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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.
Omid Zadi Akhuleh, Abbas Dadashzadeh, Aysan Judi,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: Surgical smoke (SS), is caused by the use of high temperature devices such as electrocautery, laser and ultrasonic scalpel, which are used for cutting and coagulation of tissue during surgery, is considered as a serious threat to the health of operating room (OR) personnel. Various studies have identified the workplace safety climate as one of the main causes of the occurrence or prevention of occupational hazards. This study was conducted with the aim of Perceived Safety Climate (PSC) in ORs and its relationship with the awareness of the OR staff about the SS hazards.
Materials and Methods: This cross-sectional study was conducted from April 2021 to July 2022 in the ORs of 26 public hospitals affiliated to Tabriz University of Medical Sciences. In this research, 396 surgical and anesthesia technologists were included in the study by stratified random sampling. Data were collected using a demographic questionnaire, PSC questionnaire and awareness about the hazards of SS questionnaire and analyzed using SPSS software
Results: The knowledge of the OR staff regarding the hazards of surgical smoke was evaluated at a moderate level with a mean and standard deviation of 9.82±4.32 (range 0 to 21). The average knowledge score of surgical technologists (11.1±4.56) regarding the hazards of surgical smoke was significantly higher than the average score of anesthesia technologists (8.75±4.1)(P=0.02). The PSC in the OR was evaluated at moderate level with a mean and standard deviation of 62.15±11.1 (range 19 to 95). The results of linear regression analysis showed that the effect of PSC in increasing the awareness of OR staff about the hazards of SS was significant (P=0.001). By increasing one score to the total score of the PSC, the awareness score increases by 0.201.
Conclusion: The safety climate of the OR can predict the awareness of the hazards of SS among OR staff. It is recommended to adopt strategies such as educating personnel about the hazards of SS and how to prevent it, creating a suitable supportive environment for personnel, and providing suitable protective facilities to prevent OR staff from being exposed to SS.
Materials and Methods: This cross-sectional study was conducted from April 2021 to July 2022 in the ORs of 26 public hospitals affiliated to Tabriz University of Medical Sciences. In this research, 396 surgical and anesthesia technologists were included in the study by stratified random sampling. Data were collected using a demographic questionnaire, PSC questionnaire and awareness about the hazards of SS questionnaire and analyzed using SPSS software
Results: The knowledge of the OR staff regarding the hazards of surgical smoke was evaluated at a moderate level with a mean and standard deviation of 9.82±4.32 (range 0 to 21). The average knowledge score of surgical technologists (11.1±4.56) regarding the hazards of surgical smoke was significantly higher than the average score of anesthesia technologists (8.75±4.1)(P=0.02). The PSC in the OR was evaluated at moderate level with a mean and standard deviation of 62.15±11.1 (range 19 to 95). The results of linear regression analysis showed that the effect of PSC in increasing the awareness of OR staff about the hazards of SS was significant (P=0.001). By increasing one score to the total score of the PSC, the awareness score increases by 0.201.
Conclusion: The safety climate of the OR can predict the awareness of the hazards of SS among OR staff. It is recommended to adopt strategies such as educating personnel about the hazards of SS and how to prevent it, creating a suitable supportive environment for personnel, and providing suitable protective facilities to prevent OR staff from being exposed to SS.
Mohamad Hoseini Kasnavieh, Mahsa Mahmoudinejad, Mohammad Veisy, Pouya Hedayati Shahidani, Ali Tahmasebi,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: this study aims investigating the effect of the physician's presence on the error of recording surgical codes by surgical assistants and the resulting financial effects in Rasoul Akram hospital.
Materials and Methods: The present study was a descriptive-analytical and prospective study that was performed by collecting data in the hospital and reviewing the documents from Jun to March 2022. Therefore, in order to compare the deductions according to the presence or absence of the doctor, an expert was stationed in the operating room to enter the information in special forms, and thus the types of deductions for each of the mentioned situations were identified. T-test was used for analysis between the two groups (presence and absence of physician) and data were analyzed using Excel and SPSS software.
Results: Three hundred and one records were reviewed during the presence of the physician and 300 cases during the absence of the physician based on Cochran sampling formula. The percent difference between hidden deductions in the presence and absence of the physician was not significant (P-value=0.078). However, the difference between the obvious deductions in the presence and absence of the physicians was significant (P-value=0.024). The difference in obvious deduction costs was significant in the presence or absence of a physician (P-value<0.001). But, the difference in hidden fraction costs in the presence or absence of physicians, was not significant (P-value=0.435).
Conclusion: The presence or absence of a surgeon has an effect on the amount of errors in the registration of surgical codes by the surgeon’s assistant and, as a result, this matter affects the percentage and costs of surgical deductions, especially in the obvious deductions. Therefore, planning for the presence of the surgeon in cases where the error of registering the codes by the surgeon’s assistant leads to obvious deductions, can help to more accurate documentation and, as a result, fewer deductions are accrued.
Materials and Methods: The present study was a descriptive-analytical and prospective study that was performed by collecting data in the hospital and reviewing the documents from Jun to March 2022. Therefore, in order to compare the deductions according to the presence or absence of the doctor, an expert was stationed in the operating room to enter the information in special forms, and thus the types of deductions for each of the mentioned situations were identified. T-test was used for analysis between the two groups (presence and absence of physician) and data were analyzed using Excel and SPSS software.
Results: Three hundred and one records were reviewed during the presence of the physician and 300 cases during the absence of the physician based on Cochran sampling formula. The percent difference between hidden deductions in the presence and absence of the physician was not significant (P-value=0.078). However, the difference between the obvious deductions in the presence and absence of the physicians was significant (P-value=0.024). The difference in obvious deduction costs was significant in the presence or absence of a physician (P-value<0.001). But, the difference in hidden fraction costs in the presence or absence of physicians, was not significant (P-value=0.435).
Conclusion: The presence or absence of a surgeon has an effect on the amount of errors in the registration of surgical codes by the surgeon’s assistant and, as a result, this matter affects the percentage and costs of surgical deductions, especially in the obvious deductions. Therefore, planning for the presence of the surgeon in cases where the error of registering the codes by the surgeon’s assistant leads to obvious deductions, can help to more accurate documentation and, as a result, fewer deductions are accrued.
