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Ali Nik Farjam, Hassan Ajam, Robabeh Ansari Torghii, Hajar Alimohammadi, Yousef Alimohammadi , Elahe Hesari,
Volume 19, Issue 3 (3-2022)
Abstract

Background and Aim: The process of identifying Covid 19 cases over time (the trend) can provide valuable information about the coverage of diagnostic and screening programs over time. This study aimed to investigate the outpatient trend of Covid-19 in selected comprehensive health service centers of Tehran University of Meical Sciences, Tehran, Iran.
Materials and Methods: This was a descriptive cross-sectional study. The data collected inculded the number of referalls and Polymerase Chain Reaction (PCR)-positive individuals between April 13 and December 25, 2020. Central and dispersion indices (mean, median, standard deviation and interquartile range) were used to describe quantitative variables. In addition, linear and bar charts were used to describe the trend of the variables over time. All analyses were performed using the Excel 2016 and SPSS 22 software.
Results: The highest numbers of suspected cases of Covid-19 were found to be in April, June and October. There were 2 peaks in the trend of positive cases of Covid 19, and the highest proportions of daily positive cases of Covid 19 was seen in late June and early July, as well as in late September, October, and December. The highest numbers of individuals referred and tested were observed in the South of Tehran Health Center.
Conclusion: Considering the occurrence  of two epidemic peaks during the study period, the occurrence  of further epidemic peaks is almost certain to occur if there is no proper planning for public health services and primary health care by the responsible health authorities and policy-makers.
 
Ali Akbari-Sari, Batoul Ahmadi, Mohammad Moradi-Joo, Alireza Arabi, Maryam Seyed-Nezhad,
Volume 19, Issue 4 (3-2022)
Abstract

Background and Aim: Referral system is one of the principles and foundations of primary health care services. One of the most important challenges and problems of the referral system is the lack of knowledge of people and patients of its nature, services and benefits. The purpose of this study was to identify the factors affecting the acceptance of the referral system by patients.
Materials and Methods: This was a qualitative study conducted in 2021 using the framework (structural) analysis method. The participants were 18 experts in the field of referral system and 14 patients referred to the outpatient and inpatient wards of Imam Khomeini Hospital Complex in Tehran selected by purposive sampling. Data were collected by Semi-structured interviews and analyzed using the MAXQDA.
Results: Based on the findings in this study, Factors influencing the acceptance of the referral system by patients were found to be the following: (1). Factors related to the stewardship and governance of the health system (responsibility and accountability, appropriate levels of health services, patient-centered care, and rules and regulations); (2). Factors related to the health services access (financial, physical and cultural); (3). Factors related to service providers (trusting healthcare staff, professional skills of service providers, and their behavioral and communication skills); (4). Factors related to the service delivery process (quality of service delivery, attention to patients' wants and needs, use of technology in service delivery, monitoring service delivery, and service coverage); (5). factors related to the recipients of the services (satisfaction, education, awareness and communication).
Conclusion: Considering the importance and key role of patients in the success of the referral system, health planners and policy makers should pay special attention to the factors identified in this study.
Ali Mohammad Mosadeghrad, Hosein Dargahi, Mahdi Abbasi, Mina Mirzaeianrad,
Volume 19, Issue 4 (3-2022)
Abstract

Background and Aim: Occupational injuries are an important human resource management challenge with negative effects on employees and organizations. A knowledge of the prevalence of occupational injuries is the first step in eliminating or reducing them. The aim of this study was to determine the prevalence of occupational injuries among financial employees of hospitals affiliated to Tehran University of Medical Sciences.
Materials and Methods: This was a cross-sectional questionnaire survey conducted in 2019 in 13 hospitals of Tehran University of Medical Sciences using a valid questionnaire to gather data. A total of 162 questionnaires were randomly distributed among the financial staff of the hospitals, but only 147 subjects completed the questionnaires. Data were analyzed using the SPSS statistical software.
Result: Analysis of the data showed that 52.6% and 50.2% of the financial staff of the hospitals were suffering from physical and mental occupational injuries, respectively. Most of the occupational physical injuries were related to headache, neck pain, back pain and visual impairment, and most of the occupational psychiatric injuries were stress and anxiety. Female and single employees experienced significantly more occupational injuries. Working in a sitting position for a long time, lack of proper equipment operation, lack of safety and health facilities, insufficient training and carelessness of staff were the causes of musculoskeletal injuries.
Conclusion: About half of the hospital financial staff were found to suffer from occupational injuries. Occupational injuries had had direct and indirect costs for the employees and the hospitals. Hospital managers should plan and implement measures to eliminate or reduce occupational injuries at an individual, group, and organizational level.
 
