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Ali Mohammad Mosadeghrad, Ebrahim Jaafaripooyan, Mahmood Zamandi,
Volume 14, Issue 4 (3-2017)
Abstract
Background and Aim: Economic evaluation of health interventions is critical for efficient allocation of resources. The aim of this study was to critically review empirical studies on the cost-benefit of health interventions published over the last 40 years.
Materials and Methods: This study was carried out by searching seven databases (PubMed, Cochrane Database of Systematic Reviews, Web of science, Science Direct, Scopus, Springer Link, and SID) using appropriate keywords to find articles on the cost-benefit of health interventions published during 1975-2015. All the relatedretrieved articles were analyzed after quality assessment using a valid check list.
Results: A total of 33studies on the cost-benefit of health interventions during the last 40 years were included in the review; 39%, 37%, 21% and 3%of the studies had been conducted in Asia, America, Europe and Africa, respectively. The subjects dealt with in most ofthe studies (79%) were related to immunization, education, healthy nutrition and use of health technologies. Further analysis of the data showed mental health education, healthy nutrition, use of safety equipment while driving, vaccination, diagnostic and screening tests, and oral and dental healthto have considerable clinical and economic benefits.
Conclusion: The number of studies on the cost-benefit analysis of health interventions is increasing. Preventive and promotive interventions can help planners and policy-makers to better utilize the limited resources in the health sector aiming at promoting health of the people.
Elham Rashidian, Gholamreza Garmaroudi, Arash Rashidian, Mehdi Yaseri,
Volume 15, Issue 1 (6-2017)
Abstract
: Materials and MethodsThis study was a randomized controlled trial including 396 patients, conducted in 10 randomly health centers allocated as intervention or control groups. The data were collected using questionnaires. The educational intervention included holding educational classes, distribution of pamphlets, hanging posters/flyers, ResultsAnalysis of the data showed statistically significant differences between mean scores of the health belief model components (knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers) and practice in both the intervention and control groups before and after the educational intervention (p < 0.01).
: <span lang="EN" times="" new="" roman";="" "times="" "b="" lotus";="" en;="" major-bidi;="" major-bidi;"="">Considering the self-reported increased awareness and decreased practice in the intervention group, it seems that the health belief model is an appropriate model for reducing arbitrary use of antibiotics.
Seyed Mohammad Mojtahedzadeh, Kourosh Holakouie-Naieni, Shahrzad Nematollahi, Amir Hossein Mazarei,
Volume 15, Issue 1 (6-2017)
Abstract
Background and Aim: Considering the protection of, and safeguarding, the health of industrial workforce, this study was conducted to determine the prevalence of overweight and obesity in the personnel of Abadan oil refinery in the south-west of Iran and factors related to it.
Materials and Methods: The study included 721 oil refinery staff members randomly selected based on the yearly occupational health examination records. The information recorded included anthropometric measurements and blood test results; in addition, Breslow lifestyle and Global Physical Activity (GPAQ) questionnaires were completed for each subject.
Results: The mean body mass index (BMI) was 28.2 for men and 27.5 for women. The prevalence of obesity and overweight were 29.8% and 48.7%, respectively. Further analysis of the data showed that the prevalence rates were different between men and women; while 48.6% and 30.24% of the men suffered from overweight and obesity, respectively, the corresponding proportions among women were 50% and 15%. Overweight and obesity were associated with age, fasting blood glucose level, lipid profile and hypertension (in all cases p < 0.001).
Conclusion: The prevalence of overweight and obesity among Abadan oil refinery staff is higher as compared to the mean values in the general population in Iran or to personnel of other industries globally. Development and implementation of public educational programs with particular emphasis on high-risk individuals, such as middle-aged people and those with a low socioeconomic status, and focusing on healthy lifestyle and rotation shift workers can be effective, resulting in improvements in physical and general health of the personnel.
