using in-depth semi-structured individual and group interviews and analyzed using the Granheim and Landman approaches.
Results: The participants were interviewed over a period of 5 months. 9 face-to-face interviews were conducted with 14 participants. There were 6 individual interviews and 3 group interviews. The average duration of the interview was 30 minutes. The interviews continued until data saturation and when no new themes or categories were obtained from the interviews. The findings included a theme of “unfavorable learning environment” and three categories of “confusion in learning educational content, improper professional behavior of staff and insufficient self-confidence”. The main challenge that students faced in the field of clinical learning was the unfavorable learning environment. Conditions such as confusion in learning educational content, improper professional behavior of staff and insufficient self-confidence experienced by the students in the operating room, cause the students to find the learning atmosphere in the operating room unfavorable.
Conclusion: Improving the behavior and performance of staff and physicians in accordance with the standards of professional and ethical behavior and its regular evaluation from the perspective of students and other colleagues can play an effective role in maintaining professional conditions. Also, using experienced instructors who have the role of facilitating communication and learning of students in the operating room environment will play an effective role in reducing fear and controlling inappropriate behaviors of staff towards students. Educational officials are advised to solve the existing problems in order to improve the educational atmosphere of the operating room.
Materials and Methods: The present qualitative study was performed by contract content analysis method in 2022 in Shahrekord University of Medical Sciences. Fourteen surgical technology students were purposefully selected and data were collected using in-depth semi-structured individual and group interviews and analyzed using the Granheim and Landman approaches.
Results: The participants were interviewed over a period of 5 months. 9 face-to-face interviews were conducted with 14 participants. There were 6 individual interviews and 3 group interviews. The average duration of the interview was 30 minutes. The interviews continued until data saturation and when no new themes or categories were obtained from the interviews. The findings included a theme of “unfavorable learning environment” and three categories of “confusion in learning educational content, improper professional behavior of staff and insufficient self-confidence”. The main challenge that students faced in the field of clinical learning was the unfavorable learning environment. Conditions such as confusion in learning educational content, improper professional behavior of staff and insufficient self-confidence experienced by the students in the operating room, cause the students to find the learning atmosphere in the operating room unfavorable.
Conclusion: Improving the behavior and performance of staff and physicians in accordance with the standards of professional and ethical behavior and its regular evaluation from the perspective of students and other colleagues can play an effective role in maintaining professional conditions. Also, using experienced instructors who have the role of facilitating communication and learning of students in the operating room environment will play an effective role in reducing fear and controlling inappropriate behaviors of staff towards students. Educational officials are advised to solve the existing problems in order to improve the educational atmosphere of the operating room.
Fatemeh Mohabati, Maryam Tajvar, Bahram Mohaghegh, Seyedpouria Hedayati, Mohammad Arab,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: Reforming the structure of medical universities and its continuous adaptation to the mission of the organization and new functions is an undeniable necessity. The purpose of this article was to explain how to implement this policy.
Materials and Methods: The current qualitative study was conducted in 2020 retrospectively based on Kingdon’s multiple streams model. Data collection was done using two methods: individual interviews and document review. Sampling of the managers and experts of the administrative development and transformation centers of the Ministry of Health and 12 universities of Medical Sciences as well as vice-chancellors of the universities was done in a purposeful and snowball method until data saturation was reached by conducting 19 individual interviews. Data analysis were done with framework and content analysis methods, and using MAXQDA 2020 software.
Results: The low of structural problems included quantitative and qualitative changes in new tasks in the environmental units of universities, interference and parallel work in the tasks of university units, and bargainings for restructuring by universities. The policy low included the obligation to make structural changes in the upstream laws and documents, including the Fifth Development Plan, and the cooperation of all stakeholders. The political process included the implementation of the Health Transformation and the Family Physician Plan, and the support of relevant policymakers and the approval of the law of becoming a university trustee in the law of the fifth plan of economic development and also gaining the all-round support of the stakeholders.
Conclusion: The medical sciences universities, as the headquarters arm of the Ministry of Health at the provincial level, need to have flexible structure in line with the needs of their surrounding units. In luential context factors in policy-making the reform of the structure of the headquarters of universities/colleges, in addition to the stream of structural problems, the main of which was the change in the duties of the units, along with the political determination created in the Ministry of Health, led to the simultaneous occurrence of three streams of problems, Politics and politics and finally opening the window of opportunity and changing the structure and organization of the headquarters of medical sciences universities.
