Journal of School of Public Health and Institute of Public Health Research

Developing a Model for Accreditation of General Clinics in Iran

Ebrahim Jaafaripooyan

Background and Aim: Accreditation as an external assessment model is considered a key program for evaluating health care organizations. The new health service accreditation system in Iran seems to lack the necessary standards for evaluating outpatient services and general clinics. The objective of this study was to design, based on the experiences of other countries, a model for accreditation of general clinics in Iran
Materials and Methods: This research was a qualitative review study conducted in two phases First, the methods and standards of accreditation of general clinics of selected countries were identified through a comparative review. In the second phase, the conceptual framework of the accreditation of these clinics was developed by an expert panel.
Results: The proposed framework for the accreditation of clinics starts with registering the application in the system and updating the information. After the clinic's self-evaluation and external evaluation, amendments will be made.
The key areas proposed for the accreditation of clinics included management and leadership, information management, process management, human resource management, salaries, and operational results. The country's clinics can be ranked in five levels, namely, excellent, good, average, poor, and substandard.
Conclusion: Considering the processes and areas determined in this study and the lack of a systematic approach, the proposed accreditation model could provide a scientific and practical method for the internal and external evaluating bodies to provide a relevant and valid evaluation of the general outpatient clinics in Iran.

Association between Resilience and Substance use Disorders among Young People aged 18 to 29 Years old in Kerman, Iran: A Cross-sectional Study

Abedin Iranpour

Background and Aim: One of the most significant predictors of substance use disorders is the level of resilience in individuals. This study aimed to determine the association between resilience and substance (alcohol, tobacco, and other drugs =ATOD) use disorders among young people aged 18 to 29 in Kerman city, Iran in 2022.
Materials and Methods: This was a cross-sectional study using a multi-stage sampling method including 407 young individuals aged 18 to 29 years in Kerman city, Iran from spring to winter 2022. The sample was selected from among individuals referring to five women's and five men's hair salons and four methadone maintenance treatment centers in each district of Kerman Municipality. The date on resilience, as well as demographic information, were collected using the short-form RS-14 Resilience Scale, the ACE-8 Childhood Experiences Scale and the Substance Use Disorder questionnaires through face-to-face interviews.
Results: The likelihood of substance abuse and referral to methadone maintenance treatment centers was found to increase with age, male gender, a history of domestic violence, and lower education levels. Conversely, higher resilience was associated with decreased likelihood of substance abuse and referral to treatment centers (p ≤ 0.05).
Conclusion: The findings of this study highlight the importance of developing effective programs to enhance resilience among youth, which will result in reduced risk of substance abuse. The results of this study can be used for appropriate planning and development of strategies to support youth health.

Contraceptive Methods and the Factors Influencing Them with a Brief Review during the COVID-19 Outbreak in Shiraz

Serajeddin Mahmoudiani

Background and Aim: Despite the importance of reproductive health and the utilization of contraceptive methods, their significance in public health and well-being is not yet fully understood in developing countries. It is expected that significant changes in Iran's family planning policy, coupled with the emergence of Covid-19, have influenced the contraceptive methods employed in the country.
Materials and Methods: This research was a cross-sectional study including 1200 married women of reproductive age using a quantitative survey method in Shiraz city, Iran in 2019. Sampling was done using a combination of multi-stage and systematic random classification methods. Data collection was done through a researcher-made structured questionnaire and analyzed using the SPSS software, the statistical tests being chi-square tests and multiple logistic regression.
Results: The main predictors of using contraceptive methods included women's age, actual fertility, ideal fertility, education level of the couple, and the employment status of the couple. After the Covid-19 pandemic there was an increase in the likelihood of utilizing traditional contraceptive methods.
Conclusion: Based on the findings of this study, considering the notable preference among women for traditional contraceptive methods, particularly during epidemics, it is imperative to educate them about the problems associated with these methods. As traditional contraceptive methods can result in unintended pregnancies, educating women about these methods should be integrated into population policies.

