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Saeid Ebrahimi, Mohammad Khammarnia, Nasrin Porvazn, Mahnaz Karamipur, Hajar Jamshidzahi, Fatemeh Setoodezadeh, Mostafa Peyvand,
Volume 16, Issue 2 (9-2018)
Abstract

Background and Aim: The Internet is a strong and multimedia technology that meets the most basic needs of human beings; however, this new technology can have great negative effects on people's lives. This study aimed to determine the prevalence of Internet addiction and its relationship with quality of sleep and quality of life among students of Zahedan University of Medical Sciences.          
Materials and Methods: This descriptive-analytical cross-sectional study was conducted in Zahedan in 2017.The study population included all the students of Zahedan University of Medical Sciences. A sample of 340 students were selected through stratified random sampling. Data were collected using three World Health Organization questionnaires, namely, quality of sleep, Internet addiction and quality of life questionnaires, and analyzed using SPSS (v22), the statistical tests being ANOVA and linear regression test and T-test.
Results:  Data analysis showed that Internet addiction and the quality of life among the students were mild (43 ± 15) and desirable (78.4± 1.6), respectively. However, the sleep Quality Index for 282 students (82.9%) was not desirable. There were statistically significant associations (p<0.05) between the place of residence on the one hand and Internet addiction, quality of sleep and quality of life on the other.
Conclusion: Based on the findings it can be concluded that Internet addiction has a negative effect on the quality of sleep and quality of life of the students. The students need to pay more attention to the use of the Internet. It is also recommended that behavioral and cognitive intervention be designed and implemented aiming at teaching the students proper use of the computer and the Internet.
Mohammad Khamarnia, Arezo Ali Nezhad Ranjbar, Mahdiyeh Bakhshi,
Volume 17, Issue 2 (9-2019)
Abstract

Background and Aim: Accreditation is one of the important measures in the evaluation of health services. Today, the issue of accreditation has been established with the aim of creating and promoting a safety culture and quality of patient care. The purpose of this study was to determine the effect of accreditation on key and performance indicators of public hospitals in Zahedan before and after its implementation.
Materials and Methods: This descriptive-analytic cross-sectional study was conducted in 1396 in governmental hospitals of Zahedan University of Medical Sciences (Khatam-ol-Anbia and Ali ibn Abi Talib, AS). All of the key indicators of hospital performance were evaluated two years before the implementation of the accreditation (years 1391-1392) and two years after the implementation of the accreditation (1394-1395) in these hospitals. Data was collected using a form designed for study purposes. Descriptive statistics, tables and descriptive charts were used to draw information.
 Results: Based on the results of the study, the duration of stay of patients after the implementation of the accreditation scheme in hospitals has improved somewhat and decreased by 0.5 days to 4 days in 1395. The rate of cesarean delivery has risen from 49.2% in 1391 to 56.8 in 1395. The percentage of flat occupancy has risen to over 90 percent in 1395. The bed rotation distance was reduced by 31.1%, and releasing by personal desire in 1395 was 9% lower than in 1394. The personal satisfaction score of the emergency releasing by personal desire also dropped by 7%. It should be noted that there was no change in the net mortality index before and after the validation.
Conclusion: Accreditation has had a favorable impact on hospital performance indicators of course, the implementation of the healthcare reform plan may also have an impact on this. In general, the implementation of accreditation in the hospitals of the country can reduce the problems in this sector and provide more quality services to clients. Also, for better implementation of this program, emphasis on mortality and cesarean section rates can lead to improved hospital performance.
Mohammad Khammarnia, Mostafa Peyvand, Nasim Mohammadiyane Razangi,
Volume 20, Issue 3 (12-2022)
Abstract