Materials and Methods: The current qualitative study was conducted in 2020 retrospectively based on Kingdon’s multiple streams model. Data collection was done using two methods: individual interviews and document review. Sampling of the managers and experts of the administrative development and transformation centers of the Ministry of Health and 12 universities of Medical Sciences as well as vice-chancellors of the universities was done in a purposeful and snowball method until data saturation was reached by conducting 19 individual interviews. Data analysis were done with framework and content analysis methods, and using MAXQDA 2020 software.
Results: The low of structural problems included quantitative and qualitative changes in new tasks in the environmental units of universities, interference and parallel work in the tasks of university units, and bargainings for restructuring by universities. The policy low included the obligation to make structural changes in the upstream laws and documents, including the Fifth Development Plan, and the cooperation of all stakeholders. The political process included the implementation of the Health Transformation and the Family Physician Plan, and the support of relevant policymakers and the approval of the law of becoming a university trustee in the law of the fifth plan of economic development and also gaining the all-round support of the stakeholders.
Conclusion: The medical sciences universities, as the headquarters arm of the Ministry of Health at the provincial level, need to have flexible structure in line with the needs of their surrounding units. In luential context factors in policy-making the reform of the structure of the headquarters of universities/colleges, in addition to the stream of structural problems, the main of which was the change in the duties of the units, along with the political determination created in the Ministry of Health, led to the simultaneous occurrence of three streams of problems, Politics and politics and finally opening the window of opportunity and changing the structure and organization of the headquarters of medical sciences universities.
Mohammad Jalali, Ehsan Zarei, Ali Maher, Soheila Khodakarim,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: With the outbreak of the COVID-19 pandemic, the performance of hospitals were affected, and changes were made in the utilization of hospital services. Analyzing hospital performance data during the COVID-19 pandemic can provide insights into service utilization patterns and care outcomes for managers and policymakers. This study was conducted to investigate the impact of COVID-19 on selected outcome indicators in the hospitals of Shahid Beheshti University of Medical Sciences, Tehran.
Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.
Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).
Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.
Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.
Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).
Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.
Roghayeh Gandomkar, Azim Mirzazadeh, Amin Hoseini Shavoun,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: Evaluation of hospital environments with reliable and valid tools is considered to be one of the essential prerequisites for continuous improvement of the hospital learning environment. The present study aimed to translate and evaluate psychometric properties of the short version of the PHEEM questionnaire among the residents of Tehran University of Medical Sciences residents.
Materials and Methods: This was a psychometric evaluation study. After translation and back translation, the questionnaire was provided to 18 experts. The content validity was qualitatively checked using the coefficients of content validity ratio (CVR), content validity index (CVI), and face validity. Then, the revised questionnaire was distributed among 20 residents. Face validity was evaluated by qualitative method and cognitive interview to check the questionnaire items in terms of difficulty level, appropriateness, and ambiguity. The test-retest method checked initial reliability by redistributing the questionnaire to the same residents with an interval of two weeks. In order to determine construct validity, the modified questionnaire was distributed among 548 medical residents from 24 specialized fields. The sample was selected using the convenience sampling method. Then the data were analyzed using exploratory and confirmatory factor analysis. Internal consistency was calculated using Cronbach’s alpha.
Results: The questionnaire’s content validity ratio (CVR) and content validity index (CVI) were 0.93 and 0.88, respectively. Based on the results of face validity, some minor changes were made to the vocabulary of most items, and item 12 was wholly changed. The ICC coefficient was more than 0.90 in all dimensions. In the exploratory factor analysis using the principal component method (PCA), the Kaiser-Meyer-Elkin value was 0.83. Bartlett’s test of sphericity was statistically significant (P<0.001), which confirms the functionality of the correlation matrix. The Cronbach’s alpha coefficient of the questionnaire was 0.83, which indicates the internal consistency of the questionnaire items.
Conclusions: According to the results, the PHEEM short-version questionnaire has good reliability and validity (face, content, and structure) among medical residents. Therefore, this measure can be used to evaluate residents’ perceptions regarding the quality of the educational environment of hospitals.