Arezu Amirali, Ameneh Elikaei, Roxana Mansour Ghanaie, Idesbald Boone, Abdollah Karimi, Tim Eckmanns, Andreas Lutz Jansen, Fatemeh Fallah, Noushin Marhamati, Niloofar Pashaei, Shahriar Janbazi, Ahmad Reza Shamshiri, Hamid Reza Baradaran, Mohammad Hossein Rostami, Masoud Alebouyeh,
Volume 19, Issue 4 (3-2022)
Abstract

Background and Aim: The objective of this study was to determine the seroepidemiological history of SARS-CoV-2 infection among asymptomatic children in Tehran.
Materials and Methods: Blood samples of children younger than 14 years old were collected during the period autumn-winter 2020 and spring 2021 and tested for SARS-CoV-2 IgG antibody using the EUROIMMUN ELISA kit. In addition, questionnaires were used to collect demographic and infection status information in the participants. Data were analyzed using the SPSS software.
Results: Out of the 1142 children collected from the children with no COVID-19 symptoms, 33.3% (381/1142) were found to have had a history of SARS-CoV-2. The positive samples in girls and boys were 34.1% and 33.03%, respectively. Analysis of the data showed no statistically significant differences between the infection rate on the one hand and age, family size, underlying diseases, gender or occupations of the family members on the other hand. In addition, the infection rate was significantly lower in autumn 2020 than in winter 2020 and spring 2021.
Conclusion: SARS-CoV-2 infection can occur in children with no clinical symptoms. In addition, the infection rate is in direct correlation with an increase in age of the children.
 
Maryam Nouravaran Feizabadi, Kourosh Kourosh Holakouie-Naieni , Abbas Rahimi Foroushani, Ali Taghipour,
Volume 19, Issue 4 (3-2022)
Abstract

Background and Aim: Cardiovascular diseases (CVD) are the leading cause of death globally, causing annually 17.3 million deaths, more than 75% of these deaths occurring in the low- and middle-income countries. Although extensive studies have been conducted to determine the risk factors for these diseases, limited studies have been performed to investigate these factors using a multilevel analysis method. The aim of this study was to determine the CVD risk factors in the staff of Mashhad University of Medical Sciences using a multilevel analysis approach, as well as compare the application of the conventional and multilevel logistic regressions in doing this according to the hierarchical structure of the data.
Materials and Methods: This was a case-control study including a total of 1091 randomly selected individuals from among the people in a prospective cohort study, namely, the “PERSIAN Cohort Study in Mashhad University of Medical Sciences” in 2018.  The case group included 152 patients with a definite diagnosis of CVD and the control group 939 staff members not suffering at the time from CVD. Data analysis was done using the STATA software. Data analysis (based on frequencies and percentages) was done using one-way and two-level logistic regression analysis at α = 0.05.
Results: Multivariate analysis showed that hypertension, smoking, fasting blood sugar and cholesterol were among the cardiovascular risk factors with a significant relationship with the disease. Based on the two-tier logistic regression model, the odds ratio for CVD in the hypertensive patients was 3.93 times that in individuals with a normal blood pressure with a confidence interval of 2.64-6.28. The risk in smokers was 1.85 (1.11-3.09) times that in nonsmokers. The CVD odds ratio in individuals with a high fasting blood glucose level (undiagnosed/uncontrolled diabetes) was 2.7 (1.18-6.18) times that in those with a normal blood pressure. There were no statistically differences between the case and control groups as regards the other variables ─ body mass index, diabetes (controlled or uncontrolled), or blood triglyceride level.
Conclusion: The findings show that statistical model selection can influence the results of data analysis in a dataset. It should be noted that the results of this study indicate a high prevalence of some cardiovascular risk factors among the staff. Another crucial point in this study is that the level of physical activity of the staff was found to be low, which would result in increased risk of overweight and obesity.
 