Saeed Nateghi, Ali Ganjali Khan Hakemi, Soheila Damiri, Samira Raoofi, Elham Haghshenas, Sara Akhavan Rezayat, Shamsi Ekhtiyar, , Maryam Radin Manesh,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: Effective monitoring and evaluation of human resources in countries require an agreed set of indicators and measurement tools. Due to the existence of different payment mechanisms, this study aimed to identify performance evaluation indicators in hospitals affiliated with the Tehran University of Medical Sciences.
Materials and Methods: A qualitative phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, purposive sampling, and participation of 23 members of the Senior executives and financial team of hospitals affiliated to Tehran University of Medical Sciences and analyzed by content analysis method using MAXQDA-10 software.
Results: Twenty-three experts participated in this research, 78.2% were men and 21.7% were women, and a total of 526 final codes were identified and according to the balanced scorecard management tool in 4 main themes of finance, customers, internal processes, and growth and Development. Also 8 sub-themes of resource efficiency with 86%, medical tourism with 52%, professional ethics with 65%, satisfaction with 78%, accreditation with 48%, diagnosis and treatment with 78%, education with 56% and The research was categorized with 78%.
Conclusion: The provision of optimal medical services requires managers to be aware of the performance of subordinate personnel, which makes it possible to choose the appropriate criteria, develop performance evaluation systems and conduct correct evaluation, informing Doctors regarding the indicators considered for more accurate evaluation are among the suggestions that can be a solution to the existing problems. Another important point considering the limited available resources is the role of doctors in the field of health tourism to which attention will lead to an increase in financial resources.
Materials and Methods: A qualitative phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, purposive sampling, and participation of 23 members of the Senior executives and financial team of hospitals affiliated to Tehran University of Medical Sciences and analyzed by content analysis method using MAXQDA-10 software.
Results: Twenty-three experts participated in this research, 78.2% were men and 21.7% were women, and a total of 526 final codes were identified and according to the balanced scorecard management tool in 4 main themes of finance, customers, internal processes, and growth and Development. Also 8 sub-themes of resource efficiency with 86%, medical tourism with 52%, professional ethics with 65%, satisfaction with 78%, accreditation with 48%, diagnosis and treatment with 78%, education with 56% and The research was categorized with 78%.
Conclusion: The provision of optimal medical services requires managers to be aware of the performance of subordinate personnel, which makes it possible to choose the appropriate criteria, develop performance evaluation systems and conduct correct evaluation, informing Doctors regarding the indicators considered for more accurate evaluation are among the suggestions that can be a solution to the existing problems. Another important point considering the limited available resources is the role of doctors in the field of health tourism to which attention will lead to an increase in financial resources.
Fardin Amiri, Arash Khajehvand, Sedigheh Hannani, Nemamali Azadi,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: Surgical site infection (SSI) is one of the most common health-care associated infections. Using proper antiseptic solutions for preoperative surgical site skin preparation (skin prep) is one of the methods to reduce SSIs. The purpose of this study was to compare the effect of preoperative surgical site skin preparation with povidone-iodine and chlorhexidine-gluconate on the rate of SSI in laparotomy patients.
Materials and Methods: A total of 70 Laparotomy surgery patients who referred to Firoozgar hospital in Tehran from May to September of 2021 were included in this clinical trial. Patients were randomly allocated into two groups which were treated with povidone-iodine(PVI) or chlorhexidine-gluconate (CHG) for surgical site skin prep. Skin prep was done with standard rotational method in two steps by the researcher for each group by using of PVI and CHG. SSI incidence was assessed by a researcher-made check list and also over post-surgical follow up visits by the surgeon. We used Fischer’s exact test, t-test, Chi-square and Cochrane’s Q-test to analyze the collected data.
Results: SSI was seen in five patients (14.29%) of PVI group and one patient (2.86%) of CHG group. Although the SSI incidence in PVI group was 5.54 times more than CHG group, still the difference wasn’t statistically significant (P=0.198). Comparing the incidence of SSI’s in 24 hours after surgery (0%) and 30 days after surgery (8.57%) in both groups revealed that using these antiseptics for skin prep was effective in preventing SSI (P<0.001). SSI incidence was also associated with two days of patient’s hospital admission time (P=0.001).
Conclusion: The result of this study revealed that the occurrence of SSI in PVI group was 5.54 times more than CHG group. However, the difference was not statistically significant. So both of these antiseptics can be used for surgical site skin prep.
Materials and Methods: A total of 70 Laparotomy surgery patients who referred to Firoozgar hospital in Tehran from May to September of 2021 were included in this clinical trial. Patients were randomly allocated into two groups which were treated with povidone-iodine(PVI) or chlorhexidine-gluconate (CHG) for surgical site skin prep. Skin prep was done with standard rotational method in two steps by the researcher for each group by using of PVI and CHG. SSI incidence was assessed by a researcher-made check list and also over post-surgical follow up visits by the surgeon. We used Fischer’s exact test, t-test, Chi-square and Cochrane’s Q-test to analyze the collected data.
Results: SSI was seen in five patients (14.29%) of PVI group and one patient (2.86%) of CHG group. Although the SSI incidence in PVI group was 5.54 times more than CHG group, still the difference wasn’t statistically significant (P=0.198). Comparing the incidence of SSI’s in 24 hours after surgery (0%) and 30 days after surgery (8.57%) in both groups revealed that using these antiseptics for skin prep was effective in preventing SSI (P<0.001). SSI incidence was also associated with two days of patient’s hospital admission time (P=0.001).
Conclusion: The result of this study revealed that the occurrence of SSI in PVI group was 5.54 times more than CHG group. However, the difference was not statistically significant. So both of these antiseptics can be used for surgical site skin prep.
Mehryar Taghavi Gilani, Majid Razavi, Alireza Bameshki, Arash Peivandi Yazdi,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: Treatment of acute postoperative pain is one of the most important measures to improve recovery. Different methods of local and regional anesthesia, and also numerous intravenous drugs have been used. In this study, the analgesic effect ketorolac, paracetamol and pethidine in the postoperative pain control of outpatient transurethral lithotripsy was evaluated.