Materials and Methods: This was a psychometric evaluation study. After translation and back translation, the questionnaire was provided to 18 experts. The content validity was qualitatively checked using the coefficients of content validity ratio (CVR), content validity index (CVI), and face validity. Then, the revised questionnaire was distributed among 20 residents. Face validity was evaluated by qualitative method and cognitive interview to check the questionnaire items in terms of difficulty level, appropriateness, and ambiguity. The test-retest method checked initial reliability by redistributing the questionnaire to the same residents with an interval of two weeks. In order to determine construct validity, the modified questionnaire was distributed among 548 medical residents from 24 specialized fields. The sample was selected using the convenience sampling method. Then the data were analyzed using exploratory and confirmatory factor analysis. Internal consistency was calculated using Cronbach’s alpha.
Results: The questionnaire’s content validity ratio (CVR) and content validity index (CVI) were 0.93 and 0.88, respectively. Based on the results of face validity, some minor changes were made to the vocabulary of most items, and item 12 was wholly changed. The ICC coefficient was more than 0.90 in all dimensions. In the exploratory factor analysis using the principal component method (PCA), the Kaiser-Meyer-Elkin value was 0.83. Bartlett’s test of sphericity was statistically significant (P<0.001), which confirms the functionality of the correlation matrix. The Cronbach’s alpha coefficient of the questionnaire was 0.83, which indicates the internal consistency of the questionnaire items.
Conclusions: According to the results, the PHEEM short-version questionnaire has good reliability and validity (face, content, and structure) among medical residents. Therefore, this measure can be used to evaluate residents’ perceptions regarding the quality of the educational environment of hospitals.
Rahil Nahari, Saeed Hashemzadeh, Ehsan Zarei,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: Medical tourism refers to travel for receiving health services abroad. The COVID-19 crisis affected a wide range of tourism-related businesses, including medical tourism, and caused a decrease in the supply and demand of health services in this market. This study aimed to investigate the impact of the COVID-19 pandemic on Medical Tourism in Iran.
Materials and Methods: This cross-sectional study was conducted in Iran in 2021. The data used in this study were extracted from the information system of the Ministry of Health from 2018 to 2021, which includes the number, origin, and destination of medical tourists, per capita revenue, and monthly revenue two years before and one and a half years after the COVID-19 pandemic. For data analysis, t-tests of independent groups and interrupted time series regression were used in SPSS and EViews 10 software.
Results: The COVID-19 pandemic has caused a 42% decrease in the average monthly number of medical tourists, a 45% decrease in the monthly revenue, and a 10% decrease in the per capita income per tourist (P<0.05). The arrival of medical tourists from the Republic of Azerbaijan, Bahrain, Iraq, and Oman has decreased by more than 80%, and the largest decrease in the number of tourists has been related to Ahvaz, Urmia, Tabriz, and Shiraz. In all diagnostic groups except obstetrics and gynecology, there has been a decrease between 50 to 70% The declining trend of medical tourism indicators was stopped in the second year of the COVID-19 pandemic and has continued as a constant trend.
Conclusion: The COVID-19 crisis has hurt the number of international patients and their revenue in Iran. Relative success in controlling COVID-19 can return to a pre-pandemic situation that requires appropriate policies and administrative measures by government and industry players, such as policies to facilitate patient entry, marketing measures, branding and creating a positive image of the country to potential clients, use of telemedicine facilities for consultations and follow-up, etc.
Materials and Methods: This cross-sectional study was conducted in Iran in 2021. The data used in this study were extracted from the information system of the Ministry of Health from 2018 to 2021, which includes the number, origin, and destination of medical tourists, per capita revenue, and monthly revenue two years before and one and a half years after the COVID-19 pandemic. For data analysis, t-tests of independent groups and interrupted time series regression were used in SPSS and EViews 10 software.
Results: The COVID-19 pandemic has caused a 42% decrease in the average monthly number of medical tourists, a 45% decrease in the monthly revenue, and a 10% decrease in the per capita income per tourist (P<0.05). The arrival of medical tourists from the Republic of Azerbaijan, Bahrain, Iraq, and Oman has decreased by more than 80%, and the largest decrease in the number of tourists has been related to Ahvaz, Urmia, Tabriz, and Shiraz. In all diagnostic groups except obstetrics and gynecology, there has been a decrease between 50 to 70% The declining trend of medical tourism indicators was stopped in the second year of the COVID-19 pandemic and has continued as a constant trend.