Banafsheh Taqfaghodi, Bahram Mohebbi, Roya Sadeghi, Azar Tol, Mir Saeed Yakanejad,
Volume 19, Issue 4 (3-2022)
Abstract

Background and Aim: Cardiovascular diseases are the most common cause of death in most countries of the world, hypertension being the most important cause of disability. The aim of this study conducted in 2020-2021 was to determine the effect of educational intervention on the nutritional knowledge, illness perception and dietary adherence in hypertensive middle aged women based on the transtheoretical model (TTM).
Materials and Methods: This was a quasi-experimental study on middle-aged women (30-59 years old) suffering from hypertension referred to the  health centers and health bases in the 21st district of Tehran in 2020-2021. A total of 164 subjects were randomly assigned to the intervention (n=82) or control (n=82) group by randomized quadruple blocks. A multifaceted questionnaire was completed for both the control and intervention groups and their blood pressure measured. This was followed by  a one-month virtual education for the intervention group in the form of a WhatsApp group and designing and developing fifty-six podcasts and educational clips with a maximum duration of four minutes based on the transtheoretical model constructs. After a lapse of one and six months both groups completed the questionnaire again and their blood pressure was measured. Descriptive statistics and general linear model were used for data analysis using the SPSS version 25 (p<0.05).
Results: Before the intervention the mean age of the subjects was 50.16 years and their systolic and diastolic blood pressures were 1.35 and 1.84 mmHg, respectively, and there were no statistically significantly differences between the two groups as regards contextual variables, constructs of nutritional awareness, disease perception, diet adherence, systolic and diastolic blood pressures and body mass index (as an ananthropometric index) and transtheoretical model constructs. Data one month after the intervention revealed significant differences (p<0/001) between the two groups (p <0/001) as regards the constructs of nutritional awareness, disease perception, self-sufficiency construct of the transtheoretical model and systolic blood pressure. Six months after the intervention significant differences were observed between the two groups as regatds  nutritional awareness constructs, disease perception (p<0.007), diet adherence (p<0.001), stages of change constructs (p<0.001) and self-sufficiency (p<0.001) of the transtheoretical model.
Conclusion: The results of this study show that educational intervention based on the transtheoretical model in middle-aged women with hypertension can increase their nutritional knowledge, illness perception, self-sufficiency, self-adequacy and diet adherence.
 
Alireza Delavari, Abbas Vosoogh-Moghaddam, Zahra Kazemi Esfa, Zahra Beigom Seyed Aghamiri,
Volume 20, Issue 1 (6-2022)
Abstract

Background and Aim: The District Health Network is based on the principles of equity, appropriate technology, inter-sectoral collaboration and public participation. Measuring patient satisfaction is one of the basic criteria in determining the quality of care services. The purpose of this study was to compare the level of satisfaction of service recipients between government and non-government health posts in the south of Tehran in 2021.
Materials and Methods: This was a cross-sectional, descriptive and analytical study. A two-part researcher-developed questionnaire was used to collect data. The first part included items related to demographic characteristics of the clients, insurance status, geographical location and type of health post, appointment system and frequency of visits, and the second part contained questions on the type and level of satisfaction with the services provided.
Results: In the governmental health posts, the clients were mostly satisfied with, in a decreasing order, vaccination services, post-vaccination education, waiting time and physical space. In the outsourced posts, post-vaccination care education, under-one year old child care, vaccination and a sense of responsibility obtained, in an increasing order, the highest scores of satisfaction. Further analysis of the data showed the clients’ least satisfaction with youth and middle-aged care in governmental posts and youth care in outsourced posts.
Conclusion: Continuous and frequent measurement of satisfaction and developing timely interventions based on the results obtained will help greatly promotion of the quality of health services.
 
Ali Mohammad Mosadeghrad, Tina Taherkhani, Shayan Shojaei, Matin Jafari, Sara Mohammadi, Alireza Emamzadeh, Shahrzad Akhavan,
Volume 20, Issue 1 (6-2022)
Abstract

Background and Aim: Primary health care is a holistic approach that aims to maximize people's health and well-being as quickly as possible in their immediate living environment. The primary health care system is the first point of contact of the people with the health system. Therefore, increasing its resilience will play a significant role in controlling and managing pandemics. This research aimed to identify strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic.