Materials and Methods: This clinical trial was performed on 96 patients who were candidates for outpatient transurethral lithotripsy in Mashhad Imam Reza Hospital. In randomized double blinded study, at the end of the operation, 30 mg of intravenous ketorolac to the first group, 1 gram paracetamol in half an hour to the second group and 50 mg of pethidine to the third group were injected. Pain was assessed every 10 minutes to half an hour and then, every half an hour to 4 hours by numerical rating scale (NRS). Finally, the data were analyzed by SPSS v16 software. The relationship between quantitative variables was analyzed by analysis of variance and the qualitative variables was assessed by Chi-square test and P<0.05 was considered significant.
Results: There was no significant difference between three groups in demographic information. The pain intensity in the first 10 minutes after surgery was the same between the groups (P=0.372), but the pain intensity at 20, 30 and 60 minutes after surgery was significantly different in the three groups (P.values 0.005, 006, and 0.001 respectively), and was lower in the pethidine group. In other hours after surgery, no significant difference in pain control was observed between the three groups. The need for additional analgesia was higher in the paracetamol group than in the other two groups (P=0.025) in the first hour. Hemodynamic changes and surgical complications such as nausea and vomiting were the same in both groups.
Conclusion: The present study showed that pethidine causes better pain relief than ketorolac and paracetamol in the first hour after surgery, but after 60 minutes there is no significant difference between these three groups.
Materials and Methods: This clinical trial was performed on 96 patients who were candidates for outpatient transurethral lithotripsy in Mashhad Imam Reza Hospital. In randomized double blinded study, at the end of the operation, 30 mg of intravenous ketorolac to the first group, 1 gram paracetamol in half an hour to the second group and 50 mg of pethidine to the third group were injected. Pain was assessed every 10 minutes to half an hour and then, every half an hour to 4 hours by numerical rating scale (NRS). Finally, the data were analyzed by SPSS v16 software. The relationship between quantitative variables was analyzed by analysis of variance and the qualitative variables was assessed by Chi-square test and P<0.05 was considered significant.
Results: There was no significant difference between three groups in demographic information. The pain intensity in the first 10 minutes after surgery was the same between the groups (P=0.372), but the pain intensity at 20, 30 and 60 minutes after surgery was significantly different in the three groups (P.values 0.005, 006, and 0.001 respectively), and was lower in the pethidine group. In other hours after surgery, no significant difference in pain control was observed between the three groups. The need for additional analgesia was higher in the paracetamol group than in the other two groups (P=0.025) in the first hour. Hemodynamic changes and surgical complications such as nausea and vomiting were the same in both groups.
Conclusion: The present study showed that pethidine causes better pain relief than ketorolac and paracetamol in the first hour after surgery, but after 60 minutes there is no significant difference between these three groups.
Fatemeh Bahador, Azam Sabahi, Somayeh Paydar, Fatemeh Zangooei Seno,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: Today along with information technology development, telemedicine technology has expanded dramatically. Sinse telemedicine technology relies on data transmission, it is essential to pay attention to issues such as network security, confidentiality, and privacy of patients. Therefore, the aim of this study was to determine the importance of information security requirements in telemedicine networks based on managers and employees of the information technology unit of the University and teaching hospitals of Birjand city
Materials and Methods: This descriptive cross-sectional study was conducted in year 2021. The research population was The managers and employees of the information technology unit of the university and teaching hospitals of Birjand city (40 people), who were surveyed by the census. The study tool was a researcher-made questionnaire that confirmed its validity by faculty members and experts, and its reliability was calculated with Cronbach’s alpha (0.83). After collecting the data, they were entered into the SPSS software and were analyzed using descriptive statistics.
Results: The results showed that the security requirement related to information transportation is more important than other requirements. Also in the field of human resources, providing detailed documentation and training guides for users of the systems was with an average of (4.47). In the medical diagnosis equipment field, telemedicine network systems are equipped with emergency power was with an average of (4.72). In the storage and access to information context, installing antiviruses and anti-malware on all systems was with an average of (4.75), and also in the field of information transfer, encryption of important and sensitive files and information was with an average of (4.69) were the most important security needs.
Conclusions: As the results showed, security requirements related to information transfer have more importance than other requirements; Initially, information security can be guaranteed by creating security policies, updating and monitoring their implementation, as well as training employees. However, in order to transfer sensitive medical information, encryption and qualification verification methods, secure information transfer protocols, virtual and private networks (VPN) and other new technologies can be used in this field. Of course, necessary preparations should be made to create appropriate technical infrastructure for the implementation of security policies in information transmission.
Materials and Methods: This descriptive cross-sectional study was conducted in year 2021. The research population was The managers and employees of the information technology unit of the university and teaching hospitals of Birjand city (40 people), who were surveyed by the census. The study tool was a researcher-made questionnaire that confirmed its validity by faculty members and experts, and its reliability was calculated with Cronbach’s alpha (0.83). After collecting the data, they were entered into the SPSS software and were analyzed using descriptive statistics.
Results: The results showed that the security requirement related to information transportation is more important than other requirements. Also in the field of human resources, providing detailed documentation and training guides for users of the systems was with an average of (4.47). In the medical diagnosis equipment field, telemedicine network systems are equipped with emergency power was with an average of (4.72). In the storage and access to information context, installing antiviruses and anti-malware on all systems was with an average of (4.75), and also in the field of information transfer, encryption of important and sensitive files and information was with an average of (4.69) were the most important security needs.
Conclusions: As the results showed, security requirements related to information transfer have more importance than other requirements; Initially, information security can be guaranteed by creating security policies, updating and monitoring their implementation, as well as training employees. However, in order to transfer sensitive medical information, encryption and qualification verification methods, secure information transfer protocols, virtual and private networks (VPN) and other new technologies can be used in this field. Of course, necessary preparations should be made to create appropriate technical infrastructure for the implementation of security policies in information transmission.
Mohammad Javad Kabir, Alireza Heidari, Nahid Jafari, Honarvar Mohammad Reza, Sajad Moeini, Zahra Khatirnamani,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: Many health policies are not implemented or incompletely implemented after approval. This issue significantly reduces the popularity and responsiveness of the top managers of the health system and leads to service disruption in the target community. Therefore, this study was conducted to explain the existing challenges in the implementation of health policies.
