Showing 36 results for Care
M Farahbakhsh, A Zakeri, N Khodaee,
Volume 6, Issue 3 (2-2009)
Abstract
Background and Aim: The district health information system (DHIS) converts raw data into useful manegerial information. The main purpose of DHIS is to improve quality of health services in service delivery points. This study was conducted to investigate the DHIS performance.
Materials and Methods: A total of 200 health service-delivery units were selected by systematic random sampling, and the calculation of 47 primary health care indicators was assessed by the provincial health center statistics supervisor.
Results: On the average, 41.9% of the indicators had been calculated in each unit. In the district health center, the proportions of outcome measures and process performance indicators calculated were 50% and 5.6%, respectively. On the basis of the indicators obtainable from the vital horoscope, 79% of the indicators in the district health center and 66% of those in the health service-delivery units had been calculated. Finally, there were 97 disease-surveillance forms, 35 environment-health forms, 21 family-health forms, and 23 other forms at the district level.
Conclusion: Re-designing the structure of the health information management process and determining indicator packages at the district and service-delivery level are vital steps for improving the health information system at the district level.
A Pourreza, R Khabiri, M Arab, A Akbari Sari, A Rahimi, A Toll,
Volume 7, Issue 2 (10-2009)
Abstract
Background and Aim: Factors determining the health care-seeking behaviors of an individual are social, cultural, and economic (treatment costs). Utilization of a health care system by a person will, on the whole, depend mainly on the socio-economic and demographic factors, cultural beliefs and practices, gender discrimination and women's status, the economic and political systems, environment, patterns of illness, and the health care system itself. The main objective of the present study was to examine current patterns of health care-seeking behavior in residents of Tehran, Iran in 2007.
Methods and Materials: In a cross-sectional study a two-stage cluster sampling method was used to select neighborhoods at the first stage and households at the second. The sample included a total of 1882 individuals over 18 years old in the households. The data were collected using a questionnaire. For analysis of the data the exact fisher test, X2, and multivariate logistic regression were used the software used was SPAA.3
Results: About 22/9% (431 persons) of the participants reported 1-2 illnesses during the previous month. Multivariate logistic regression indicated that age, sex, perceived severity of the illness, educational level, and marital status were all statistically associated with an attempt to seeking care, whether self-treatment or consulting a health center. The effects of different variables on decisions related to seeking care from a health care center versus self-care were also examined. The data showed that age, sex, perceived severity of the illness, income, educational level, household size, and method of payment were statistically the most significant variables affecting seeking care from a health center.
Conclusion: Based on these findings, it may be concluded that increasing social awareness about side effects of medicines, potential dangers of self-treatment, continuous education and training of physicians and pharmacists, improving health insurance systems and universal insurance coverage will be appropriate strategies for better utilization of health care services by the people.
M Farahbakhsh,
Volume 8, Issue 1 (6-2010)
Abstract
Background and Aim: Monitoring and evaluation are basic components of any health program. Control charts show clearly the process performance trend longitudinally and help managers and staff to detect general and specific variations and evaluate the process performance correctly. This study was conducted to design and utilize control charts in the primary health care (PHC) system.
Materials and Methods: This study was conducted in two stages. In the first stage, the average weekly, monthly and seasonal delays in receiving health services were compared retrospectively. In the second stage, appropriate control charts were introduced with due consideration of the PHC system.
Results: More than 95% of the weekly average delays were below the upper control limit, while in 100% of the cases the monthly and seasonal averages were under the upper control limit.
Conclusion: Desirable health outcomes result from appropriate services. It is necessary to monitor health processes coverage and performance with simple and specific indicators. With regard to the health process outputs in the PHC system, it is suggested that the R-X, np and C charts be used in monitoring processes.
The control charts help the service providers to determine and manage process performance by gathering simple, applicable data. Some of the advantages of using these charts are the possibility of longitudinal surveys, simplicity of the calculation methods, and their high applicability.
Akbari Sari A, Z Beheshti Zavare, M Arab, A Rashidian, B Golestan,
Volume 8, Issue 3 (9-2010)
Abstract
Background and Aim: Pressure ulcer is a common problem and a large drain on hospital resources, especially in wards such as ICU where patients stay for a long time. The aim of this study was to explore the likely factors contributing to pressure ulcers in the ICU units of Tehran University of Medical Sciences teaching hospitals, Tehran, Iran.