Conclusion: The COVID-19 crisis has hurt the number of international patients and their revenue in Iran. Relative success in controlling COVID-19 can return to a pre-pandemic situation that requires appropriate policies and administrative measures by government and industry players, such as policies to facilitate patient entry, marketing measures, branding and creating a positive image of the country to potential clients, use of telemedicine facilities for consultations and follow-up, etc.
Shima Moradi, Fatemeh Rezaei Zadeh, Monireh Rahimkhani,
Volume 17, Issue 4 (10-2023)
Volume 17, Issue 4 (10-2023)
Abstract
Background and aim: This study aimed to determine the position of Iran in terms of scientific publications in Immunology and Microbiology, and also to identify the general status of science production and the patterns of publishing in the world, the Middle East, and Iran, analyze Iran scientific collaboration with the Middle East and the world, and explore the relationship between these indicators.
Materials and Methods: The study population contained 30622 Middle Eastern publications in Immunology and Microbiology from 2009 to 2018. Positioning the countries and exploring the relations of indicators, the exploratory factor analysis, and the correlation matrix were conducted using Scival.
Results: According to the findings Iran, Turkey, and Saudi Arabia were among the most powerful countries in the region in terms of publication, citation, regional, international, and overall scientific collaboration. As for regional positioning, the citations had the highest weight comparing to other indicators. Iran have the first rank in the indices of scientific production and citations with 43.63% and 33.76% respectively, third rank in the regional cooperation index with 43.63%, second rank in the extra-regional cooperation index with 23.56%, and also second rank in the total cooperation index with 22.12%.
Conclusion: The indicators were strongly connected togather; however, the citations and international scientific collaborations displayed the strongest amongst others. Despite Iran’s prominent position in both fields, the quality of the publication was lower than the regional and global average. This identified the most powerful and weak countries in the region in regards to scientific capacities in Immunology and Microbiology. Moreover, it reckoned that there was a strong relation between citations and scientific production in contrast with others.
Azam Shahbodaghi, Maryam Shekofteh, ,
Volume 17, Issue 6 (2-2024)
Volume 17, Issue 6 (2-2024)
Abstract
Background and Aim: Systematic reviews and meta-analyses are the most reliable sources of evidence in evidence-based practice. Analyzing the scientometric and authorship features of these articles at the national level can provide useful information for various decision-makers. This study aimed to investigate the scientometric and authorship characteristics of Iran’s systematic review and meta-analysis articles indexed in Scopus.
Materials and Methods: The current research was conducted using a scientometric approach. The research population includes 9579 systematic review and meta-analysis articles published between 2011 and 2021, and Iran is the affiliated country of at least one of the authors. The quantitative and qualitative growth process of articles as well as the authorship characteristics are examined in this research, among other things.
Results: Review of 9579 articles indicate an increasing trend in the publication, with the highest number of articles (2565) being published in 2021. The thematic analysis shows that the majority of articles are related to the field of Medicine, with 7112 articles, followed by Biochemistry, Genetics, and Molecular Biology with 1433 articles. The highest H-index, 68, refers to the year 2018 and the highest percentage of articles included in the Hirsch Index horizon refers to the year 2011. The highest average number of citations per article is 146.44, observed in 2012, while the lowest is 4.62, reported in 2021. The highest average number of citations in relation to the age of the articles was 9735/34 in 2020, whereas the minimum was 279 in 2011.Calculating the percentage of articles above the H-index horizontal line based on total articles of each year, along with the average citation per article, shows a decreasing trend with slight fluctuations. On the other hand, there is a growing trend when considering the number of citations in relation to the age of the articles. The lowest average author count (5.48) is linked to 2011, whereas the highest count (12) is related to 2012. The first and the corresponding author of more than 91% of the articles was from Iran. In conducting the examined articles, researchers from the United States collaborated the most (12.05%) with researchers from Iran. University of Tehran, as the authors' affiliated organization, has contributed the most to the examined articles (27.81%). The Iranian Journal of Public Health has published the most of the examined articles (36/1%).
Conclusion: The articles under investigation show an increasing trend of growth, yet further research is needed to assess their qualitative trend. Given the rising significance of evidence-based practice, the stakeholders need to ensure the maintenance of the quantitative growth trend and the enhancement of the qualitative growth of these articles.