Masoumeh Dashtian, Hasan Eftekhar Ardebili, Kambiz Karimzadeh Shirazi, Mostafa Shahmoradi, Kamal Azam,
Volume 15, Issue 2 (9-2017)
Abstract
Background and Aim: Self-care has a vital role in the control and prevention of complications in patients with Type-2 diabetes mellitus (T2DM), two important behaviors in self-care being medication adherence and physical activity. Regular physical activity has been shown to improve glycemic control, reduce blood pressure, reduce lipids and improve cardiorespiratory fitness in individuals with T2DM. In addition, medication adherence is a key factor in controlling and decreasing the risk of related complications. This study aimed to determine and predict the most important factors affecting the levels of physical activity and medication adherence in patients with T2DM based on the theory of planned behavior.
Materials and Methods: This cross-sectional study, based on the planned behavior theory, was performed on 160 selected men and women with T2DM referring to urban health centers in Yasuj, Iran in 2016; the selection was done by random cluster sampling. Data on medication adherence and physical activity were collected using questionnaires and analyzed using SPSS version 20 software, the statistical tests being descriptive statistics, Pearson correlation coefficient and multiple linear regression; a p<0/05 was considered to indicate statistical significance.
Results: Altogether, 45% and 43% of the patients had a low and medium level of physical activity, respectively, only 12% having an acceptable level. The adherence to medication was much better ─ 76% had a good adherence. As regards the planned behavior theory constructs, perceived behavior control had a significant relationship with physical activity and medication adherence. Results of multiple linear regression also showed that perceived behavior control was a predictive variable for physical activity level and medication adherence in the patients.
Conclusion: Based on the findings, which indicate that the most important construct is perceived behavior control as regards medication adherence and level of physical activity, it is concluded that it is vital to strengthen the self-care component of health programs and support such programs.
Saeid Ebrahimi, Abolghasem Pourreza, Fereshteh Farzianpour, Abbas Rahimi Foroushani,
Volume 15, Issue 2 (9-2017)
Abstract
Background and Aim: Human resources in any organization are its main capital. They are the only unique asset that are not liable to depreciation over time, but they even create more added value. The Social Security Organization (SCO) as a social insurer organization needs urgent assessment of its human resource management. In this regard, it appears that such an essential assessment can be done using the European Foundation for Quality Management (EFQM) model.
Materials and Methods: This project was an applied descriptive study conducted at the Social Security General Department in Tehran, Iran. The data collection tool was a standard questionnaire for performance assessment based on the EFQM model, the reliability of which (0.989) was determined by using the Cronbach's alpha coefficient. A total of 388 questionnaires were distributed, of which 311 were completed and returned to the researcher; the response rate was 81%. Analysis of the data was done using the SPSS-16 software.
Results: The human resource managers in the SCO achieved a score of 495.72. The empowerment and results dimensions rated 261.34 and 198.38, respectively. In the empowerment dimension, policy and strategy criteria had the highest score (56.12) and process the lowest (51.28), while in the results dimension, community criteria had the highest (50.27) and the customers criteria the lowest (51.18) score.
Conclusion: Based on the findings it can be concluded that the European Foundation for Quality Management (EFQM) model is suitable for assessing both the performance, strengths and weaknesses of the Tehran Security General Department human resources and improving its performance. Certainly better implementation of programs and achieving excellence will be possible through sustainable collaboration.
Zahra Karimian, Fatemeh Atoof, Razieh Maasoumi, Mohammad Ali Besharat, Effat Sadat Merghati Khoei,
Volume 15, Issue 2 (9-2017)
Abstract
Background and Aim: Considering that the knowledge of, and attitude towards, sexuality is a key factor influencing sexual behavior, the main objective of this survey was to determine the bases of sexual knowledge and formation of attitude towards sexual script in women of reproductive age in Kashan City, Iran.