Materials and Methods: This project was conducted in all the seven ICUs of four teaching hospitals affiliated to Tehran University of Medical Sciences. In the first phase the researcher performed a direct observation of all the 90 patients who were admitted to the ICU units to check the presence of any pressure ulcer. In the second phase, 310 patients discharged from the same ICU units between March 2007 and February 2008 was randomly selected and their medical records reviewed. A structured questionnaire was used to collect the data.
Results: Pressure ulcer occurred more frequently in the elderly women patients who were less active and had less mobility, hospitalized for a long time, or those with fever, diabetes, high blood pressure, paralysis, or respiratory diseases. In addition, pressure ulcer was seen more frequently in the patients hospitalized in the general ICUs, as well as in those with infections and different types of tumors.
Conclusion: Using a standard risk assessment tool and paying attention to the main risk factors of pressure ulcer can be a useful method for identifying the high-risk patients before admission in order to prevent them from developing such ulcers.
Mehdi Mohebali, Gholamhossein Edrissian, Mohammad Reza Shirzadi, Yavar Hosseingholizadeh, Mohammad Hossein Pashaei, Akbar Ganji, Zabihallah Zarei, Ahmad Kousha, Behnaz Akhoundi, Homa Hajjaran, Hossein Malekafzali,
Volume 9, Issue 2 (11-2011)
Abstract
Background and Aim: Visceral leishmaniasis is a systemic parasitic disease with a high fatality rate in under-5-year-old children. The disease is endemic in some parts of Iran, particularly in the north-west region. In 2001 a visceral leishmaniasis (VL) surveillance system was established for children aged ≤ 12 years in the primary health system in Meshkin-Shahr District, Ardebil Province, situated in the north-west of Islamic Republic of Iran.
Materials and Methods: All cases with clinical signs and symptoms of VL and confirmed positive by the direct agglutination test (DAT) were referred for physical examination and treatment.
Results: The mean annual incidence of VL decreased significantly from 1.88 per 1000 children before (1985-2000), to 0.77 per 1000 child population after (2001-07), the intervention. In the control area with no surveillance, it increased from 0.11 to 0.23 per 1000.
Conclusion: Early detection of VL using serological tests and timely treatment of cases can decrease the mortality and morbidity rates of VL in endemic areas.
Alireza Didarloo, Davood Shojaeizadeh, Hasan Eftekhar Ardebili, Shamseddin Niknami, Ebrahim Hajizadeh, Mohammad Alizadeh,
Volume 9, Issue 2 (11-2011)
Abstract
Background and Aim: Many studies show that the only way to control diabetes and prevent its debilitating complications is continuous self-care. This study aimed to determine factors affecting self-care behavior of diabetic women in Khoy City, Iran based the extended theory of reasoned action (ETRA).
Materials and Methods: A sample of 352 women with type 2 diabetes referring to a Diabetes Clinic in Khoy City in West Azarbaijan Province, Iran participated in the study. Appropriate instruments were designed to measure the relevant variables (diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention, and self-care behavior) based on ETRA. Reliability and validity of the instruments were determined prior to the study. Statistical analysis of the data was done using the SPSS-version 16 software.
Results: Based on the data obtained, the proposed model could predict and explain 41% and 26.2% of the variance of behavioral intention and self-care, respectively, in women with type-2 diabetes. The data also indicated that among the constructs of the model perceived self-efficacy was the strongest predictor for intention for self-care behavior. This construct affected both directly and indirectly self-care behavior. The next strongest predictors were attitudes, social pressures, social norms, and intervals between visiting patients by the treating team.
Conclusion: The proposed model can predict self-care behavior very well. Thus, it may form the basis for educational interventions aiming at promoting self-care and, ultimately, controlling diabetes.
Zohreh Sadat Mirsaeedi, Hassan Eftekhar Ardebili, Keramat Allah Nouri Jalyani,
Volume 10, Issue 4 (3-2013)
Abstract
Background and Aim: The most important single determinant of the quality of life of the elderly is health. Studies have shown that health declines with age. Because of high vulnerablity of the elderly due to many problems, they need particular attention and self-care programs for their health promotion. The objective of this study was to assess the quality of life of elderly clients under coverage of the Southern Tehran Health Center and determine the effects of a self-care program on it.