Background and Aim: Diabetes is a disease in which blood sugar level is high due to hormonal disturbances. Monitoring and evaluation certainly helps to prevent, manage and control this widespread disease. The aim of this study was to study the epidemiology of diabetes in the Diabetes Clinic in Bu-Ali Hospital, Zahedan in South East Iran.
Materials and Methods: This was a cross-sectional descriptive-analytical study conducted in 2020 including all the 1164 patients referring to the Diabetes Clinic in Bu-Ali Hospital.  Data were collected using a standard check list and analyzed using the Stata-v14 software.
Results: Information on 1164 patients with diabetes was recorded and analyzed. Most (97.7%) of the patients had type-2 diabetes. The average fasting blood sugar in patients with type-1 and type-2 diabetesd was 236 and 201 mg/dL respectively, the corresponding A1C levels being abnormally high ─ 9.6% and 8.4%. Fasting blood sugar was associated with diabetic foot complications and nephropathy (p<0.05).
Conclusion: Based on the findings of this study the level of care of diabetic patients in terms of quantity and quality is not quite acceptable, not conforming to the respective national standards. This issue indicates the unfavorable performance of the Diabetes Center, which can be attributed to the poor conditions of the geographic region, insufficient equipment and specialized manpower and low health literacy of the people. Therefore, increasing the awareness of overweight and obese people, especially those with a family history of diabetes, about prevention can help to reduce the incidence of the disease or minimize its complications.
 
Mohammad Zia Hoseini, Fatemeh Setoodehzadeh, Mehdi Zanganeh Baygi,
Volume 20, Issue 4 (3-2023)
Abstract

Background and Aim: As a pandemic disease, Covid 19 has taken the lives of many people all over the world and has put a lot of pressure on the health care system and health care personnel. The experiences of managers and employees can help increase the efficiency of the health systems in future crises. This study was carried out in order to use the experiences of the personnel of the Crisis Section of Zahedan Medical University Public Health Deputy (ZMUPHD) in controlling the Covid-19 epidemic.
Materials and Methods: This was a qualitative research conducted in 2021-22 using the content analysis method including 30 employees of the Crisis Staff of the ZMUPHD selected by purposeful sampling. Data were collected based on semi-structured, in-depth interviews and analyzed in eight stages including typing the text of the interviews, determining semantic units, coding the text, revising the codes, classifying and developing the classes, revising the classes, identifying the themes and reporting the data.
Resulte: The experiences of the managers and employees of the ZMUPHD to deal withا the Corona pandemic were identified and extracted in 5 main areas including "Legislative", "Operational", "Manpower", "Supervisory" and "Financial", and 13 sub-areas.
Conclusion: Based on the results of the present study, one of the problems in the administration and management of the Covid crisis was the lack of sufficient supervision and political requirements in order to control and prevent the spread of the disease, as well as the lack of a single decision-making organization. Also, financial problems and problems related to human resources were found to be among the most important issues.  On the other hand, from the point of view of the interviewees, the use of the 4030 system was one of the turning points in crisis management.
 
Mostafa Peyvand, Hossein Ansari, , , Mohamad Ali Yadegari, Hossein Moein,
Volume 21, Issue 3 (12-2023)
Abstract

Background and Aim Cardiovascular complications in diabetes mellitus are one of the most common complications of this disease. The aim of this study was to determine the cumulative probability of occurrence of cardiac complications in type 2 diabetes mellitus using survival analysis in patients referring to the Diabetes Clinic, Bu-Ali Hospital, Zahedan, Iran.
Materials and Methods: This was a descriptive and analytical historical cohort study using the survival analysis method in 2020 on 410 patients referring to the Diabetes Clinic, Bu-Ali Hospital, Zahedan, Iran. Data were collected and analyzed using the SPSS-v21 software, the statistical tests being descriptive tests, followed by the Kaplan-Meier method and the Cox proportional hazards model of survival.
Results: The results of this study showed that 122 individuals (29.7%) of the diabetic patients had cardiac complications. The median survival time (in months) of the occurrence of cardiac complications was found to be related to fasting and two-hour postprandial blood sugar levels (p<0.05). Further analysis of the data showed that two variables, namely fasting blood sugar and regular visits, remained in the final model of the multiple Cox regression.
Conclusion: The findings of this study showed that the cardiac complications of diabetes in the population studies are relatively high. Therefore, it is essential to plan and implement interventions aiming to change lifestyle and control regularly blood pressure, cholesterol and blood sugar in the patients in order to prevent the disease
Fatemeh Setoodehzadeh, Hossein Ansari, , Fatemeh Nazari, Fatemeh Khabiri, Mohammad Hassan Amiri Moghaddam,
Volume 21, Issue 3 (12-2023)
Abstract