Ali Mohammad Mosadeghrad, Mahdiyeh Heydari, Mahya Abbasi, Mahdi Abbasi,
Volume 18, Issue 2 (5-2024)
Volume 18, Issue 2 (5-2024)
Abstract
Background and Aim: Health insurance organizations play an important role in increasing people’s access to health services and protecting them financially against catastrophic health costs. Iran Health Insurance Organization (IHIO) is one of the largest public health insurance organizations in Iran, which faces many challenges. The purpose of this research is the strategic analysis of health financing performance of IHIO.
Materials and Methods: This qualitative research was conducted using interpretive phenomenology method through using semi-structured interviews with 25 managers and employees of IHIO. In addition, relevant documents and archival data of IHIO were collected and analyzed. Thematic analysis method was used to analyze the data.
Results: Overall, 19 strengths, 24 weaknesses, 14 opportunities, 37 threats and 43 solutions were identified for the health financing system of IHIO. Increasing the coverage of health services, correcting the information databases of the insured and electronic prescribing were the most important strengths, and inappropriate pooling of financial resources, incomplete risk pooling, high administrative costs, and inefficient control were the most important weaknesses of IHIO. The most important opportunities for IHIO include the government’s support for universal health coverage and emphasis on primary health care, legal support for consolidating health insurance funds and improving the health technology assessment system in the country. The main threats to IHIO include political and economic unstability, low health insurance premiums, decisions without scientific support and insufficient enforcement of laws. Finally, solutions such as modernizing the tax system, increasing the health literacy of the community, reducing bureaucracy, increasing transparency and accountability, and reforming the monitoring and evaluation system were identified to strengthen the performance of the financing system of IHIO.
Conclusion: Iran’s health insurance organization is facing numerous structural, contexual and process challenges that have reduced its productivity. Decrease in revenues, increase in costs and decrease in efficiency have caused problems in the financing performance of this organization. Recognizing the weaknesses and challenges of financing performance and applying corrective interventions is the first step in strengthening the sustainability of health financing of IHIO.
Materials and Methods: This qualitative research was conducted using interpretive phenomenology method through using semi-structured interviews with 25 managers and employees of IHIO. In addition, relevant documents and archival data of IHIO were collected and analyzed. Thematic analysis method was used to analyze the data.
Results: Overall, 19 strengths, 24 weaknesses, 14 opportunities, 37 threats and 43 solutions were identified for the health financing system of IHIO. Increasing the coverage of health services, correcting the information databases of the insured and electronic prescribing were the most important strengths, and inappropriate pooling of financial resources, incomplete risk pooling, high administrative costs, and inefficient control were the most important weaknesses of IHIO. The most important opportunities for IHIO include the government’s support for universal health coverage and emphasis on primary health care, legal support for consolidating health insurance funds and improving the health technology assessment system in the country. The main threats to IHIO include political and economic unstability, low health insurance premiums, decisions without scientific support and insufficient enforcement of laws. Finally, solutions such as modernizing the tax system, increasing the health literacy of the community, reducing bureaucracy, increasing transparency and accountability, and reforming the monitoring and evaluation system were identified to strengthen the performance of the financing system of IHIO.
Conclusion: Iran’s health insurance organization is facing numerous structural, contexual and process challenges that have reduced its productivity. Decrease in revenues, increase in costs and decrease in efficiency have caused problems in the financing performance of this organization. Recognizing the weaknesses and challenges of financing performance and applying corrective interventions is the first step in strengthening the sustainability of health financing of IHIO.
Fahimeh Mohammadi, Maryam Shekofteh, Maryam Kazerani,
Volume 18, Issue 3 (7-2024)
Volume 18, Issue 3 (7-2024)
Abstract
Background and Aim: The growth and development of scientific fields depends on correct and accurate planning and a general and comprehensive understanding of the structure of these fields. Scientific maps are a type of scientometric methods that help to understand the current state of scientific fields and reveal their internal structure. The aim of the present study is to analyze co-authorship and word co-occurrence maps of scientific publications of Iran in the field of endocrinology and metabolism.