Materials and Methods: A qualitative study was conducted in 2021. The participants in the study were 20 scientific and executive experts. The data was collected using an interview guide and the in-depth individual interview method and was analyzed using the content analysis method using thematic analysis with Graneheim and Lundman's approach.
Results: The challenges include the policies formulation (lack of evidence-informed decision-making, lack of attention to the details of the implementation, the change of the initial text of the policy, conflict of interests, unclarity the executives, the lack of proper integration between the political and technical components of the policies, the weak participation of the main stakeholders, the lack of the same understanding of policies concept between policy makers and executives and lack of budget forecasting), challenges of policies implementation (uncertainty about roles of executive organizations, lack of executive attachment, conflict of interest, lack of project management, change of formulated policies with change of executives, little belief among executives, lack of executive guarantee, lack of operational plan) and challenges of policies evaluation (Inadequate supervision and the absence of an informational and supervisory dashboard).
Conclusion: Using effective solutions to solve the challenges extracted in the stages of formulation, implementation and evaluation of health policies can lead to achieving the goals of the formulated policies and improving the health of the society.
Materials and Methods: A qualitative study was conducted in 2021. The participants in the study were 20 scientific and executive experts. The data was collected using an interview guide and the in-depth individual interview method and was analyzed using the content analysis method using thematic analysis with Graneheim and Lundman's approach.
Results: The challenges include the policies formulation (lack of evidence-informed decision-making, lack of attention to the details of the implementation, the change of the initial text of the policy, conflict of interests, unclarity the executives, the lack of proper integration between the political and technical components of the policies, the weak participation of the main stakeholders, the lack of the same understanding of policies concept between policy makers and executives and lack of budget forecasting), challenges of policies implementation (uncertainty about roles of executive organizations, lack of executive attachment, conflict of interest, lack of project management, change of formulated policies with change of executives, little belief among executives, lack of executive guarantee, lack of operational plan) and challenges of policies evaluation (Inadequate supervision and the absence of an informational and supervisory dashboard).
Conclusion: Using effective solutions to solve the challenges extracted in the stages of formulation, implementation and evaluation of health policies can lead to achieving the goals of the formulated policies and improving the health of the society.
Arash Farvahari, Mina Danaei, Ali Sheibani Tezerji, Mohsen Momeni,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: Nowadays, due to people using antibiotics without prescription, the resistance of the bodies to antibiotics has been a major health issue in the world. This study aimed to investigate the consumption of antibiotics without prescription among the people that go to the health care centers of Kerman.
Materials and Methods: This descriptive-analytical study was conducted from April to September 2019, cross-sectionally on 331 people who were referred to the health care centers of Kerman city by the available sampling method. In this research, a valid questionnaire was used to collect information. Data was analyzed with SPSS statistical software, using t-test and chi-square statistical tests.
Results: The average age of the referred people in this study was 38.6±10.76 years, 135 (40.4%) were males and 194 (60.6%) were females. More than two-thirds of people had a higher education than deploma degrees. The self-medication prevalence with antibiotics was 32.9%. The most common cause of self-inflicted use of antibiotics is unwillingness to pay (34.4%), the most common types of antibiotics used are amoxicillin (25%) and azithromycin (24%), and the most common form of medicine used is pills (55.5%). Respiratory infections were also the most common cause of self-inflicted use of antibiotics (42.2%). Pharmacies were the most common source of information about how to use antibiotics (53.9%). Also, self-medication with antibiotics in married people (P=0.015). people with self employed jobs (P=0.031) and people without medical insurance (P<0.001) were significantly more than the other studied group.
Conclusion: The results of the present study showed self-medication with antibiotics is highly prevalent in Kerman city, and policy makers should take interventions to increase people’s awareness of the risks and side effects of self-inflicted use of antibiotics, as well as drug resistance created as a result, in order to reduce the self-inflicted use of these drugs.
Materials and Methods: This descriptive-analytical study was conducted from April to September 2019, cross-sectionally on 331 people who were referred to the health care centers of Kerman city by the available sampling method. In this research, a valid questionnaire was used to collect information. Data was analyzed with SPSS statistical software, using t-test and chi-square statistical tests.
Results: The average age of the referred people in this study was 38.6±10.76 years, 135 (40.4%) were males and 194 (60.6%) were females. More than two-thirds of people had a higher education than deploma degrees. The self-medication prevalence with antibiotics was 32.9%. The most common cause of self-inflicted use of antibiotics is unwillingness to pay (34.4%), the most common types of antibiotics used are amoxicillin (25%) and azithromycin (24%), and the most common form of medicine used is pills (55.5%). Respiratory infections were also the most common cause of self-inflicted use of antibiotics (42.2%). Pharmacies were the most common source of information about how to use antibiotics (53.9%). Also, self-medication with antibiotics in married people (P=0.015). people with self employed jobs (P=0.031) and people without medical insurance (P<0.001) were significantly more than the other studied group.
Conclusion: The results of the present study showed self-medication with antibiotics is highly prevalent in Kerman city, and policy makers should take interventions to increase people’s awareness of the risks and side effects of self-inflicted use of antibiotics, as well as drug resistance created as a result, in order to reduce the self-inflicted use of these drugs.
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.
Keyhan Fatehi, Farimah Rahimi, Reza Rezayatmand,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Colorectal cancer is one of the most common cancers that its incidence and prevalence and so deaths due to this cancer have increased worldwide recently. This study examines the economic burden of colorectal cancer from different perspectives by conducting a scoping review.
Materials and Methods: In this scoping review, by searching Scopus, PubMed, Embase, Cochrane, and Web of Science, the articles reporting the costs of CRC were reviewed. The search was limited to those published in the past years leading up to 2020. In addition to categorizing different aspects of the reviewed paper, per capita costs were adjusted with the purchasing power parity in order to make some comparisons possible. In this study, the calculated costs of retrieved studies were categorized based on the perspective of each study.