Materials and Methods: This study was conducted using the scoping review method. Using appropriate keywords search was done on the subject of the study in PubMed, Web of Science, Scopus, SID, Iranmedex and Magiran databases and Google and Google Scholar search engines. Finally, after screening and reviewing the titles, abstracts and texts of the retrieved documents, 36 articles were selected and strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic were extracted from them.
Results: A total of 48 strategies/solutions were extracted to strengthen the resilience of the primary health care system, categorized into 6 groups, namely, governance and leadership, financing, human resources, medicines and equipment, health information systems, and health service delivery. Among the most frequently solutions mentioned were the following: Dynamic and accountable leadership, using valid research evidence in policy-making, contingency planning, increasing inter-sectoral cooperation, advocacy for health policies, community involvement, sustainable financing, recruiting additional staff and training and supporting them, providing sufficient stocks of medicines and diagnostic kits, developing and modernizing public health information systems, facilitating people's access to health centers, continuing to provide health services, and increasing the community’s health literacy.
Conclusion: The structural and process components of the primary health care system including "governance and leadership", "financing", "staff", "equipment, vaccines and medicines", "information" and "health care delivery" should be strengthened in a coordinated manner in the primary health care system to be prepared for future epidemics.
 
Zahra Tavakoli, Bahram Mohebbi, Roya Sadeghi, Azar Tol, Mirsaeed Yekaninejad, Masoud Alimardi,
Volume 20, Issue 1 (6-2022)
Abstract

Background and Aim: Physical activity and nutrition are important topics in adolescent health. This study aimed to determine the predictors of nutritional knowledge, behaviors, and physical activity in fifth-grade elementary school female students
Materials and Methods: This cross-sectional descriptive-analytical study was performed on 480 female students in the fifth grade of the elementary school in Gods city in 2020-2021 by cluster random sampling. Data were collected using a researcher-made questionnaire two-part questionnaire of contextual questions and questions about knowledge, nutritional and physical activity, virtual in the Shad messenger. The content validity ratio and content validity index was used to determine validity, and the intra-cluster correlation index to determine the reliability, of the questionnaire. In data analysis, descriptive statistical tests, Pearson         
correlation coefficient, and multiple regression analysis were performed using SPSS 27.
Results: The results of multiple regression analysis showed the effect of nutritional knowledge variables on nutritional behavior (p <0.001, β = 0.159) and physical activity knowledge on nutritional behavior (p = 0.008, β = 0.120) if the Physical activity knowledge variable was not effective on physical activity behavior and also nutritional knowledge variable had no effect on physical activity behavior.
Conclusion: Increasing knowledge of nutrition and physical activity improves students' nutritional behavior, but this increase in knowledge does not affect physical activity behavior. The sedentary lifestyle and the presence of the Covid-19 pandemic appear to have significantly reduced physical activity. By increasing knowledge, nutritional behavior and physical activity can be improved to some extent
 
Ali Mohammad Mosadeghrad, Mahya Abbasi, Mahdieyh Heydari,
Volume 20, Issue 2 (9-2022)
Abstract

Background and Aim: The health financing system is "the process of collecting, pooling and managing financial resources and purchasing healthcare services”. Iran's health financing system is facing challenges. The aim of this study was to evaluate the Iranian health financing system.        
Materials and Methods: This descriptive study retrospectively evaluated the health financing system of Iran between 2000 and 2019 using archival data. Data were collected from the World Bank website and analyzed using the Excel software.
Results: Iran's health expenditure per capita increased by 3.7% annually between 2000 and 2019 and reached $868 (purchasing power parity) in 2019. Iran's total health expenditure increased from $32 billion in 2000 to $72 billion (purchasing power parity) in 2019 (5.9% annual increase). Iran accounted for about 0.6% of the world total health expenditure in 2019. In that year about 6.7% of the country's gross domestic product was spent on health, the global average being 9.8%, while the general government health expenditure (% of the then current health expenditure) in Iran and the world were 49.5% and 59.8%, respectively. Out-of-pocket expenditure (% of the then current health expenditure) decreased in the last decade in Iran, reaching 39.5% in 2019, compared to 18% worldwide.
Conclusion: Iran’s health system costs are increasing at a faster rate than the growth of its Gross Domestic Product (GDP). The country’s health expenditure (% of GDP) and, as a result, the general government health expenditure (% of general government expenditures) has decreased and out-of-pocket expenditure (% of current health expenditures) has increased. Therefore, reforms should be implemented to strengthen the country's health financing system.
 