Materials and Methods: This is a cross-sectional scientometrics study. The research population is all scientific publications of Iran in the field of Endocrinology and Metabolism on the Web of Science. The co-authorship and co-word maps were analyzed using VOSviewer, Gephi, and NodeXL software. Network analysis was done using social network analysis indicators. Thematic clusters and emerging subjects were also identified through the examination of word co-occurrence networks.
Results: The total scientific publications of Iran in the field of endocrinology and metabolism on the Web of Science was 4847 documents. The co-authorship network is a type of sparse network. The value of the cluster coefficient of this network was 0.212 and its diameter was 11. The average degree of the co-authorship network (6.62) shows that each node is connected with about 6 other nodes on average. The diameter of the co-authorship network is 11. The most productive and influential outhors are Azizi F and Larijani B. Six thematic clusters were identified in the word co-occurrence network, the largest one is oxidative stress and gene expression, followed by the obesity and diabetes cluster. The word “autoimmunity” is one of the emerging words in this field.
Conclusion: Iran’s research in the field of Endocrinology and Metabolism shows an increasing trend, but there is little cooperation between the authors of the field. Their co-authorship networks are sparse, and the authors’ tendency to form clusters is low. Therefore, planning is needed to increase scientific cooperation and the density of networks. It is suggested that the researchers of this field pay attention to the thematic clusters of the co-word network and emerging subjects in the design of their future research.
Materials and Methods: This is a cross-sectional scientometrics study. The research population is all scientific publications of Iran in the field of Endocrinology and Metabolism on the Web of Science. The co-authorship and co-word maps were analyzed using VOSviewer, Gephi, and NodeXL software. Network analysis was done using social network analysis indicators. Thematic clusters and emerging subjects were also identified through the examination of word co-occurrence networks.
Results: The total scientific publications of Iran in the field of endocrinology and metabolism on the Web of Science was 4847 documents. The co-authorship network is a type of sparse network. The value of the cluster coefficient of this network was 0.212 and its diameter was 11. The average degree of the co-authorship network (6.62) shows that each node is connected with about 6 other nodes on average. The diameter of the co-authorship network is 11. The most productive and influential outhors are Azizi F and Larijani B. Six thematic clusters were identified in the word co-occurrence network, the largest one is oxidative stress and gene expression, followed by the obesity and diabetes cluster. The word “autoimmunity” is one of the emerging words in this field.
Conclusion: Iran’s research in the field of Endocrinology and Metabolism shows an increasing trend, but there is little cooperation between the authors of the field. Their co-authorship networks are sparse, and the authors’ tendency to form clusters is low. Therefore, planning is needed to increase scientific cooperation and the density of networks. It is suggested that the researchers of this field pay attention to the thematic clusters of the co-word network and emerging subjects in the design of their future research.
Mazyar Karamali, Azadeh Soleimaninejad, Peirhossein Kolivand, Reza Dehkhodaei,
Volume 18, Issue 4 (10-2024)
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: The Iranian Red Crescent Society (IRCS) is recognized as one of the ten most powerful national societies among the Red Cross and Red Crescent societies globally in responding to disasters and emergencies. The purpose of this study is to outline the research topics of the Iranian Red Crescent Society by analyzing its scientific outputs over the past years.
Materials and Methods: The research is of an applied type with a scientometric approach and bibliometric analysis, which uses event network visualization techniques and synonym analysis. The statistical population of the study included all research conducted by the Iranian Red Crescent Society and articles indexed in the Scopus database since the 1990s. The synonym analysis of research titles conducted in the organization and article abstract information and data visualization techniques were used with VOSviewer, NVIVO, WordCloud and iThoughts software.
Results: The trend of publishing research outputs has been upward. Analysis of outputs showed that Shiraz University of Medical Sciences had the highest output and the Gastroenterology and Liver Research Center and Isfahan University of Medical Sciences had the lowest output among the 10 most active institutions. Also, the Iranian Red Crescent Medical Journal had the highest output, and among the topics related to outputs, the field of medicine was ranked first and the field of Multidisciplinary was ranked lowest. Among the frequently used words, “human” was ranked first. Identifying and drawing a map of research issues for this organization showed that the problem-oriented research topics of the Red Crescent Society were categorized into nine main areas, among which relief and rescue was ranked first with 21.4% and technology and innovation was ranked lowest with 4.6%.