Results: Out of 29 studies, only two have reported indirect costs of CRC, and 4 studies have reported both direct and indirect costs. In other studies, only direct costs of CRC have been reported. Nearly 40% of studies calculated CRC costs from the provider’s perspective. The highest reported annual per-patient cost was $175020(PPP-adjusted) which is related to the average annual costs of patients with CRC at the fourth stage in the United States from a provider perspective. The lowest reported amount was $ 954(PPP-adjusted) which was related to average annual inpatient costs in Brazil from a provider perspective.
Conclusion: Due to variations in study characteristics in terms of perspective, type of costs, type of patient included, etc. any comparison between the economic burden of CRC should be made with caution. However, reviewing various aspects of the economic burden of CRC reported in included studies, will provide researchers and policymakers with a better insight into the CRC burden while designing intervention programs will reduce the budget impact of the those programs.
Materials and Methods: In this scoping review, by searching Scopus, PubMed, Embase, Cochrane, and Web of Science, the articles reporting the costs of CRC were reviewed. The search was limited to those published in the past years leading up to 2020. In addition to categorizing different aspects of the reviewed paper, per capita costs were adjusted with the purchasing power parity in order to make some comparisons possible. In this study, the calculated costs of retrieved studies were categorized based on the perspective of each study.
Results: Out of 29 studies, only two have reported indirect costs of CRC, and 4 studies have reported both direct and indirect costs. In other studies, only direct costs of CRC have been reported. Nearly 40% of studies calculated CRC costs from the provider’s perspective. The highest reported annual per-patient cost was $175020(PPP-adjusted) which is related to the average annual costs of patients with CRC at the fourth stage in the United States from a provider perspective. The lowest reported amount was $ 954(PPP-adjusted) which was related to average annual inpatient costs in Brazil from a provider perspective.
Conclusion: Due to variations in study characteristics in terms of perspective, type of costs, type of patient included, etc. any comparison between the economic burden of CRC should be made with caution. However, reviewing various aspects of the economic burden of CRC reported in included studies, will provide researchers and policymakers with a better insight into the CRC burden while designing intervention programs will reduce the budget impact of the those programs.
Mahdi Hadi, Ali Jahan, Lila Najafi, Mohamad Ali Shariat,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Parallel to the progress of services, organizational complexity levels in health care centers (HCCs) have increased. The influential factors in this regard include the variety of services, the non-uniformity of the centers’ management conditions, and the rising expectations from the health system. Therefore, considering many factors influenced and effective, improvement of health services requires development of a systematic approach to evaluate their efficiency and management system. The aim of this study was to develop a balanced scorecard (BSC) model suitable for HCCs using a hybrid approach that combines the Fuzzy Delphi and DNAP techniques.
Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives.
Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.
Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.
Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives.
Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.
Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.
Maryam Aghajarinezhad, Yahya Salimi, Shahab Rezaeian, Ghobad Moradi, Mehdi Moradinazar, Fatemeh Khosravi Shadmani, Roya Safari_ Faramani, Mitra Darbandi, Farid Najafi,
Volume 17, Issue 2 (5-2023)
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: All people living in a society are not equally at risk of COVID-19 infection and hospitalization. The current study is aimed to determine the factors related to COVID-19 infection and hospitalization among participants of Ravansar Non-Communicable Disease (RaNCD) cohort study.
Materials and Methods: The present study was conducted between 28th February, 2020 to 27th November, 2021. Data from the RaNCD study, morbidity and hospitalizations cases (extracted from the medical care monitoring system, SAMA system and the handwritten list of the health department) and positive serological results were used. For the case-cohort study, 626 confirmed and/or probable cases and 2107 randomly selected participants as sub-cohort were recruited. For the case-control study, 188 COVID-19 hospitalized patients from RaNCD (as cases) and 632 positive outpatients identified as controls. Data were analyzed using Cox and logistic regression, respectively.
Results: In case-cohort study, the hazard ratio of COVID-19 among people living in rural areas, in smokers and those in middle socioeconomic status was, 0.37 (0.24, 0.58), 1.50 (1.07, 2.11), as compared to the reference groups. While the hazard ratio of people aged 46-64 and those ≥65 years old, as compared to the reference group within the first year, was 3.47 (1.76, 6.86) and 6.45 (2.80, 14.85), the corresponding value after one year was 2.23 (1.13, 4.40) and 3.52 (1.53, 8.10), respectively. The hazard ratio among those with at least one comorbidity was 2.45 (1.53, 3.92) in the first year of study and after one year decreased to 1.82 (1.14, 2.92). In addition, moderate and vigorous physical activity decreased the hazard ratio. In case-control study the odds ratio of hospitalization increased by 0.03% (1.03(1.01, 1.05)) with an increase of one year in age and in people with at least three comorbidities was 2.43 (1.24, 4.73) times of those without comorbidity.
Conclusion: Overall, one year after starting the study the decrease in hazard ratio of COVID-19 was significant. Increase in age and having comorbidities are factors that increased the odds ratio of hospitalization. Such people can be considered for the next waves of COVID-19 prioritized for health care and booster vaccination.
Materials and Methods: The present study was conducted between 28th February, 2020 to 27th November, 2021. Data from the RaNCD study, morbidity and hospitalizations cases (extracted from the medical care monitoring system, SAMA system and the handwritten list of the health department) and positive serological results were used. For the case-cohort study, 626 confirmed and/or probable cases and 2107 randomly selected participants as sub-cohort were recruited. For the case-control study, 188 COVID-19 hospitalized patients from RaNCD (as cases) and 632 positive outpatients identified as controls. Data were analyzed using Cox and logistic regression, respectively.
Results: In case-cohort study, the hazard ratio of COVID-19 among people living in rural areas, in smokers and those in middle socioeconomic status was, 0.37 (0.24, 0.58), 1.50 (1.07, 2.11), as compared to the reference groups. While the hazard ratio of people aged 46-64 and those ≥65 years old, as compared to the reference group within the first year, was 3.47 (1.76, 6.86) and 6.45 (2.80, 14.85), the corresponding value after one year was 2.23 (1.13, 4.40) and 3.52 (1.53, 8.10), respectively. The hazard ratio among those with at least one comorbidity was 2.45 (1.53, 3.92) in the first year of study and after one year decreased to 1.82 (1.14, 2.92). In addition, moderate and vigorous physical activity decreased the hazard ratio. In case-control study the odds ratio of hospitalization increased by 0.03% (1.03(1.01, 1.05)) with an increase of one year in age and in people with at least three comorbidities was 2.43 (1.24, 4.73) times of those without comorbidity.