Materials and Methods: This was a controlled interventional study conducted in 2010-2011. A total of 132 elderly clients (52 in the intervention, and 80 in the control, group) were selected by randomised cluster sampling from 5 Health Care Centers in Southern Tehran. A 3-month educational program was prepared with contents based on books published by the Ministry of Health and Medical Education and implemented. The quality of life was assessed in both groups at the beginning and 2 months after the intervention using a short questionnaire (sf36). Data were collected through a structured interview (demographic characterstics) and analyzed using descriptive and analytical statistical tests.
Results: The mean quality-of-life score of the experimental group increased after education the mean score of physical domain of the quality of life increased from 52.75 in 66.11 and that of the emotional domain from 53.61 to 70.85. The scores of different domains of quality of life of the control subjects did not change significantly.
Conclusion: The findings show that a self-care educational program can have a positive affect on quality of life of the elderly.
Saeed Karimi, Marzieh Javadi, Mina Iravani, Elham Chavoshi,
Volume 11, Issue 1 (8-2013)
Abstract
Background and Aim: Global growth in the elderly population for both health care providers and families and also the community is an important challenge . Elders are the largest and fast factor for increasing hospital admissions in Society . Increasing costs of aging is the most concern to elders and their families. This study aimed to investigate the health team s approach about cost–effective alternatives for aging health services.
This study is a qualitative research which was done through content analysis.
18 people consisting of five faculty members , 6doctors , 3 nurses and 4health public health expert were participated. Samples were selected based on purposive sampling . Data were collected through interviews .
Results: Four core themes derived from this study which included: 1- Emphasis on training for aging care ( including training doctors, nurses , health professionals , public health experts, elder sand their family caregivers). 2- Emphasis on proper implementation of primary health care for the elderly. 3- Emphasis on home care for elderly.4-attntion to mental health of elderly.
Conclusion: It seems effectiveness of tree alternatives emphasis to training, home care and mental health for elderly are obvious and evident, so implementing and applying these suggestions would be helpful.
But the second alternative emphasis on proper implementation of primary health care for the elderly must be performed based on a comprehensive needs assessment in elders population. Finally it is stressed that calculating and comparing actual costs of each alternative in elders caring must be measured through quantitative researches.
Hossein Malekafzali,
Volume 12, Issue 2 (10-2014)
Abstract
In this article 40 years of Iranian experience in primary health care in west Azarbaijan and behvarzs is presented. In this regard quantitative development of PHC during this period will be discussed, moreover challenges and opportunities of this program will be analysed. Finally family physician program should be considered as an appropriate tool to achieve universal coverago of PHC in iran.
Arezoo Fallahi, Siamak Derakhshan, Tahereh Pashaee, Parvaneh Teymoori,
Volume 13, Issue 2 (9-2015)
Abstract
Background and Aim: Although self-care is known to affect favorably the control and treatment of osteoporosis, the effective factors from the patients’ viewpoint have not been investigated. The aim of this study was to explore factors affecting self-care from the viewpoint of women suffering from osteoporosis.
Materials and methods: This was a qualitative study conducted with a content analysis approach in 2014, including 15 women consulting the bone mass densitometry centers in Sanandaj, Iran, selected by purposeful sampling. The inclusion criteria were women aged &ge 50 years suffering from osteoporosis diagnosed definitively at least 6 months before, a T-score index > -2.5 (lower back or hip bone), taking drugs upon a physician’s advice, ability to speak, and willingness to participate in the study. Data were collected through face-to-face and group semi-structured in-depth interviews and analyzed using the content analysis method. The accuracy and rigor of the data were confirmed based on such criteria as credibility, confirmability and transferability.
Results: Five main categories were extracted including “ background factors of the disease ”, “hope and weakness in confrontation with the disease”, “role of the physician”, “role of the family”, and “administrative centers and organizations”. Based on further analysis of the data, 11 subcategories were emerged including “cultural issues”, “lack of knowledge”, “non-priority of health”, “weakness and fear”,
“hope for the future” , “positive role of the physician”, “negative role of the physician”, “ active role of the family”, “ passive role of the family”, “ role of the media”, and “information centers”.
Conclusion: The finding of the study show that the responsibility of women suffering from osteoporosis towards their health is not a single-factor, but rather a multifactorial, phenomenon. Pre-requisites for empowering women to adopt self-care behaviors include increasing their hope to live longer, physician’s attention to the patient’s needs, increasing health promotion programs in the media, and strengthening role of the family (particularly role of men).
