Showing 11 results for Patient
M.r Shidfar , D Shojaizadeh , M Hosseini , N Assasi , F Majlesi ,
Volume 2, Issue 3 (6-2004)
Abstract
To determine the level of knowledge and to assess attitudes and lifestyles in patients with unstable angina. A descriptive study was conducted among CCU patients in Mashad hospitals. 180 subjects were chosen by sequential admission. They filled an 82-item questionnaire covering demographic variables (4 items) - knowledge (5 items) –attitude (56 items) – lifestyle (17 items). Findings indicate that the global level of knowledge is sufficient on issues such as cardiac risk factors, current treatments, and treatment compliance. The same patients showed very low knowledge of pain-inducing behaviors. Meanwhile, attitude scores turned out to be relatively low in some areas including perceived threat of disease (severity and susceptibility) and internal health Locus of Control. Health care professionals (physicians, nurses,..) tended to ignore the need for proper education of cardiac patients. There is a strong need to promote patient education in order to enhance knowledge and bring about a change in attitudes.
A Pourreza , Z Kavosi , M Mahmoudi , A Batebi ,
Volume 4, Issue 3 (6-2006)
Abstract
Background and Aim: The purpose of this study was the assessment of inappropriate admissions and hospital stays and reasons for this in the hospitals affiliated to Tehran university of Medical Sciences.
Materials and Methods: We used the Appropriateness Evaluation Protocol (AEP) to evaluate the appropriateness of 258 admissions to Dr. Shariati and Imam Khomeini hospitals and 1732 days of hospital stay for the same patients.
Findings indicate that on the whole, 22.8% of admissions were inappropriate and the length of stay for patients who were inappropriately admitted was significantly shorter than for those whose admission was judged to be appropriate.
Results: Results show that 8.6% of the total number of patient stay days were unnecessary the figures differ significantly between the two hospitals. The most frequent reason for inappropriate hospital stay was the delay in the discharge process .Consultations and delay in surgical operations were other causes of inappropriate patient stay.
Conclusion: A substantial proportion of hospital admissions and stays were found to be inappropriate due to hospital procedures and inadequacies in the lower levels of healthcare. Efficient use of hospital resources should be promoted by modifying procedures, improving the performance of the healthcare system and revising insurance policies.
M Alavi, A Albaji,
Volume 7, Issue 1 (8-2009)
Abstract
Background and Aim: Tuberculosis (TB) remains a major public-health problem in Iran, despite employing the DOTS (directly observed treatment short course) strategy in the National Tuberculosis Program (NTP). The aim of this study was to determine the role of teaching hospitals in improving NTP indices.
Materials and Methods: In a retrospective cross-sectional study, the medical files of treated TB patients in Tehran Razi Teaching Hospital and the Khuzestan Provincial Health Center were reviewed. Diagnosis, treatment and follow-up were based on the NTP procedures. The patients hospitalized for at least the first 2 weeks of treatment were placed in the hospitalized TB (HTB) group and the outpatients in the outpatient TB (OTB) group. The NTP indices (the sputum smear positive, fully cured, treatment failure, defaulted, and death rates) and pre-treatment counseling were compared between the 2 groups. Data related to demographic characteristics, risk factors, and the treatment outcome were compared by SPSS 11.5 using the chi square and fisher's tests
Results: A total of 235 patients (mean age 38 years), 67 of whom were hospitalized TB patients, were studied. 122 men (51.9 %) and 42 women (17.9%) had a history of imprisonment, among whom 20 (47.6%) were positive for human immunodeficiency virus (HIV), 53 (22.5%) injection drug users, and 120 (51.1%) smear-positive for pulmonary TB. The rates of cured cases, treatment failures, defaulted and death were, respectively, 80.6%, 8.9%, 4.5%, and 5.9%, in the HTB group, and 66.6%, 17.3%, 10.1%, and 5.9% in the OTB group. Pre-treatment counseling had been done in 75% of the HTB and 52% of the OTB cases.
Conclusion: Teaching hospitals can have an important role in improving pre-treatment counseling and NTP indices, such as increased sputum positivity, cured rate, and, probably, decreased treatment failure and defaulted rate.