Conclusion: Overall, one year after starting the study the decrease in hazard ratio of COVID-19 was significant. Increase in age and having comorbidities are factors that increased the odds ratio of hospitalization. Such people can be considered for the next waves of COVID-19 prioritized for health care and booster vaccination.
Davoud Haseli, Somayeh Paknahad,
Volume 17, Issue 2 (5-2023)
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: Bibliometric analysis by describing the state of publications and identifying key entities and emerging topics plays an important role in evaluating research. The aim of the paper is to study the global trends of scientific collaboration networks of researchers, organizations and countries and the co-occurrence of words in the field of social medicine in the database of Web of Science.
Materials and Methods: The method of investigation is bibliometric. The sample comprises 8494 publications in the area of social medicine between 2002 and 2021 in the Web of science database. The drawing of the scientific collaboration network of researchers, organisations and countries, and the analysis of the words network of co-occurrence, was made using the bibliometric software Vosviewer.
Results: The publication process of social medicine documents in the target period is increasing. Research articles had the highest number of documents frequency and review articles received the most citations. The United States had the most published literature in this area, and most authors and organizations were from that country. The degrees of two countries, Canada and Australia, had the most citations per documents, and the five countries of South Africa, Portugal, Pakistan, India, and Iran were emerging players in this field. The network of words co-occurrence of social medicine in three groups was devoted to “preventive research in social medicine”, “social determinants of health” and “healthy lifestyle, nutrition and physical activity”. In terms of temporal occurrence, the five keywords public health, mental health, social medicine, meta-analysis and epidemiology were emerging subjects in the area of social medicine.
Conclusion: Understanding impact of non-clinical studies of social medicine on people’s lives has led to an increase in research in this field. In addition to the traditional role of developed countries, some developing countries are also new players in this field and seeking to develop their infrastructure in social medicine.
Materials and Methods: The method of investigation is bibliometric. The sample comprises 8494 publications in the area of social medicine between 2002 and 2021 in the Web of science database. The drawing of the scientific collaboration network of researchers, organisations and countries, and the analysis of the words network of co-occurrence, was made using the bibliometric software Vosviewer.
Results: The publication process of social medicine documents in the target period is increasing. Research articles had the highest number of documents frequency and review articles received the most citations. The United States had the most published literature in this area, and most authors and organizations were from that country. The degrees of two countries, Canada and Australia, had the most citations per documents, and the five countries of South Africa, Portugal, Pakistan, India, and Iran were emerging players in this field. The network of words co-occurrence of social medicine in three groups was devoted to “preventive research in social medicine”, “social determinants of health” and “healthy lifestyle, nutrition and physical activity”. In terms of temporal occurrence, the five keywords public health, mental health, social medicine, meta-analysis and epidemiology were emerging subjects in the area of social medicine.
Conclusion: Understanding impact of non-clinical studies of social medicine on people’s lives has led to an increase in research in this field. In addition to the traditional role of developed countries, some developing countries are also new players in this field and seeking to develop their infrastructure in social medicine.
Zeynab Arbabi, Abdolali Banaiefar, Sajjad Arshadi, Hamid Tabatabaei,
Volume 17, Issue 2 (5-2023)
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: Metabolic syndrome refers to a set of metabolic disorders related to obesity, such as abdominal obesity, increased body fat mass, lipid disorders, hypertension, increased blood glucose, and insulin resistance. The present study was conducted with the aim of determining the effect of 8 weeks of CXWORX exercises combined with inulin consumption on some indicators of oxidative stress in obese women with metabolic syndrome.
Materials and Methods: Forty eight obese women with metabolic syndrome in the age range of 30 to 40 years were randomly divided into Control, inulin, CX exercise and combined groups were included. Subjects were present in the laboratory environment and 5 cc of blood was taken from their brachial vein. Blood sample was taken to measure malondialdehyde and xanthine oxidase (pre-test). Then the aforementioned interventions were performed on the studied groups for a period of 8 weeks. Finally, blood sampling was done again to measure the variables (post-test).
Results: The results of the correlated t-test revealed that in all three groups, the intervention led to a significant decrease in malondialdehyde compared to the pre-test; However, xanthine oxidase variable did not change significantly in the exercise group and significantly decreased in the inulin and combined groups compared to the pre-test. ANOVA results revealed that compared to the control group, the amount of malondialdehyde is significant only in the combined group (P≤0.05). The amount of this variable in the combined group decreased significantly compared to the exercise and inulin group (P≤0.05). No significant difference was observed between the exercise and inulin groups (P>0.05). Amount of xanthine oxidase, a significant difference had between the inulin and combination groups with the control group (P≤0.05). No significant difference was observed between the exercise and inulin groups (P>0.05). Despite this, a significant difference in xanthine oxidase levels was observed between the combined group with the exercise and inulin groups (P≤0.05).
Conclusion: Based on the available findings, it is concluded that the implementation of CX exercises combined with the use of inulin reduces the oxidative stress function more than the application of each of them alone in women with metabolic syndrome.
Materials and Methods: Forty eight obese women with metabolic syndrome in the age range of 30 to 40 years were randomly divided into Control, inulin, CX exercise and combined groups were included. Subjects were present in the laboratory environment and 5 cc of blood was taken from their brachial vein. Blood sample was taken to measure malondialdehyde and xanthine oxidase (pre-test). Then the aforementioned interventions were performed on the studied groups for a period of 8 weeks. Finally, blood sampling was done again to measure the variables (post-test).