Cultural Critique of the Adolescent Communication Educational Package Within the Mental Health, Social Health, and Addiction Services of the Iranian Ministry of Health and Medical Education

iman zaghian

Background and Aim: Adolescence is a period of rapid biological, cognitive and neurological changes. The aim of this research was to conduct a cultural critique of the educational package of intra-family and extra-family communication for adolescents, which was implemented as part of the mental health services within the health network and based on Iranian-Islamic culture.
Materials and Methods: This qualitative study utilized the theme analysis method developed by Brown and Clark in 2006. The study population comprised all mental health contents within the health network. Targeted sampling was used to investigate the content related to communicating with adolescents. Data analysis involved the use of theme format analysis, theme network, and comparative analysis.
Results: Data analysis resulted in the extraction of 30 primary, 4 secondary and 2 overarching themes. The secondary themes included respect for parents, social norms, moral norms and a lack of cultural norms, while the overarching themes included values and norms.
Conclusion: The findings of this study highlight the need to revise and rewrite the content of the family foundation-strengthening program for parents and adolescents.

Prevalence of Viral Infections among Kidney Transplant Recipients in Iran: A Systematic Review Study

Armin Naghipour

Background and Aim: Various viral infections are one of the risk factors of kidney transplant rejection in patients receiving this organ. This research was conducted with the aim of investigating the frequency of viral infections in kidney transplant recipients in Iran.
Materials and Methods: This study was a systematic review. Keywords in the titles or abstracts of the articles published in Persian and English were searched in various databases during the period 2013-2023.
Results: A total of 2822 samples were examined, the largest and smallest sample sizes being 1615 and 50 patients, respectively. The highest viral infection frequencies were found in Gilan, Mashhad, Rasht and Ahvaz provinces with frequencies of 54 (52.9%), 54 (21.9%), 54 (49%) and 51 (41.8%), respectively. The frequencies of BK virus, cytomegalovirus and hepatitis C virus were the most common viral infections among the kidney transplant recipients.
Conclusion: Based on the findings of this study and higher prevalence of BK and CMV virus infections in kidney transplant recipients it is essential to screen organ donors for these viruses in the country.

Identifying and Analyzing the Components of Physical Health from the Perspective of the Qur'an and Hadiths with Shannon Entropy

Behnam Behari

Background and Aim: The soul and body of a person are one of the noblest subjects that require a person to study and reflect on. In this regard, the Holy Qur'an and Atrat, in addition to their basic purpose, which is to guide humanity to salvation, have also explained the issues essential for improving the quality of worldly life. Undoubtedly, the physical health of individuals and human societies is one of the most important concerns of contemporary wise people. In this research, different aspects of physical health are discussed. The objective of this study was to examine the components of physical health from the perspective of the Qur'an and hadiths.
Materials and Methods: This study was an applied research carried out in two stages. The first stage was a descriptive and analytical qualitative study. The triangulation method was used to extract and compile the materials, that is, the study was done by referring to the foundations of the Qur'an and the narrations of the innocents (PBUH) as well as using the related research and theoretical foundations. In the second stage the content analysis method was used to check the frequency and importance of physical health components in the Quran. The content of the research project was examined from the point of view of the respondent (the text of the Holy Quran) and nineteen main components in the area of physical health.
Results: Data analysis showed the absolute frequencies (A.F.) of the components of physical health from the perspective of the Qur'an to be as follows: (A). Components with an A.F. of 1: 1. Commanding people to look at foods; 2. Consumption of honey as a health promoting food; (B). Components with an A.F. of 2: 1. using animal skin to cover human body parts; 2. Abulition (ghosl), ablution before prayer (vozoo), abulition with earth or sand (tayammom); (C). Components with an A.F. of 3: 1. placing animals in a special place; 2. being halal the consumption of aquatic animals and plants (sea foods); (D). Components with an A.F. of 4: 1. prohibition (being haram) of eating the meat of dead animals; 2. eating decayed bodies of dead animals; 3. the prohibition of eating pork; 4. the prohibition of drinking blood; 5. allowing the milk of domestic animals for feeding; 6. prohibition of wine; 7. breastmilk to feed infants; (E). Components with an A.F. of 5: wearing clothes to cover the human body; (F). Components with an A.F. of 9: eating clean and halal foods; (G). Components with an A.F. of 13: 1. sending water for drinking and quenching people; 2. fasting; (H). Components with an A.F. of 14: being halal (allowed to be eaten) and permissible the consumption of the meat of halal domestic animals; (I). Components with an A.F. of 47 (the highest A.F.): growing all kinds of fruits and plants for feeding.
Conclusion: The findings of this study show that among the components of physical health from the perspective of the Qur'an, the highest and the lowest coefficients of importance were growing all kinds of fruits and plants for feeding (0/055) and consumption of honey as a health promoting food (0/034), respectively.