Materials and Methods: This was a cross-sectional study including 500 women of reproductive age referring to all health centers in Kashan Iran, selected by simple random sampling,. The data collection tool was the Sexual Knowledge and Attitude Scale (SKAS). The data were analyzed using descriptive statistics, correlation and regression model.
Results: The age range of the majority of the participants (51.9%) was 26-35 years, and the educational level of 39.9 % of them was high school education. The majority of them had a high level of sexual knowledge and attitude (51.4% and 62.9% respectively). The Pearson correlation test showed a significant positive correlation between knowledge and attitude of the women (p<0.05), and based on the multivariate regression analysis their knowledge score correlated with education and economic status and their sexual attitude scores with age and education.
Conclusion: The participating women were young and educated and their knowledge and attitude scores were high. However, they had erroneous attitudes and ideas, such as a feeling of shame and anxiety at intercourse, considering initiation in sexual relation responsibility of the man, and considering childbearing as the main purpose in sexual relations. It is essential to design and implement appropriate educational programs to help the women change their attitudes and ideas.
Zahra Farahmand, Davoud Shojaeizadeh, Azar Tol, Kamal Azam,
Volume 15, Issue 2 (9-2017)
Abstract
Background and Aim: Diabetes mellitus (DM) is one of the most common public health problems worldwide. Diabetic foot as a late complication of DM imposes high physical and emotional costs to the patients. The purpose of this study was to determine the effect of an educational program based on the Health Belief Model (HBM) on diabetic foot care in type-2 DM patients.
Materials and Methods: Ninety seven (female=57, male=40) type-2 diabetes patients, randomly divided into two groups ̶ and intervention (n = 47) and a control group (n = 50) ̶ participated in this study. Using questionnaires data were collected, initially and 3 months after the educational intervention, on demographic characteristics, awareness and the HBM constructs. The intervention group participated in 3 educational sessions during the3-month period. The data were analyzed by SPSS 20, the statistical test being Shapiro-Wilk, Chi-Square, Wilcoxon, McNemar tests and paired T-Test.
Results: There were no statistically significant differences before the intervention between the experimental and control groups with respect to the mean scores of knowledge and HBM’s components (perceived susceptibility, severity, benefits and barriers, as well as self-efficacy and self-care). The intervention improved the scores significantly in the experimental groups (p<0.05), while there were no significant changes in the control group scores (p>0.05).
Conclusion: This study shows that type-2 diabetic patients need to learn how to take care of their feet and that implementing educational programs based on the Health Belief Model can be effective in this regard.
Ebrahim Jaafaripooyan, Abolghasem Pourreza, Fatemeh Kheirollahi,
Volume 15, Issue 3 (12-2017)
Abstract
Background and Aim: Following the deployment of the Health Transformation Plan (HTP) in most of the public hospitals, various changes occurred in the relationships between insurance organizations and hospitals. The purpose of this study was to find the obstacles and challenges facing the two types of organizations and suggest solutions.
Materials and Methods: This was an exploratory study. The research population was a total of 74 participants from Tehran public, private and military hospitals (managers, senior nursing officers, financial officers, and chiefs of accounting) and basic and complementary insuring organizations (insurance agents in hospitals, insurance officers from insuring organizations, and insurance managers). Data were gathered through semi-structured interviews and analyzed using thematic analysis.
Results: The most important challenges were as follows: acting on one’s own preferences, deductions, delays in the payments of hospital expenditures, an insufficient number of insurance agents in some hospitals, insufficient accountability of hospital personnel in expenditure management, lack of sufficient interaction between the two organizations, and lack of contracts between complementary insurance companies and public hospitals and between private hospitals and basic insurance organizations.
Conclusion: Given the importance and sensitivity of the relations between the health service providers and receivers and considering further the complexity and challenges that appeared after HTP and hospital accreditations, a knowledge of the challenges identified in this research can help policy-makers and managers to find suitable, effective strategies for enhancing relations and communication between insurance companies and hospitals.