Results: The results of the correlated t-test revealed that in all three groups, the intervention led to a significant decrease in malondialdehyde compared to the pre-test; However, xanthine oxidase variable did not change significantly in the exercise group and significantly decreased in the inulin and combined groups compared to the pre-test. ANOVA results revealed that compared to the control group, the amount of malondialdehyde is significant only in the combined group (P≤0.05). The amount of this variable in the combined group decreased significantly compared to the exercise and inulin group (P≤0.05). No significant difference was observed between the exercise and inulin groups (P>0.05). Amount of xanthine oxidase, a significant difference had between the inulin and combination groups with the control group (P≤0.05). No significant difference was observed between the exercise and inulin groups (P>0.05). Despite this, a significant difference in xanthine oxidase levels was observed between the combined group with the exercise and inulin groups (P≤0.05).
Conclusion: Based on the available findings, it is concluded that the implementation of CX exercises combined with the use of inulin reduces the oxidative stress function more than the application of each of them alone in women with metabolic syndrome.
Fatemeh Setoodehzadeh, Azar Abolpur, Kosar Rezaei, Mehdi Mohammadi, Mohammad Khammarnia, Farnaz Keykhah, Mostafa Peyvand,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: Children’s health is important as the future builders of society. Many children under 5 years of age around the world and in Iran have growth disorders. Due to the importance of growth disorder and its impact on the development, learning and future of the child, the present study was conducted with the aim of determining the frequency of deviations from the growth curves of children under 5 years of age and related factors in Zahedan city.
Materials and Methods: This case-control study was conducted in 2020 in Zahedan. The study population included all children under 5 years old, born in Zahedan between 2013 and 2020 that 784 of whom were selected by random sampling method. To determine the factors related to growth disorder multiple logistic regression analysis was used and to check the significance level, chi-square test and Pearson correlation were used. In this research, the data were analyzed with SPSS software.
Results: The results of this research showed that 54% of the boys and 51.20% of the girls had growth disorders. Between child growth disorder and maternal chronic disease (P<0.05), maternal body mass index (P<0.05), Maternal weight gain during pregnancy (P<0.05), distance between births (P<0.05) maternal urinary tract infection during pregnancy (P<0.05), mother’s age (P=0.006), mother’s education (P<0.05), birth weight (P<0.001), birth order (P<0.05), father’s occupation (P<0.05) and father’s education (P<0.05) a significant association was found. In the present study, the average birth weight in children with growth disorders was 2.75±0.58 and in healthy children was 2.95±0.57, and this difference was statistically significant (P=0.001). The average age of mothers of children with growth disorders was 29.19±6.07 and the average age of mothers of healthy children was 27.98±6.10, this difference was statistically significant (P=0.006).
Conclusion: Growth disorder is a multi-causal complication. Risk factors can be corrected and prevented by developing health education and increasing mothers’ awareness and knowledge. Also, the father’s job and literacy are effective in the child’s growth disorder, so Increasing community health literacy and encouraging fathers’ learning and literacy can partially prevent growth disorders in children.
Sedighe Hannani, Nazanin Sarraf Shahri, Asma Feizy Dehkharghani, Najme Samii, Azar Arab Khazaie, Azin Arab Khazaie, Kiarash Kamboozia,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: Virtual networks have become one of the most influential tools in people’s lives, affecting various aspects of life. In medical sciences, with numerous advancements, the use of virtual networks is increasing. However, virtual networks can lead to wastage of students’ time and a reduction in study hours, which negatively impacts their knowledge and practical skills. Therefore, this study aimed to investigate the impact of using virtual networks on the knowledge and practical skills of surgical technologist students.
Materials and Methods: This descriptive-analytical study was conducted on 60 students in the 6th and 8th semester of operating room technology at Iran University of Medical Sciences in 2020-2021. At the end of the semester, the students underwent a comprehensive 40-question theoretical exam to assess their theoretical knowledge. To evaluate the level of virtual network usage, the students filled out a researcher-designed questionnaire. The practical skills of the students were measured based on their internship grades. Normality of the data was assessed using the Kolmogorov-Smirnov, and Pearson correlation coefficient test. Data analysis was performed using SPSS software.
Results: According to the findings of this study, there was a significant negative relationship between the level of virtual network usage and theoretical knowledge (P<0.05). This means that with an increase in virtual network usage, the level of students’ knowledge decreased. On the other hand, there was a significant positive relationship between theoretical knowledge and practical skills. This means that as the scores of the comprehensive exam increased, the scores of practical skills (internship) also increased. However, no significant relationship was found between the level of virtual network usage and students’ practical skills (P>0.21).
Conclusion: Based on the findings of this study, virtual networks lead to a weakening of students’ theoretical knowledge, as evidenced by the decrease in scores on the researcher-designed questionnaire (level of virtual network usage) and the comprehensive exam scores. Another result of the study was the significant positive relationship between theoretical knowledge and practical skills, indicating that as the comprehensive exam scores increased, the scores obtained in internships also increased.
Materials and Methods: This descriptive-analytical study was conducted on 60 students in the 6th and 8th semester of operating room technology at Iran University of Medical Sciences in 2020-2021. At the end of the semester, the students underwent a comprehensive 40-question theoretical exam to assess their theoretical knowledge. To evaluate the level of virtual network usage, the students filled out a researcher-designed questionnaire. The practical skills of the students were measured based on their internship grades. Normality of the data was assessed using the Kolmogorov-Smirnov, and Pearson correlation coefficient test. Data analysis was performed using SPSS software.
Results: According to the findings of this study, there was a significant negative relationship between the level of virtual network usage and theoretical knowledge (P<0.05). This means that with an increase in virtual network usage, the level of students’ knowledge decreased. On the other hand, there was a significant positive relationship between theoretical knowledge and practical skills. This means that as the scores of the comprehensive exam increased, the scores of practical skills (internship) also increased. However, no significant relationship was found between the level of virtual network usage and students’ practical skills (P>0.21).
Conclusion: Based on the findings of this study, virtual networks lead to a weakening of students’ theoretical knowledge, as evidenced by the decrease in scores on the researcher-designed questionnaire (level of virtual network usage) and the comprehensive exam scores. Another result of the study was the significant positive relationship between theoretical knowledge and practical skills, indicating that as the comprehensive exam scores increased, the scores obtained in internships also increased.
Roya Balaghiinaloo, Alireza Noruzi, Mohammadreza Esmaeili Givi,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: It is not possible to provide health information services in health crises without a comprehensive understanding of these services and how to provide them due to the health crisis. Based on this, the aim of the current research was to obtain comprehensive information about the components of providing health information services in health crises.