Mohammad Moradi-Joo, Ali Akbari-Sari, Maryam Seyed-Nezhad, Seyed Mansoor Rayegani, Alireza Olyaeemanesh,
Volume 20, Issue 3 (12-2022)
Abstract

Background and Aim: Clinical Practice Guidelines (CPGs), are "recommendations intended to optimize patient care based on systematic reviews of available evidence and assessment of the benefits and harms of alternative care options". CPGs play an important role in improving the quality of care, reducing the diversity of treatment methods, reducing medical errors, managing health costs and increasing patient safety. This study was conducted with the aim of analyzing the decisions, consequences and policy trends of using CPGs in Iran during the period 2001-2021.
Materials and Methods: This study was a type of health policy analysis, carried out using analysis of the policy process approach. Data were collected through reviewing policy documents (n=79) and qualitative interviews (n=27). Analysis of policy documents was done using the content analysis method, the software used being Excel software, while for analysis of the interviews the framework analysis method was used, the software being the MAXQDA10 software.
Results: The policy of using CPGs in Iran started in 2001 and has improved over the past two decades. During the period 2016-2021 a total of 836 CPGs (knowledge products) were published, but according to the participants, many of these CPGs or knowledge products did not have the necessary quality and were not used by physicians. The findings of this study also showed that in Iran there is a suitable atmosphere for implementing CPGs and the policies of using them are sound policies; however, there is a huge gap between the development and implementation of CPGs.
Conclusion: Although the process of applying CPGs has improved in Iran, their implementation faces challenges and, thus, they have not been fully implemented. Therefore, there is a need to adopt new standard methods and approaches to improve the quality and reliability of CPGs. Certainly, the support of the government, Ministry of Health and Medical Education, the medical community, insurance organizations and other stakeholders, along with proper collaboration and appropriate policy formulations, are essential to achieve success.
 
Somayeh Mokhtari Molaei, Roya Sadeghi, Azar Tol, Maryam Sabouri, Shahrzad Saadat Gharin, Abbas Rahimi Foroushani,
Volume 20, Issue 3 (12-2022)
Abstract

Background and Aim: Food preferences and health literacy ─ key determinants of food choices in childhood and adolescence ─ are determinants of chronic diseases in adulthood. This study aimed to determine associations between food preferences, health literacy and body mass index (BMI) among elementary school students in Malekan city, east Azarbayejan Province, Iran in 2021-2022.
Materials and Methods: This cross-sectional descriptive-analytical study included 582 male and female primary-schoolers in the fourth, fifth and sixth grades in both the public and private  schools in Malekan County (Malekan, Lilan, and Mubarakshahr) selected by the two-stage randomized cluster method. A questionnaire including background questions and questions about health literacy and a researcher-made checklist of food preferences was used to collect data online using the Pros-Online Platform. The content validity ratio and index were used to determine validity and Cronbach's alpha index to check for the reliability of the questionnaire (CVI=0.98, CVR=0.91, Cronbach's alpha > 0.7). Data were analyzed using Mann-Whitney, t-test, one-way analysis of variance, Kruskal-Wallis and Chi-square tests at a significance level of 0.05 using SPSS 26.
Results: The average health literacy score of all the students was rather low (52.9±00.33), that of the female students (55.7±36.49) being slightly higher than that of the boys (49. 9±29.79). Further analysis of the data showed that there was a statistically significant relationship between the students' food preferences and health literacy variables (p<0.001). Furthermore, statistically significant relationships were observed between the students' BMI and their food preferences (p˂0.001) and health literacy (p˂0.001).
Conclusion: Considering the low level of health literacy of the adolescents and a positive relationship between health literacy, food preferences and BMI in adolescents, it can be concluded that increasing their health literacy will improve their healthy food choices. Therefore, it seems that interventions based on a theoretical framework aiming at increasing the students’ health literacy and improving their food preferences can be beneficial to them as a potential strategy for improving their healthy eating patterns resulting in preventing overweight and obesity.                
 