Shirin Rezaei, Abbas Rahimi Foroushani, Mohammad Arab, Ebrahim Jaafaripooyan,
Volume 14, Issue 2 (9-2016)
Abstract
Background and Aim: A New Health Reform Plan consisting of seven programs was initiated in Iran in mid-May 2015 aiming to reduce the out-of-pocket payments, improve the public’s health, and promote the public health indicators. This study was conducted to determine the effect of the Plan on the performance indicators of Hamedan university hospitals.
Materials and Methods: In this longitudinal descriptive-analytical study, based on the interrupted time series design, data related to hospital performance indicators were collected from all (15) Hamedan University hospitals for a period of 15 months (7 months before, and 7 months after, the implementation of the Plan, with a one-month interval in between). The SPSS software was used for data analysis.
Results: The data indicated changes in all the performance indicators after the implementation of the Plan. The largest changes were in the number of emergency and selective surgeries and the smallest in the ratio of active to total beds. Further analysis of the data showed that, as compared to the same months in the previous year, only a small number of these changes (number of emergency surgical operations and the ratio of active to total beds) were statistically significant.
Conclusion: Based on the findings it can be concluded that changes have occurred in all the selected indicators as a result of implementation of the New Reform Plan, indicating that the Plan has affected favorably performance of the hospitals. However, the effects observed should be judged cautiously, considering the possible negative consequences such as induced demand and hospital workload increase in the long run.
Mehdi Memarpour, Ashkan Hafezalkotob, Seyed Khalil Allah Sajjadi, Mahnaz Mayel Afshar,
Volume 14, Issue 2 (9-2016)
Abstract
Background and Aim: Nowadays selecting an appropriate technology for storing and disposal of health care wastes is a difficult task. For example, selecting an optimum technology for storing and disposal of hospital wastes is a complex multi-criteria decision-making process, which requires consideration of qualitative and quantitative factors and criteria. This paper presents a new decision-making model for selecting a better method in the management of health care wastes in the City of Tehran.
Materials and Methods: So far selection of technologies for health care wastes storing has been based on inaccurate information or uncertain data, and linguistic variables have been used by decision-makers (experts) to assess the ranks, criteria and options described.In this study a combinational multi-criteria decision-making model has been used which includes the fuzzy analytic network process technique and the fuzzy MULTIMOORA method. This model uses the fuzzy analytic network process to get the related with criteria and sub-criteria of better health care wastes storage technology and uses MULTI MOORA method for evaluation of five available technologies based on the above-mentioned criteria.
Results: Analysis of the data showed that the "environmental" and "technical" criteria were the most important criteria for selection of the best technology, while for storing health care wastes "hydroclave" is the most appropriate technology in the City of Tehran.
Conclusion: The proposed framework for assessing health care wastes technologies for storing hospital wastes is effective, and the hydroclave technology is to be considered as the best solution and the most suitable option from the environmental, public health and technical perspectives in the City of Tehran.
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.
Mahnaz Mayelafshar, Mehdi Memarpour, Leyla Riahi,
Volume 15, Issue 3 (12-2017)
Abstract
Background and Aim: Medication is a very important part of care and therapeutic services in health service delivery units. Therefore, medication errors in hospitals may cause serious problems in patient care and, even, death. This study aimed to determine the relationship between the type of medication errors reported and patient safety standards in a public hospital in Tehran, Iran.
Materials and Methods: In this study, the establishment of safety standards in 30 departments of Rajaee Hospital in Tehran, Iran and its relation to quality reporting medication errors by the hospital medical staff during the period 1391-1395 were investigated. Data were collected using two separate checklists, namely, "The establishment of medication safety” using the model 6R" and "The quality of reporting medication errors" and analyzed using the SPSS software, the statistical tests being inferential statistical tests including chi-square, phi coefficient and Cramer’s V.
Results: The data showed that the drug safety standards were established as regards five of the six components in this hospital (the sixth was safe patient positioning). The patient safety establishment was statistically significantly associated with the type of medication errors reported in the hospitals.
Conclusion: Since the process of drug therapy is a common practice in nursing services in the cardiac intensive care units, increased knowledge of nurses about the causes of medication errors, in order to prevent and reduce the occurrence of these errors, is considered quite necessary. Recommendations were made to reduce medication errors in hospitals.
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.