M Arab, A Zarei, M Hosseini,
Volume 8, Issue 2 (9-2010)
Abstract
Background and Aim: Patients who consult hospital due to physical or mental damages have legal rights. Observation of patients' rights will result in patient satisfaction, which will help to improve hospital services. The aim of this study was to determine awareness and observation of patient's right in hospitals affiliated with medical universities in Tehran.
Materials and Methods: This was a cross-sectional study conducted in 2009 in hospitals affiliated with medical universities in Tehran. A total of 601 patients were randomly selected from 11 hospitals affiliated with three medical universities in Tehran. Data were collected using a 50-item questionnaire the validity and reliability of which had been confirmed. Chi-square and Kruskal-Wallis tests were used for statistical analysis. The software used was SPSS.17.
Results: The mean age of the patients (59% females and 41% males) was 43.3 (SD=18.5) years and the average length of hospitalization 7.1 (SD=7.4) days. Data analysis showed that the proportions of the patients with a poor, intermediate and desirable patients' rights awareness were 71.5%, 22.0% and 5.8%, respectively. Observation of patients' rights was good in 13.8% of the cases, medium in 82.9% of the cases and poor in 3.3% of the cases. There was a significant statistical relationship between observation of patients' rights on the one hand and the hospital ward and length of stay on the other hand (p=0/007). Further analysis of the data showed that the strongest and the weakest observed rights were patient awareness right and the right of making objections and lodging complaints, respectively.
Conclusion: The results of this study showed that patients are not well aware of patients' rights and that observation of patient's rights is not at a desirable level. We recommend organizing public educational programs including components on patients' rights and follow-up of patient' rights violations, as well as passing a comprehensive act to ensure observation of patients' rights and specific programs designed for monitoring and supervising it.
Marzieh Javadi, Saeed Karimi, Ahmadreza Raiesi, Maryam Yaghoubi, Asadollah Shams, Maryam Kadkhodaie,
Volume 9, Issue 4 (3-2012)
Abstract
Background and Aim: Responsiveness is of extreme importance in every health system, especially for policy-makers and health managers. Responsiveness relates to how the health system responds to legitimate expectations of the patients regarding non-clinical aspects of health care. Furthermore, justice in an organization requires fair treatment of the patients on the part of the health personnel. In other words, organizational justice relates to how to treat the personnel so that they feel they are treated fairly. The objective of this study was to investigate the responsiveness of hospital as perceived by patients and nurses and the relationship between the responsiveness rate and organizational justice as perceived by nurses in the hospitals.
Materials and Methods: This was a descriptive-analytical study aiming at determining the correlation between responsiveness and organizational justice in 8 elected hospitals (4 private and 4 public) in Isfahan, Iran. The study population was patients and nurses. A total of 320 individuals (160 patients and 160 nurses), selected by stratified random sampling, participated in this study. Two questionnaires, namely the adjusted WHO Responsiveness Questionnaire (for patients and nurses) and the Equity Questionnaire (for nurses), the validity and reliability of both of which had been determined, were used to collect data. The software used for data analysis was SPSS
Results: The overall score (out of 4) of organizational justice was 1.9 0.77, while the mean score of responsiveness as perceived by the nurses and the patients was 2.32 0.54 and 2.48 0.58, respectively. There was no statistically significant difference between the 2 groups with regard to responsiveness, but there was a positive association between responsiveness and organizational justice as perceived by nurses (r = 0.2, p = 0.03).
Conclusion: The variables in the hospitals studied are generally at an intermediate level and there are no statistically significant differences between private and public hospitals. There is no difference in organizational justice between private and public hospitals, but responsiveness is higher in private hospitals as compared to public ones. Thus, the public sector needs to attempt to create more incentives in health professionals in the health sector in order to guarantee higher-quality services and better responsiveness.
Roghayeh Abedini, Alireza Choobineh, Jafar Hassanzadeh,
Volume 10, Issue 3 (1-2013)
Abstract
Background and aims: Work-related musculoskeletal disorders (WMSDs) are a serious problem among the nursing staff. Manual patient-handling tasks, such as lifting, transferring, and repositioning patients, are the major causes of WMSDs among nursing staff. The objective of the present study was risk assessment of musculoskeletal disorders during patient transfers by the movement-and-assistance-of-hospital patient (MAPO) technique among hospital nursing staff of Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.