Aboulghasem Pour-Reza, Ali Mohammad Mosadeghrad, Farinaz Moghadasi,
Volume 20, Issue 3 (12-2022)
Abstract

Background and Aim: Surgical site infection (SSI) is an infection that occurs within 30 days after surgery and involves the skin and subcutaneous tissue of the surgical incision. It is one of the most common nosocomial infections which, in addition to endangering lives of the patients, increases the heath care expenditures in the health system. The objective of this study was to estimate the cost of surgical site infections in hospitals.
Materials and Methods: This was a case-control study conducted in a teaching hospital in Kashan, Iran in 2017 to find information about direct hospitalization costs of surgical site infections. Detailed information about the hospiutalization costs of case and control patients was extracted using patient records and the hospital information system software.
Results: Out of all the patients 115 (1.04%) experienced an SSI. The median additional direct medical cost was US$ 2577 and US$ 1034 for the case and control in-patients, respectively (p <0.001). The cost of treating SSI was US$ 1543 per patient. The direct hospitalization costs were 2.5 times greater for patients with an SSI than for those without an SSI.  Further analysis of the data showed that the cost of SSI was related to the patient's age, duration of surgery and length of hospital stay before infection.
Conclusion: Surgical site infection treatment costs imposes high costs  on the patients, health insurance companies and the hospitals. Therefore, hospitals managers should design and implement interventions to reduce surgical site infections.
 
Ali Mohammad Mosadeghrad, Mahya Abbasi, Mahdi Abbasi, Mahdieh Heidari,
Volume 20, Issue 4 (3-2023)
Abstract

Background and Aim: Health system financing is the process of collecting, pooling, and allocating financial resources to maintain, restore or promote the health of the people. Developing countries face many challenges in mobilizing, managing and allocating health financial resources. The aim of this study was to identify sustainable financing methods in developing countries.
Materials and Methods: This study was conducted using the scoping review. All the studies related to health system financing methods in developing countries were searched in the English electronic databases (i.e., Pubmed, Scopus, Science Direct, and Web of science), Persian electronic databases (i.e., Magiran, Iranmedex, and SID) and Google Scholar and Google search engines using appropriate keywords. Finally, 94 suitable documents were selected and analyzed using the framework analysis method and MAXQDA software.

Results: Forty-two methods were identified to strengthen the sustainability and resilience of the health financing system in developing countries; these methods were grouped into three categories: collection and management of financial resources, pooling of financial resources and purchasing of health services. The most frequently used solutions to strengthen the sustainability of the health financing system in developing countries were as follows: expanding social health insurance plans, integrating multiple health insurance plans, strengthening public-private partnerships, establishing a robust referral system, imposing taxes on harmful commodities, using perspective fixed payment methods, defining needs-based health service packages, promoting donors’ contributions, and reforming health service tariffs.

Conclusion: The health financing system in developing countries should be strengthened. The financial reforms of the health system should be accompanied by reforms in providing health services to make possible efficient and effective results. Health policymakers and senior managers should strengthen the governance of the health financing system at the macro level. In addition, healthcare managers should increase the efficiency and reduce resource wastage by strengthening budget capacity and financial management at the micro level.
Hossein Rashnoud, Davood Jalili Naghan,
Volume 20, Issue 4 (3-2023)
Abstract

Background and Aim:  Dust storms have negative effects on public health, social economy and environment and, thus, lead to many damages in human resources, health sector and agriculture. Iran is one of the areas affected by particulate matter, with serious damages annually.  For these reasons particulate matter increases should receive particular attention in Iran.
Materials and Methods: This research was conducted on solid/mineral section of dust fall in Poldokhtar, Lorestan Province, Iran. Sampling of the particles was done in nine spots in three stages during three months to measue heavy metals, cations and anions. Analysis of the samples for cations and anions was done using the Ic Metrohm system and that for heavy metals using the Icp OES-arcoss system.
Results: Sampling of dust fall was done in February, March and April 2019. Data analysis showed the most highly concentrated cation and anion were SO4 and F, respectively, while the concentrations of Fe and Al were the highest among heavy metals. 
Conclusion: The highest amounts of dust fall were found to occur in February 2019, followed by that in March 2019, and the lowest occurring in April 2019. Due to the fact that compounds/elements with both natural and unnatural origins were found in this study, it can be concluded that the origins of the compounds/elements observed could be both natural and unnatural.
 