Conclusion: The study of the scientific and research outputs of the Iranian Red Crescent indicates the breadth and diversity of research issues in the subject areas raised. The status of research conducted in the map of Iranian Red Crescent issues by comparing the keywords showed that the research performance of this organization is higher in the fields of health services, relief and rescue, and education. Given the breadth of issues commensurate with its missions, it needs balanced growth in research and knowledge production in other areas.
Materials and Methods: The research is of an applied type with a scientometric approach and bibliometric analysis, which uses event network visualization techniques and synonym analysis. The statistical population of the study included all research conducted by the Iranian Red Crescent Society and articles indexed in the Scopus database since the 1990s. The synonym analysis of research titles conducted in the organization and article abstract information and data visualization techniques were used with VOSviewer, NVIVO, WordCloud and iThoughts software.
Results: The trend of publishing research outputs has been upward. Analysis of outputs showed that Shiraz University of Medical Sciences had the highest output and the Gastroenterology and Liver Research Center and Isfahan University of Medical Sciences had the lowest output among the 10 most active institutions. Also, the Iranian Red Crescent Medical Journal had the highest output, and among the topics related to outputs, the field of medicine was ranked first and the field of Multidisciplinary was ranked lowest. Among the frequently used words, “human” was ranked first. Identifying and drawing a map of research issues for this organization showed that the problem-oriented research topics of the Red Crescent Society were categorized into nine main areas, among which relief and rescue was ranked first with 21.4% and technology and innovation was ranked lowest with 4.6%.
Conclusion: The study of the scientific and research outputs of the Iranian Red Crescent indicates the breadth and diversity of research issues in the subject areas raised. The status of research conducted in the map of Iranian Red Crescent issues by comparing the keywords showed that the research performance of this organization is higher in the fields of health services, relief and rescue, and education. Given the breadth of issues commensurate with its missions, it needs balanced growth in research and knowledge production in other areas.
Mohammad Mehdi Sepehri, Minoo Fathi, Nasrin Taherkhani, Roghaye Khasha,
Volume 19, Issue 1 (4-2025)
Volume 19, Issue 1 (4-2025)
Abstract
Background and Aim: The development of self-management application for gestational Diabetes based on mobile health, can increase the quality of life of pregnant mothers and reduce the cost of health care and treatment. In order to develop such an application, it is necessary to identify the key players of this system and examine the relationships between them. Then a gestational Diabetes self-management network based on mobile health tools can be presented.
Materials and Methods: The study was conducted in four phases. In the first phase, key players and roles were identified through literature review. In the second phase, interviews with experts were conducted to assess the identified players and their roles. The third phase involved identifying the relationships between players and their roles, accomplished by designing and completing questionnaires that explored the existence or absence of connections between them. In the final phase, the most critical roles and players were determined using social network analysis, employing three centrality indices: degree centrality, betweenness centrality, and closeness centrality.
Results: A total of 22 role players and 17 roles were identified. Based on the results, the Ministry of Health, with a degree centrality index of 41.12, was found to be the most influential and powerful role player in this network. The endocrinologist, nutritionist and obstetrician, with degree centrality indices of 38.52, 36.79, and 31.60. were ranked next. This indicates that the acceptance of this network by the medical community plays a critical role. Additionally, all three centrality indices showed that the role of patient education had the highest values, followed by roles such as education for specialists and healthcare staff, supporting patients in self-care behaviors, and ensuring patient safety and privacy, which were identified as the key roles.
Conclusion: This study aimed to identify various aspects of network design and the influential roles impacting the self-management of gestational Diabetes through mobile health. The Ministry of Health and the National Prevention Committee exhibited the most connections with each other in fulfilling their shared roles. Therefore, the Ministry of Health can fully delegate some roles to the National Prevention. Additionally, recognizing key roles underscores the necessity of prioritizing education and resource allocation for these roles.
Materials and Methods: The study was conducted in four phases. In the first phase, key players and roles were identified through literature review. In the second phase, interviews with experts were conducted to assess the identified players and their roles. The third phase involved identifying the relationships between players and their roles, accomplished by designing and completing questionnaires that explored the existence or absence of connections between them. In the final phase, the most critical roles and players were determined using social network analysis, employing three centrality indices: degree centrality, betweenness centrality, and closeness centrality.