Esmaeil Kazemi, Gholam Reza Garmaroudi, Elham Shakibazadeh, Saeid Yekaninejad,
Volume 15, Issue 4 (3-2018)
Abstract
Background and Aim: Mental health plays a vital role in psycho-social development of an individual in various periods of life, particularly during adolescence. Addressing the mental health problems of adolescents is considered as a global health promotion and disease prevention priority. The aim of this study was to assess the mental health status of adolescent boys and determine the role of contextual factors and life skills in predicting mental health of the students in 2016 and present n appropriate model.
Materials and Methods: This was a cross-sectional study conducted on 550 secondary male school tudents, selected by cluster random sampling, in Ray County, Iran. Data were collected using a standard valid General Health Questionnaires (GHQ-28) and a life skills questionnaire and analyzed using the SPSS software 22.0, the statistical tests being Chi-square and logistic regression.
Results: Analysis of the data showed that 46.9% of the students were suspected of having mental health problems, the rest (53.1%) having no disorder. The most common disorder (56%) was in the social functioning. As regards life skills, the proportions of the students with a low, moderate and high life skills were 35.3%, 32.5% and 32.2%, respectively. Statistically significant correlations were found between mental health and its four dimensions on the one hand and the independent variables, namely, self-awareness, decision-making and age on the other.
Conclusion: The findings indicate a fairly moderate prevalence of mental disorders among the students and demonstrate the role of life skills training in promotimg mental health in adolescents and the youth.
Elahe Zarean, Mehdi Yaseri, Mahmood Mahmoodi, Rasoul Entezar Mahdi,
Volume 15, Issue 4 (3-2018)
Abstract
Background and Aim: Gastric cancer is one the most common gastrointestinal tract cancers in Iran, with East-Azerbaijan Province ranking second in the country. The objectives of this research were to determine the feasibility of using cure models in survival analysis and factors affecting short-term and long-term patient survival rates using the mixture cure cox model.
Materials and Methods: We used the available information on 184 patients diagnosed with gastric cancer in East-Azerbaijan Province cities referring to medical centers during the period 2009-2010 and followed up for 5 years.
Results: The median of survival time was 8.33 months (95% CI = 5.9-10.6). Fitting the univariate and final cox cure models showed that in the short-term survival the effect of the chemotherapy factor was statistically significant (Hazard ratio =0.49, 95% CI = 0.34, 0.69, p-value <0.001).
Conclusion: If the population under study consists of two groups of susceptible and non-susceptible individuals for the intended incident, the mixture cure models can be used for the discrete analysis of long-term and short-term survival of patients diagnosed with gastric cancer and identification of variables affecting the two survival rates.
Beyram Bayat, Bahram Mohebbi, Azar Tol, Roya Sadeghi, Mir Saeid Yekaninejad,
Volume 15, Issue 4 (3-2018)
Abstract
Background and Aim: Quality of life is considered as an effective indicator for general, as well as mental, health. With increasing longevity of individuals, health-promoting behaviors and rising quality of life will become much more important. This study aimed to determine the quality of life predictors among health volunteers in South Tehran Health Centers.
Materials and Methods: : This cross-sectional study was conducted on 200 health volunteers of South Tehran Health Centers selected by cluster sampling. Data were collected using valid and reliable questionnaires for demographic variables, Health-promoting Behaviors (HPLPII) and Quality of life (SF-36), as well as the BAZNEF model constructs, whose validity and reliability were assessed (α: %88). Data analysis was done using the SPSS24 software, the statistical tests being descriptive statistics and multi-linear regression; a p-value <0.05 was used to show statistical significance.
Results: Regression analysis revealed that the strongest predictors for the quality of life were age (p=0.003), enabling factors (p=0.02) and general health-promoting behaviors (p<0.001).
Conclusion: The findings of this study confirm the suitability of the BAZNEF model for predicting health-promoting behaviors for the quality of life. Using this model can help in identifying factors influencing the quality of life of health volunteers and designing an appropriate educational program for them.