Background and Aim: The health system is trying to prevent unnecessary referrals to higher levels by providing tiered services and thus reduce the cost of health care. Therefore, this study was conducted in Zahedan City, Iran with the aim of finding the causes of referrals from level 1 to higher tiers in rural areas.
Materials and methods: This cross-sectional study was conducted on 458 rural patients referred to the second level in the rural areas of Zahedan City, Iran. Data were collected from the family health files available in the Sib system and analyzed using the SPSS-16 statistical software, the statistical tests being descriptive statistics (percentage, frequency) and Chi-square test.
Results: The highest (57.6%) and lowest (4.1%) proportions of referrals to the second level of service provision were found to have been in 2018 and 2016, respectively. From among the referred patients nearly 50% had been referred due to the need for a higher expertise, thus most referrals (67.2%) were to specialists. Further analysis of the data showed that only in 23.6% of the cases there was a feedback from the higher level to the first level.
Conclusion: The findings show that referrals from family physicians to higher levels in the health system requires higher medical expertise and patient insistence. In addition, feedback to the first level of service provision has not received proper attention. Establishing interactions between physicians and other health service levels, refresher training of physicians, emphasizing the importance of providing feedback and promoting the awareness of patients can reduce to a large extent inappropriate referrals.
 
Mohammad Amin Mirzaei, Majid Sartipi, Mehdi Mohammadi,
Volume 21, Issue 4 (3-2024)
Abstract

Background and Aim: Kidney transplantation is the treatment of choice in most patients with kidney disease. It is a surgical operation in which a person’s kidney with chronic failure is replaced with a healthy kidney. The present study was conducted with the aim of estimating the survival probability of a transplanted kidney in patients with chronic kidney failure in Zahedan city, Iran.
Materials and Methods: This was a descriptive-analytical retrospective cohort study using the survival analysis method carried out in 2020. The sample size was estimated to be 211 patients.
Data were analyzed with SPSS.VER22 software using descriptive tests, the Kaplan-Meier method and the Cox proportional hazards model of survival.
Results: The data obtained showed that in general 45 (21.3%) clients had been rejected. In the multiple logistic regression model of kidney transplantation several variables, including survival time, patient survival variables, marital status, donor status, blood pressure and diabetes remained in the model (P<0.05). Further analysis of the data revealed that in the kidney disease patients with transplant survival in Zahedan city, only donor status variables, high blood pressure and diabetes remained in the final multiple Cox regression model.
Conclusion: Based on the results, it can be said that the probability of survival of kidney disease patients is independent of the type of donor and the characteristics of the recipient, which indicates the evolution of kidney transplant management over the past few years; dialysis before kidney transplantation also has an effect on the probability of survival. These factors can help to increase the probability of kidney transplant survival.
 
Hosein Izadi Rad, Fereshteh Narouei, Parisa Mohammadi,
Volume 21, Issue 4 (3-2024)
Abstract