Materials and Methods: The current research was conducted with a qualitative approach and a meta-combined method, using the seven-step method of Sandelowski and Barroso. The statistical population consisted of articles and theses published in persian and international databases between 1991 to 2022 AD and 1370 to 1400 solar. Out of a total of 8363 resources identified based on the critical skills assessment program, 40 resources were approved. Extracted information was coded and coding reliability was measured and confirmed using Kappa coefficient.
Results: From the results of the research, 74 codes were extracted in 21 concepts and 6 categories in the field of providing health information services to patients. which categories and codes include health information needs assessment (disease, health, health information sources, patients); accessibility and dissemination of health information (health information, access ways); Awareness and notification of health information (information, tools); Education (patients, managers and staff of hospital libraries, methods); Planning (health crisis, resources, budget, infrastructure, patients, librarians and Medical Information Specialists) and obstacles and limitations (expert force, budget, facilities and infrastructure and resources) were categorized.
Conclusion: Dealing with the issue and components of providing health information services to patients in health Disasters in hospital libraries can cause policymakers in this field to know more about the dimensions, concepts, and consequences of providing these services in order to provide access to health information for everyone, especially patients. According to the identified components, efforts can be made to prepare the necessary infrastructure in order to plan to strengthen the strengths and eliminate the existing weaknesses and make appropriate policies in order to play the role of health counseling and launch the health information service department in hospital libraries.
Materials and Methods: The current research was conducted with a qualitative approach and a meta-combined method, using the seven-step method of Sandelowski and Barroso. The statistical population consisted of articles and theses published in persian and international databases between 1991 to 2022 AD and 1370 to 1400 solar. Out of a total of 8363 resources identified based on the critical skills assessment program, 40 resources were approved. Extracted information was coded and coding reliability was measured and confirmed using Kappa coefficient.
Results: From the results of the research, 74 codes were extracted in 21 concepts and 6 categories in the field of providing health information services to patients. which categories and codes include health information needs assessment (disease, health, health information sources, patients); accessibility and dissemination of health information (health information, access ways); Awareness and notification of health information (information, tools); Education (patients, managers and staff of hospital libraries, methods); Planning (health crisis, resources, budget, infrastructure, patients, librarians and Medical Information Specialists) and obstacles and limitations (expert force, budget, facilities and infrastructure and resources) were categorized.
Conclusion: Dealing with the issue and components of providing health information services to patients in health Disasters in hospital libraries can cause policymakers in this field to know more about the dimensions, concepts, and consequences of providing these services in order to provide access to health information for everyone, especially patients. According to the identified components, efforts can be made to prepare the necessary infrastructure in order to plan to strengthen the strengths and eliminate the existing weaknesses and make appropriate policies in order to play the role of health counseling and launch the health information service department in hospital libraries.
Mohamad Jebraeily, Shima Touraj, Farid Khorrami,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: In the health system, reimbursement methods are an important criterion for the allocation of resources and the performance of service providers. The use of diagnosis-related groups (DRG) system reduces the length of stay and additional costs of the patient, prevents unnecessary treatment, increases resource efficiency and transparency of health care services. The development of the DRG system focuses on the accurate documentation of medical records and the correct coding of diagnoses and procedures. The purpose of this research is to evaluate the documentation and coding requirements of medical records in the implementation of a payment system based on diagnosis-related groups in Iran.
Materials and Methods: This research was descriptive-cross-sectional and was conducted in 2022. The data collection tool was a researcher-made checklist, the validity of which was confirmed based on the opinion of experts (health information management health economics) and its reliability was obtained by calculating Cronbach’s alpha (0.83). The research population consisted of 418 medical records in five medical training centers affiliated to Urmia University of Medical Sciences, which were selected through stratified-proportional sampling. Data were analyzed using SPSS software.
Results: The results of the evaluation of the documentation and coding requirements of medical records for the implementation of the DRG system showed that the demographic/administrative variables including age, sex, type of admission, length of stay, health insurance, and doctor’s expertise were completely recorded. Evaluation of clinical variables also showed that the main diagnosis, main procedure, secondary diagnosis and other procedures were documented in medical records in 98%, 97%, 88% and 75% respectively. Regarding the coding of the main diagnosis and the main procedure, 100%, secondary diagnosis 68% and other procedures 80% have been done.
Conclusion: Considering that some essential clinical variables for the implementation of DRG, especially co-morbidities, complications and other procedures are not recorded separately and completely, therefore it is necessary to define separate information elements in medical records and HIS for accurate recording of these variables and proper interaction between coders and doctors is established to increase the possibility of correct coding. It is also suggested that the DRG system be implemented in our country in a phased and gradual approach so that necessary changes are made in the documentation process and hospital information systems.
Materials and Methods: This research was descriptive-cross-sectional and was conducted in 2022. The data collection tool was a researcher-made checklist, the validity of which was confirmed based on the opinion of experts (health information management health economics) and its reliability was obtained by calculating Cronbach’s alpha (0.83). The research population consisted of 418 medical records in five medical training centers affiliated to Urmia University of Medical Sciences, which were selected through stratified-proportional sampling. Data were analyzed using SPSS software.
Results: The results of the evaluation of the documentation and coding requirements of medical records for the implementation of the DRG system showed that the demographic/administrative variables including age, sex, type of admission, length of stay, health insurance, and doctor’s expertise were completely recorded. Evaluation of clinical variables also showed that the main diagnosis, main procedure, secondary diagnosis and other procedures were documented in medical records in 98%, 97%, 88% and 75% respectively. Regarding the coding of the main diagnosis and the main procedure, 100%, secondary diagnosis 68% and other procedures 80% have been done.
Conclusion: Considering that some essential clinical variables for the implementation of DRG, especially co-morbidities, complications and other procedures are not recorded separately and completely, therefore it is necessary to define separate information elements in medical records and HIS for accurate recording of these variables and proper interaction between coders and doctors is established to increase the possibility of correct coding. It is also suggested that the DRG system be implemented in our country in a phased and gradual approach so that necessary changes are made in the documentation process and hospital information systems.
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