Ali Mohammad Mosadeghrad, Ensiyeh Ashrafi,
Volume 15, Issue 4 (3-2018)
Abstract
Background and Aim: Quality management, as an organizational strategy, helps enhance hospital effectiveness and efficiency. This study aimed to examine the effect of a quality management model on the efficiency
of the respiratory intensive care unit in Labafijejad Hospital, Tehran in 2013-14.
Materials and Methods: This was a participatory action research conducted in
the respiratory intensive care unit in Labafijejad Hospital, Tehran in 2013-14. A quality improvement team was formed to implement the quality management system and promote working processes. The team identified and standardized working processes, determined the quality goals for the processes, and improved the processes based on the 10-stage Mosaddeghirad Quality Management model. Performance indicators of the unit (bed occupancy, bed turnover, and bed interval rates; patient average length of stay in the ward) were calculated and compared before and after the intervention.
Results: Implementing quality management brought about an increase of 2.8% and 19.2% in bed occupancy rate and bed turnover rate, respectively, as well as a decrease of 14.1% in patient average length of stay and a decrease of 35.6% in bed interval rate in the respiratory intensive care unit of the hospital.
Conclusion: Implementing quality management can increase the efficiency of the respiratory intensive care unit of a hospital. A suitable quality management system and the commitment of the hospital manager and staff can result in enhancement of efficenicy in a hospital.
Payam Safaei, Afsaneh Mohajer, Gholam Reza Jahed Khaniki,
Volume 15, Issue 4 (3-2018)
Abstract
Background and Aim: Attitude, as the most important social psychology concept, has a special place in research; undoubtedly, in university life having a positive attitude is essential for success in any field of study. The aim of this study was to determine tha attitude of food safety and hygiene students toward their field of study and future career in the Iranian universities of medical sciences.
Materials and Methods: This was a descriptive cross-sectional study, conducted in 2016, including 77 food safety and hygiene students in the Iranian universities of medical sciences, selected by census. Data were collected using a questionnaire containing 24 questions and analyzed by SPSS-24 software, the statistical tests being descriptive statistical tests.
Results: The attitude score (Mean ± SD) of the students toward their field of study was
35.0 ± 12.4, indicating that they had a positive attitude, while the score of their attitude toward future career was 23.05 ± 10.86, which was less than acceptable. Further analysis of the data showed a significant association between the students’ attitude toward their field of study and employment status (p = 0.036).
Conclusion: Based on the results of this study, the food safety and hygiene students have a positive attitude towards their field of study, while their attitude toward future career is lower than acceptable, which demonstrates lack of a desirable attitude. Strengthening of training programs and advice and support for the students can play an effective role in reinforcing their attitude.
Ali Mohammad Mosadeghrad, Seyed Shahabeddin Shahebrahimi, Mehdi Ghazanfari,
Volume 16, Issue 1 (6-2018)
Abstract
Background and Aim: Hospital accreditation is a systematic external evaluation of a hospital’s structures, processes and results (outputs/ outcome) by an independent professional accreditation body using pre-established optimum standards. This study aimed to examine the relationship between accreditation and hospital performance. In addition, the most important accreditation constructs affecting hospital performance were identified and ranked.
Materials and Methods: This descriptive, correlational and cross-sectional study was conducted using the data related to accreditation scores and nine performance indicators of 121 hospitals in 2014 and 123 hospitals in 2015 in Tehran province, Iran. Shannon entropy method was used for calculating the weights of the hospital indicators. Then, Feature Selection method in data mining was used to explore the relationship between accreditation scores and hospital indicators. Data were analyzed using IBM SPSS Modeler software. Analyses were carried out at the 0.05 significance level
Results: The mean of hospitals’ accreditation scores were 61.98% and 69.56% in 2014 and 2015 respectively. All performance indicators except the number of outpatients were increased in 2015 compared to 2014. There was no significant difference in the scores between 2014 and 2015 data. Hospitals’ accreditation scores were not associated with their performances. However, accreditation scores of leadership and management; accident and emergency; and procurement departments had the most effect on hospitals’ performance.