Maryam Tajvar, Omolbanin Atashbahar, Firoozeh Dadras, Haniye Sadat Sajadi,
Volume 21, Issue 1 (10-2023)
Abstract

Background and Aim: Performance evaluation is a useful way to obtain information for decision-making and management of healthcare organizations. The purpose of this study was to assess the performance of health houses in rural areas in Kerman City, Iran during the outbreak of Covid-19.
Materials and Methods: This cross-sectional study was conducted in 2021-22 using descriptive and analytical methods. The research population included all the health houses in Kerman City (n=57), Iran. The tool for data collection was the Health House Performance Evaluation Checklist of the Ministry of Health and Medical Education developed to supervise the performance of health houses during the outbreak of Covid-19. Data analysis was done using SPSS 26 software, the statistical tests being descriptive statistics (mean and standard deviation) and analytical statistics including independent t-test, one-way analysis of variance and Pearson and Spearman correlations.
Results: The average performance score of the health houses (n =55) in managing Covid-19 was 96.37 out of 136. Installation of the village map on the wall of the health house  (92.3%), screening and following up the positive-test individuals and informing the health care team to track and isolate individuals in close contact (84.6%) were found to have the highest, and injecting the third dose (78.8%) and the second dose (75%) of the Covid vaccine the lowest,  scores. From among the characteristics investigated the variable of native Behvarzes (the personnel of health houses) had a statistically significant positive relationship with the performance score (p=0.01). In addition, the health houses with more than one Behvarz were found to perform better than those with only one Behvarz (p=0.05).
Conclusion: Assessing the performance of health care units at times of crisis, including communicable diseases epidemics, will make it possible to identify the bottlenecks that need improvement for better preparedness in the future. Based on the findings of this  research, the expansion of the coverage of the covid-19 vaccination, updating the disease incidence, the performance of health care teams at home visits, and the progress of the operational plan were the variables that needed improvement most.
 
Zeinab Azizi Mianaii, Roya Sadeghi, Mamak Shariat, Azar Tol, Abbas Rahimi Foroushani, Hossein Jalahi, Yaser Tedadi,
Volume 21, Issue 1 (10-2023)
Abstract

Background and Aim: Considering the quality of prenatal care services, indentification of the avoidable and inevitable maternal factors and proper promotion of the knowledge and skills of health care service providers is vital for providing suitable preventive and interventional services with the aim of ensuring a successful pregnancy and proper management in the health care system.  This study was conducted to compare the adverse pregnancy outcomes among women with or without a history of Covid-19 in the pregnancy and postpartum stages covered by the Babol University of Medical Sciences, Babol, Iran.
Materials and Methods: This was a descriptive-analytical cross-sectional study including 4124 women, either pregnant or after a recent childbirth (with or without Covid-19) between 20.2.2020  and  29.3.2022, registered in the Sib electronic system (hereinafter Sib) of Babol University of Medical Sciences, Babol, Iran. Using a checklist developed and validated by an expert panel data were collected on the prevalence of maternal and neonatal outcomes in mothers with or without a history of Covid-19 and compared. The data collected were analyzed with SPSS 24 using descriptive tests such as chi-square and Fisher's exact test and STATA version 22, and the adverse outcomes with high frequencies following Covid-19 were determined.
Results: Analysis of the data showed the following to be the most common outcomes among mothers with a history of Covid-19: 1. obstetric complications and maternal disorders/diseases (hypertension, type-2 diabetes mellitus, at least one case of bleeding during pregnancy, premature/delayed birth and premature rupture of the amniotic sac, n= 457, 27.8%); 2. medical and surgical problems (unhealthy pregnancy weight gain and thromboembolic events, n=206, 12.5%). In addition, there was a statistically significant difference between the two groups of pregnant mothers with and without a Covid-19 infection as regards medical and surgical problems (P=0.001) and obstetric complications and maternal diseases (p=0.002). As regards the adverse neonatal outcomes in pregnant mothers with and without a history of Covid-19, there was a statistically significant difference between the two groups in terms of Apgar score at minutes 1 and 5 (p≥0.001) and exclusive breastfeeding (P=0.001) and the presence of Covid-19 symptoms in the baby (p<0.001).
Conclusion: Based on the findings of this study it seems that Covid-19 infection during pregnancy is associated with a higher risk of some of the undesirable maternal and neonatal outcomes.  Therefore, it is essential to plan and implement programs for health education, creation of a sound attitude towards better management, enhancement of the skills and capabilities of the health-care providers and, finally, promotion of the knowledge of service recipients. 
 