Background and Aim:  Women referring to health centers are one of the most important groups at risk of disease. Thus, in order to enjoy a high level of health, it is necessary for them to have health literacy. The purpose of this research was to find the demographic predictors of health literacy in women referring to comprehensive health service centers in Zahedan, Iran.
Materials and Methods: This was a descriptive-analytical study including 400 women selected by random cluster sampling from health centers under coverage of Zahedan University of Medical Sciences in 2022. The short form of the HELIA standard questionnaire was used to measure health literacy of the women. Data were analyzed using SPSS-22 software, the statistical tests being ANOVA, Kendall's correlation, and multiple regression.
Results: The subjects were between 18 and 60 years old. They were found to have obtained most of the information related to health and disease by asking doctors and healthcare workers (about 52.25%). The scores of the components of the subjects’ health literacy were as follows: average health literacy 69.91±23.34, reading 72.17±29.80, access 34.73±27.91, understanding 71.41±29.43, assessment 62.10±25.51, and the scope of decision-making and behavior 71.49±20.27. The strongest predictor of health literacy was found to be education, such that with an increase in the level of education, the health literacy of a woman would increase by 0.53 units. In addition, education variables, income level, age and ethnicity would predict 55% of the health literacy of the women.
Conclusion: This study shows that the health literacy score is related to age, education level, marital status, occupation, economic status and ethnicity, the strongest predictor of health literacy being the a high level of education. Therefore, considering the available evidence on the importance of health literacy and factors related to it and the low level of health literacy of women in this study, it is clear that women need to acquire, process and understand the basic information on health and therapeutic services in order to be able to make appropriate decisions. Briefly, women need to receive simple and understandable information and have more time to communicate with the health service personnel to understand health information.
 
Jalal Big Mohammadi, Mehdi Zanganeh,
Volume 21, Issue 4 (3-2024)
Abstract

Background and Aim: The Health Transformation Plan (HTP) has been developed to be implemented in the rural areas with the goal of easy access of the villagers to the physician, their equitable benefit of the public facilities and improving the outpatient services. The present study was conducted to find and explain the experiences of family physicians of the rural centers and managers after the execution of HTP of the public health sector in Zahedan University of Medical Sciences (ZAUMS), Zahedan, Iran.
Materials and Methods: This was a qualitative study using the content analysis method conducted in 1402 in the public health section in ZAUMS. The research population was the physicians and managers working in the rural areas of ZAUMS between 2015 and 2022; a sample was selected using the purposeful sampling method. Data were collected using the semi-structured interview based on the interview guide; content analysis was done using contract analytics.
Results: A group of 31 individuals including 20 men and 11 women and 19 physicians and 12 managers entered the study. Data were collected, analyzed and grouped in 6 main classes, namely, service delivery, integrated health system, resources, people and service recipients, monitoring and supervision, and suggestions; 12 sub-classes were extracted.
Conclusion: Based on the results of this study it can be concluded that appropriate training, service quality, financial support, and sustainable skilled manpower are the factors that will help solve the challenges in the Health Transformation Plan. On the other hand, considering that one of the components of the health system for successful implementation of the Health Transformation Plan is human resources, the ability and flexibility of the personnel play an important role in the speed of service delivery and service quality.
 
Fatemeh Limoparvar, Hossein Ansari, Majid Sartipi, Zahra Arab Borzu,
Volume 23, Issue 1 (6-2025)
Abstract

Background and Aim: Domestic violence is a major social harm against women, with serious negative effects on the health and well-being of both mothers and children. This study aimed to determine the prevalence of domestic violence among women attending comprehensive health service centers in Zahedan and to examine its relationship with the developmental status of their children.
Materials and Methods: This cross-sectional study was conducted in 2024 on 454 women who visited comprehensive health service centers in Zahedan with their children. Participants were selected through a multi-stage sampling method. Data were collected using the standardized Domestic Violence against Women questionnaire developed by Mohseni Tabrizi. Statistical analyses were performed using chi-square tests and logistic regression in Stata 14 software.
Results: The overall prevalence of exposure to domestic violence among women was 43%. Domestic violence showed a significant association with poor child development (CI: 1.39–3.00, OR: 2.06). Logistic regression analysis indicated that maternal exposure to domestic violence, along with factors such as parental history of childhood violence, paternal addiction, and maternal age, were significantly related to behavioral disorders in children (p ≤ 0.05).
Conclusion: The findings highlight the crucial impact of domestic violence on women’s well-being and the developmental outcomes of their children. These results can assist policymakers and social planners in designing effective strategies to reduce domestic violence and promote healthy child development.

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