Conclusion: Accreditation was not correlated with hospital performance. Thus, improving accreditation system including standards, methods and surveyors and using quality management strategies in hospitals are necessary for improving hospital’ performance.
Marzieh Mohammadpour, Mehdi Yaseri, Mahmoud Mahmoudi, Rasoul Entezar Mahdi,
Volume 16, Issue 1 (6-2018)
Abstract
Background and Aim: Breast cancer is one of the most prevalent cancers in women and is the second cause of mortality due to cancer in women, with lung cancer being the first.
Materials and Methods: In this study we followed all the cases for 5 years, patients from West-Azerbaijan and East-Azerbaijan Provinces that diagnosed with breast cancer in 2009 and 2010 that attended to health cares. Using multivariate cure cox model for the influence of variables in this study.
Results: In this study 171 cases which suffering from breast cancer had the mean age of 55.9 ± 12.9 and the range of 23 to 89 years, in time of cancer diagnosis. Mean of patients follow-up was 51.7± 23.4 months with range of 11 days to 78 months. Overalls 52 death occurred and patient survival rate of 5 years was estimated 60. 6 percent. Eventually the two variables which are economic status and emergency hospitalization were found the two factors of pre-warning in long term survival of patient suffering from breast cancer.
Conclusion: Due to the findings, it seems using cure model in patients suffering from breast cancer was better than classical survival models.
Masoumeh Amiri Siavashani, Davoud Shojaeizadeh, Kamal Azam,
Volume 16, Issue 1 (6-2018)
Abstract
Background and Aim: Observance of the principles of infection control in dentistry is the basis of preventing the transmission of dangerous diseases such as AIDS, hepatitis and preventing the spread of diseases in the community. In view of the importance of dentistry education in the field of observance of the principles of infection control, the aim of this study was to determine the effect of educational intervention on infection control among dental students of Shahid Beheshti University of Medical Sciences.
Materials and Methods: The present study is a pre and post interventional study that the number of samples is 75 dental students referred to Endodontics Department of Shahid Beheshti University of Medical Sciences for endodontic treatment and radiotherapy of teeth during treatment in the academic year of 95-96 that were selected by available sampling method and after determining the sample size, a researcher-made questionnaire was prepared based on the Health Belief Model and verified in terms of validity and reliability, and completed in two stages before and after training with a 3 month interval. Three training sessions were conducted in this study for 15-30 minutes during the course of one month as group training and question and answer. During these meetings, students were given useful materials about infection control in dentistry, pathogenic microorganisms, transmission methods, and infection control guidelines in dentistry radiology. The data gathering tool was a questionnaire based on Health Belief Model. after data collection, spss21 software was used to analyze them. Non-parametric Kolmogorov-Smirnov tests, paired t-test and non-parametric Wilcoxon test were used for statistical analysis of the 0/05 significance level before and after the knowledge and structures of the health belief model.
Results: The results of statistical analysis showed that 62.7% of the participants were female students and 89.3% of single students, and the participants in the study were from 8,9,11 terms. The results of this study showed that the mean and standard deviation of knowledge and performance scores of students toward infection control before training were 11.48 ± 2.23 and 5.48 ± 0. 93, respectively, and after the training were increased to 14.75±0.57 and 9.36 ± 0.91. This difference was statistically significant by doing paired t-test (p the comparison of the mean and standard deviation of the scores of other aspects of the health belief model regarding infection control among dentistry students also showed a significant increase.
Conclusion: According to the results, it can be concluded that education based on the health belief model has been effective in controlling infection in dentistry students.