Hossein Dargahi, Mahboubeh Anbari, Mahmoud Biglar,
Volume 21, Issue 1 (10-2023)
Abstract

Background and Aim: Organizational citizenship behavior (OCB) of employees in an organization as an optional and voluntary behavior may help to improve organizational productivity. It is important to know that encouraging employees to perform voluntary behaviors needs pre-employment education training in the format of organizational socialization. Therefore, this study was conducted to find the association between organizational socialization and OCB among Tehran University of Medical Sciences Senate staff members, Tehran, Iran 
Materials and Methods: This research was a cross-sectional descriptive-analytical study conducted in 2021-2022. The research population was a group of 1419 staff members in the Tehran University of Medical Sciences Senate, Tehran, Iran, from among whom an available sample of 243 was selected according to Krejcie and Morgan Table based on a response rate of 86%.  Data were collected using the Katz’s Organizational Socialization and the Organ & Konovsky’s OCB Questionnaires, the face and content validity of which had been determined by experts, and based on the Cronbach's alpha test the reliability of the questionnaires was found to be 0.83 and 0.81 for the organizational socialization and OCB questionnaires, respectively.  Data analysis for descriptive and analytical statistics was done using the SPSS software.
Results: The means of the employees’ organizational socialization and OCB scores were 3.8 and 3.35 (relatively high), respectively.  A statistically significant correlation was observed between the organizational socialization and OCB and their subthemes.
Conclusion: Explaining and encouraging voluntary behaviors of organizational citizenship among the employees through implementation of pre-employment and on-the-job training and empowerment courses may help to promote organizational productivity.
 
Gholamreza Jahed Khaniki, Nabi Shariatifar, Hedayat Hosseini , Abbas Rahim Foroushani,
Volume 21, Issue 2 (9-2023)
Abstract

Background and Aim: Considering the needs of the society food safety and hygiene graduates can be employed in positions related to their field of study and provide services to solve the food safety and hygiene problems at the community level. The aim of this research was to explain the current situation and future prospects of the food safety and hygiene field in terms of occupational positions and the needs of the society.
Materials and Methods: A descriptive and applied study was conducted with the time series analysis method regarding the current situation and the future perspective of the food safety and hygiene field in terms of occupational positions and the society's need. A valid and reliable questionnaire was developed and used for data collection. In order to predict the future of the field, the time series statistical analysis method (Autoregressive integrated moving average =ARIMA) was used. In addition, its strengths, weaknesses, opportunities and threats were identified and analysed using the SWOT qualitative content analysis.
Results: Analysis of the data obtained showed that the number of food safety and hygiene graduates has an increasing trend. The proportions of the graduates in relevant occupations, in non-relevant occupations and out of job were 48.00%, 24.75% and 27.25%, respectively. The data also revealed that this field of study had good strengths, so attempts should be made to increases them, reducing the weaknesses and threats, using the available and potential opportunities.
Conclusion: Based on the findings of this study the numbers of individuals accepted and graduated in the field of food safety and hygiene have an increasing trend, which are expected to continue in the next ten years. On the whole, the current moderate situation and the future perspective of the food safety and hygiene field in terms of the occupational positions and the society's need can be relatively favourable. In any case it is essential to make serious attempts continuously to maintain and promote this field of study.
 
Maryam Tajvar, Mohammad Sarkout Ghosi, Elham Ehsani-Chimeh,
Volume 21, Issue 2 (9-2023)
Abstract

Background and Aim: Assessment of disease risk with the ultimatevaim of implementing preventive strategies in the workplace is a necessity. This study was conducted to assess the risk of COVID-19 in hospital occupational groups in Saghez city, Iran.
Materials and Methods: This cross-sectional study was conducted in 2021 among three hospital occupational groups (total sample size = 300) in Saghez city, Iran, including physicians and nurses, as well as laboratory, administrative, financial, radiology and general service personnel, using the COVID-19 rapid risk analysis technique. Data were collected using a valid questionnaire based on the Likert scale and analysed (to determine acceptable, tolerable and intolerable risks) using the descriptive and inferential methods, the software used being SPSS-26.
Results: As regards the probability variable, the highest probability of occurrence of COVID-19 was related to the general service and administrative-financial occupational groups with an average of 1.6 and 1.5, respectively. The level of attitude was generally good and excellent. The analysis of the severity of the outcome variable was at a critical level in the physicians group (42.5) and at a catastrophic level in the other groups. In total, all occupations were rated at an unacceptable risk level (H), the general service and administrative-financial occupational groups being at a higher risk than other groups. There were statistically significant differences between the types of occupation on the one hand and the variables studied, as well as the individual characteristics and COVID-19 morbidity on the other hand.
Conclusion: Considering the high risk of occurrence of COVID-19 among the hospital professionals it is essential to develop and implement plans aiming at preventing and reducing the disease risk in them.
 

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