Results: A total of 22 role players and 17 roles were identified. Based on the results, the Ministry of Health, with a degree centrality index of 41.12, was found to be the most influential and powerful role player in this network. The endocrinologist, nutritionist and obstetrician, with degree centrality indices of 38.52, 36.79, and 31.60. were ranked next. This indicates that the acceptance of this network by the medical community plays a critical role. Additionally, all three centrality indices showed that the role of patient education had the highest values, followed by roles such as education for specialists and healthcare staff, supporting patients in self-care behaviors, and ensuring patient safety and privacy, which were identified as the key roles.
Conclusion: This study aimed to identify various aspects of network design and the influential roles impacting the self-management of gestational Diabetes through mobile health. The Ministry of Health and the National Prevention Committee exhibited the most connections with each other in fulfilling their shared roles. Therefore, the Ministry of Health can fully delegate some roles to the National Prevention. Additionally, recognizing key roles underscores the necessity of prioritizing education and resource allocation for these roles.
Fatemeh Najafi, Hooman Shahsavari, Golnar Ghane, Zahra Zare,
Volume 19, Issue 3 (9-2025)
Volume 19, Issue 3 (9-2025)
Abstract
Background and Aim: Ensuring the quality of care and maintaining patient safety are fundamental challenges within the nursing profession. Having a culturally relevant and valid tool to assess the phenomenon of “missed nursing care” can significantly assist in identifying actions and conditions that result in negative patient outcomes or situations where care is inadequately provided. Therefore, the aim of the present study was to culturally adapt and validate the Iranian version of the Missed Care Survey tool.
Materials and Methods: The translation and psychometric testing were carried out in six stages: 1) translation from the original language to the target language, 2) comparison of the two translated versions, 3) back-translation, 4) comparison of the back-translated versions with the original, 5) pilot testing of the pre-final version with a monolingual sample, and 6) full psychometric validation of the pre-final version. These stages were conducted with a sample of 330 nursing staff from hospitals affiliated with Tehran University of Medical Sciences.
Results: A total of 330 participants were included in the present study, the majority of whom were female and worked rotating shifts. Approximately half of the participants were aged between 25 and 34 years, and the longest duration of employment in the nursing profession was more than ten years (100 participants, 30.3%). In addition, more than half of the participants held a bachelor’s degree in nursing, and the majority worked more than 30 hours per week (316 participants, 95.8%).The Cronbach’s alpha for the entire instrument was 0.89, and for the subscales of Part B it ranged from 0.79 to 0.93. Moreover, the test–retest correlation coefficients for Part A (missed nursing care, including a list of nursing activities) and Part B (reasons for missed nursing care) were 0.83 and 0.80, respectively. The results of confirmatory factor analysis indicated an acceptable and satisfactory model fit for the three-factor structure of Part B based on overall goodness-of-fit indices. Collectively, these findings provide evidence for the instrument’s robust construct validity and reliability, supporting its suitability for assessing missed nursing care in clinical settings.
Results: A total of 330 participants were included in the present study, the majority of whom were female and worked rotating shifts. Approximately half of the participants were aged between 25 and 34 years, and the longest duration of employment in the nursing profession was more than ten years (100 participants, 30.3%). In addition, more than half of the participants held a bachelor’s degree in nursing, and the majority worked more than 30 hours per week (316 participants, 95.8%).The Cronbach’s alpha for the entire instrument was 0.89, and for the subscales of Part B it ranged from 0.79 to 0.93. Moreover, the test–retest correlation coefficients for Part A (missed nursing care, including a list of nursing activities) and Part B (reasons for missed nursing care) were 0.83 and 0.80, respectively. The results of confirmatory factor analysis indicated an acceptable and satisfactory model fit for the three-factor structure of Part B based on overall goodness-of-fit indices. Collectively, these findings provide evidence for the instrument’s robust construct validity and reliability, supporting its suitability for assessing missed nursing care in clinical settings.
Conclusion: Given the critical role of nurses in the healthcare system, providing high-quality and safe nursing care becomes increasingly important. The growing diversity of populations worldwide highlights the pressing need for researchers and healthcare providers to access valid tools across different cultural groups and languages. The Iranian version of the “Missed Nursing Care Survey” is a reliable tool with acceptable internal consistency, good test-retest reliability, and sufficient validity due to its correlation with the original version. Therefore, this tool can be utilized in studies aimed at generating deeper insights into the factors influencing or moderating this complex phenomenon.
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