Somayeh Barmar, Masoumeh Alimohammadian, Seyed Alireza Sadjadi, Hasan Poustchi, Seyed Mostafa Hosseini, Mehdi Yasseri,
Volume 16, Issue 1 (6-2018)
Abstract
Background and Aims: Generalized Structural Equation Modeling (GSEM) is a family of statistical techniques utilized in the analysis of multivariate, categorical and ordinal data in order to measure latent variables and their connection with each other. The aim of this study is to consider the structure of data, and introducing GSEM to medical science researchers and presenting a practical example of in medical science researches.
Materials and Methods: An introduction to Structural Equation Modeling (SEM), along with its advantages and disadvantages was presented, and also GSEM and its all kind of forms was specified. An example to study hypertension risk factors in patients suffering from diabetes was carried out, which was a demonstration of using GSEM method for binary response variables. The data includes a random sample of 2716 people from Golestan province cohort studies.
Results: Age, body mass index, abdominal obesity, residence place, socioeconomic status, salt intake had direct effect on hypertension. Race, education, vitamin D and physical activity had direct and reverse effect on hypertension (p.value<0.05).
Discussion: Unlike SEM, the limitative hypothesis that our data should have a normal distribution do not needed in this model, also GSEM is powerful tool in the analysis of categorized data. Nevertheless this method cannot perform goodness of fit test, and adjustment and modification method of the model directly, and that they are some limitation in using this method.
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.
Alireza Heidari, Mohammad Arab, Kourosh Etemad, Behzad Damari, Mansoureh Lotfi,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: The purpose of phenylketonuria (PKU) screening is to assess the risk of, and prevent, the disease in the newborns likely inflicted with it. The aim of this study was to investigate why and how PKU screening was decided to be included in the national health agenda, initiated and implemented in Iran.
Materials and Methods: This qualitative study was conducted based on the Kingdon’s framework model in 2015. The participants were thirty-eight policy-makers, managers and researchers selected by purposeful sampling.Data were collected using semi-structured interviews and analyzed using framework analysis.
Results: The physical and mental disabilities, medical and maintenance costs and the need for rehabilitation services were examples of the problem stream. In addition, sampling based on the National Congenital Hypothyroidism Program and implementation feasibility at the national level were examples of the policy stream. Finally, pressure by the patients' families, the Scientific Children Association and executive managers were examples of the political will stream. When the three streams occurred simultaneously, health policy-makers agreed to implement the program and then was opened the window of opportunity.
Conclusion: Successful implementation of the National Phenylketonuria Screening Program in Iran has been the result of interactions among three streams, namely, nature of the problem, political will and optimal use of policy-makers of the window of opportunity opened.
Azar Tol, Bahram Mohebbi, Elham Shakibazadeh, Mehdi Yaseri, Maryam Sabouri,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: In health promotion, empowerment is a process through which people gain greater control over decisions and actions affecting their health. This study aimed to assess the predictive factors of health care empowerment among women in reproductive age in 2016.
Materials and Methods: This cross-sectional study was conducted on 549women in reproductive age referring to health centers in South Tehran. The participants were recruited through cluster and multi-stratified sampling. Data were collected using the Health Care Empowerment Questionnaire (HCEQ), which has three subscales, namely, degree of control, involvement in interactions and involvement in decision-making. The data were analyzed using the descriptive and analytical tests and multi-regression analysis.
Results: Husbands' education level, women's employment, family size, ethnicity, history of chronic diseases and economic status were predictors of degree of control. Husbands' education level (under high school diploma and high school diploma), family size (2-3, 3-4) and moderate economic status (sufficient income) predicted involvement in interactions. In addition, husbands' education (incomplete high school diploma and high school diploma), family size (2-3, 3-4), women's employment and history of chronic diseases predicted involvement in decision-making.
Conclusion: The findings indicate that various individual, family and socio-economic conditions of reproductive-age women influence their potential empowerment for receiving health care services. A family-based approach to facilitate receiving reproductive health care seems to be essential.