Shabnam Hashemi Bakhshi, Zahra Jalili, Mahmoud Mahmoudi,
Volume 16, Issue 1 (6-2018)
Abstract
Background and Aim: Nowadays, the need for informing children and teens in different ages, about sexual problems, is felt more than ever before. Sexual training and education; such as every other original training, must be done at the right place and time. On the other hand, this training should be based on a systematic program and educational models to achieve the desire results. The aim of this study is to determine the effect of educational intervention on the BAZNEF Model on mother's skill about sexual care of their children, Tehran 2017.
Materials and Methods: This study was a quasi-experimental intervention with control group. Ninety six mothers of children aged 5-6 were selected in Tehran pre-schools. They were randomly divided into two groups; intervention and control. Data were collected by a researcher made questionnaire based on BAZNEF Model whose the validity and reliability were confirmed. After pre-test, according to educational needs, educational content and program were based on BAZNEF Model and that were conducted in the intervention group. Data were analyzed by SPSS23, independent t, Mann-Whitney and Chi- squar statistic tests.
Results: The mean scores of attitude, subjective norms, behavioral intention and behavior showed no significant difference before the education in both intervention and control group. However, the result showed compelling difference in mean scores of attitude, subjective norms, behavioral intention and behavior after the education (p<0/001).Enabling factors showed no important variation among intervention and control groups before and after the experiment.
Conclusion: The finding of current study confirmed the educational intervention, based on BAZNEF Model, was effective on mother's attitude, subjective norms, behavioral intention and behavior about sexual care of their children.
Maryam Yaghoubi, Marzieh Javadi, Saeid Karimi, Vahid Pirasteh,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: Iran's Health Sector Evolution Plan (HSEP) is one of the most important national health reform plans. HSEP has attracted many criticisms. An important criticism is about its service costs. This article reports the results of a project conducted to compare the costs of normal and caesarian section delivery before and after implementation of the HSEP.
Materials and Methods: This was an applied research project using hospital accounting records as data. A total of 120 delivery files (60 normal delivery and 60 caesarian section) were selected randomly from the accounting software of a large hospital in Isfahan before and after May, 2014.The data in each subject’s file ─ paid shares of the hospital, patient and insurance ─ but not hoteling, inpatient and other costs was extracted. The health service providers’ incomes based on the annual tariffs of the services and changes in payments for each service for gynecologist and anesthesiologists were calculated. Data were analyzed using the excel software.
Results: The costs of normal delivery and caesarian section after implementation of the National HSEP had increased by 193% and 226%, respectively. In addition, of the treating physicians (gynecologists and anesthesiologists) had also increased by 257% for the normal and by 130% for caesarian section. Changes in the sums of money involved in service delivery indicates shifting of parts of the costs from the patients to the health subsidy and insurance systems.
Conclusion: The health System Evolution has not lead to real reductions in the out-of-pocket money paid by the patients. Higher cost of services will imply the need for better cost management. Increased costs of services will be to the benefit of neither patients nor the health system. This would mean that in designing and implementation of the Health Sector Evolution Plan economic aspects should be taken into consideration more carefully.
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.
Sajjad Dorri Kafrani, Atefeh Zolfagharnasab, Fatemeh Torabi,
Volume 17, Issue 2 (9-2019)
Abstract
Background and Aim: Along with the expansion of health systems, the importance of primary health care as the basis of an efficient health system is more evident and the quality of the provided services at this level becomes more important. In this way, the present study attempts to collect patterns used to improve the quality of primary health care.
Materials and Methods: The present study is a systematic review. The advanced search was done in the Web of Science, Scopus, Embase, PubMed, Cochrane, SID, MagIran, IranDoc, and Google Scholar databases in title, abstracts and keywords fields. Inclusion criteria include a comprehensive attitude, focus on primary health services, English or Persian language, published between 2006 and 2018. Exclusion criteria include studies that focus outside of primary health care. The quality of the studies was evaluated using the JBI checklist. Two independent researchers conducted the task of selecting studies, extracting data and evaluating the quality of studies, and disagreement cases were resolved by the third researcher.
Results: After screening and reviewing the criteria for the entry of 10095 studies, 11 studies were finally included. The quality of the four studies was evaluated average and the rest of the quality was high. Two studies have provided patterns for improving the quality of primary health care, three evaluated the effectiveness of quality improvement tools, and five presented conceptual frameworks.
Conclusion: A total of eight types of systems extracted to assess and improve the quality of primary health services. Studies on primary health care have been used at various levels of personal, professional, practical and national policy, and have developed models, tools and frameworks that each of them can be used separately or combined for different situations with regard to the limitations and facilities mentioned and improve health outcomes.