The Effectiveness of Cognitive Behavioral Therapy on Cognitive Flexibility and Executive Functioning in Epilepsy Patients

Zeynab Zaheri

Background and Aim: The purpose of this study was to determine the effectiveness of cognitive behavioral therapy on cognitive flexibility and executive functioning in epilepsy patients.
Materials and Methods: This research was a semi-experimental study with a pre-test and post-test format with a control group. The statistical population was all girls aged 7 to 14 years with epilepsy in Mazandaran province, Iran. The statistical sample included 40 girls (20 in the experimental group and 20 in the control group) selected by the available sampling method and randomly assigned in the two groups. The data collection tools were Dennis et al.'s Cognitive Flexibility (2010) and Coolidge's (2002) Executive Function questionnaires. Data analysis was done using SPSS software version 26.
Results: Multivariate analysis of covariance (MANCOVA) showed that the cognitive behavioral training program had a direct effect on cognitive flexibility and executive functioning of the girls with epilepsy. The effect on cognitive flexibility (F=5.44 (35,1)) and executive functioning (F=2.73 (1,35)) was significantly different at the 0.001 level (P>0.01).
Conclusion: It is concluded that cognitive behavioral therapy has an effect on the cognitive flexibility and executive functioning of epilepsy patients, and the patients affected by cognitive behavioral therapy improve their cognitive flexibility and executive functions.

Identifying Factors Related to Effective Psychotherapy from the Perspective of Therapists and Clients: A Qualitative Research

Seyedeh Maryam Pourmousavi

Background and Aim: Available evidence shows the effectiveness of psychotherapy. However, the number of patients who deteriorate or do not improve is still problematic. On the other hand, while some therapists are generally more successful than others, most therapists have experienced both success and failure of therapy in different cases. The purpose of this study was to determine the factors effective in psychotherapy from the perspective of therapists and clients.
Materials and Methods: Based on the purpose of this research, it can be considered as an applied research and qualitative in nature. Data were collected through interviews and analyzed using the content analysis method based on the analogical approach. The samples of therapists and clients were selected purposefully from the statistical population including 1. Therapists (psychiatrists, psychologists and counselors) licensed by the Psychology and Counseling Organization with 5 years or more of therapy experience, and 2. Clients who had participated in at least one psychotherapy course. The sample size was based on theoretical saturation and, therefore, the interview process continued until ensuring sufficiency of the collected data; thus the interviews ended with the 21st person in the therapists group and the 15th person in the clients group.
Results: The factors in effective treatment were found to be in three areas, namely, the therapist (attitude, competence, personality, maturity, ability and appearance), the client (demographic characteristics, reason and method of referral, insight), and environmental factors (economic, socio-political issues, location of the psychological center, supporting problems, and daily living events of clients and therapists).
Conclusion: The findings of this research show the components and importance of the model of effective factors in effective psychotherapy to policy makers, trustees, professors and therapists in the field of mental health. The achievement of these components can increase the efficiency of the therapists in achieving their goals and also help a clients to choose a therapist.