Materials and Methods: This cross-sectional study included 400 randomly selected nurses from 75 wards in 11 hospitals in Shiraz. Data were collected using demographic and Nordic Musculoskeletal Disorders Questionnaires and the MAPO index checklist. Statistical analysis was performed using SPSS version 16.
Results: The means of age and job tenure of the subjects were 30.76±6.44 and 6.92±5.75 years, respectively. The 12-month prevalence of musculoskeletal disorders was 88.2%. The results of assessment by the MAPO index revealed that more than 83% of the subjects were at risk, 20.5% of them exposed to high risk. Further analysis of the data indicated that the musculoskeletal disorders occurrence was significantly associated with the MAPO index score (p<0.05).
Conclusion: Work-related musculoskeletal disorders were found to be associated with the MAPO index. Therefore, MAPO is an appropriate tool for musculoskeletal disorders risk identification and assessment due to patient handling in the nursing personnel. In any attempt to improve the working conditions, patient transfer aids, environmental factors, and proper training should be taken into consideration.
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.
Maryam Tajvar, Alimohammad Mosadeghrad, Mehdi Yaseri, Maria Mohammadi,
Volume 17, Issue 4 (3-2020)
Abstract
Background and Aim: Iran is experiencing a very fast population ageing, ranking 3rd globally in terms of pace of population ageing. The increase in the elderly population has been accompanied by an increase in demand for health services. A knowledge and understanding of the utilization of health services by the elderly are essential for resource allocation and health planning. This study aimed to investigate the utilization of in-patient services by the Iranian elderly and explore its determinants.
Materials and Methods: This study was a secondary analysis of the data of a cross-sectional National Study on the Utilization of Health Services in Iran, including 22470 households across the country. The study population was people aged 60 years and over, the sample size being 8205 individuals selected by stratified random sampling from provinces, towns and villages. A questionnaire was used to collect information on the need of the individuals to hospitalized services during the last one year and receiving the required services and analyzed using multilevel logistic regression to identify the factors related to the utilization of inpatient health services.
Results: Of the 8205 participants, 1411 (17%) reported that they needed in-patient services at least once during the previous year, about 93% of whom referred to a hospital, of whom about 1288 (97%) finally had finally received the required services. The factors related to inpatient service utilization were age (p=0.03) and having insurance status (p<0.001), such that the older individuals and those with no insurance, although they had higher inpatient service needs, received less services. The most important cause of dissatisfaction in the towns was related to the behavior of nurses and non-physician personnel and in villages long waiting time for receiving a service. Finally, the most important causes being not willing to be hospitalized were the high service cost and no health insurance coverage.
Conclusion: The older people and those with no insurance should be priority groups in health service utilization policy-making and planning, so that they can access and receive better services. The causes of low inpatient service utilization and dissatisfaction should be taken into consideration seriously by health service providers and managers.
Mir Masoud Fatemi, Mohammad Kharrazi Afra,
Volume 17, Issue 4 (3-2020)
Abstract
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.
Farahnaz Mohammadi-Shahboulaghi, Tahereh Ramezani, Dariush Panahizadeh, Sholeh Hazarian, Reza Fadayevatan,
Volume 19, Issue 4 (3-2022)
Abstract
Background and Aim: Delivering health services to the elderly is one of the most important responsibilities of the health care system of any country. In order to improve the provision of health services to the elderly population under its coverage, the National Social Security Organization conducted this study with the aim of designing, implementing and evaluating a model for providing outpatient health care services to the elderly population under the coverage of its Tehran Province Office.
Materials and Methods: This was a sequential-exploratory mixed-method study. The initial model was developed and validated using the integrated review method and the final model using the Delphi technique and group discussions with experts. Then the educational program was developed and implemented for the health team. Assessment of the effectiveness of the program was done using a researcher-made knowledge and attitude questionnaire (pre- and post-test). The model was then implemented in the Khandan-e-Hakim Clinic. The effectiveness of the model implementation was determined based on the qualitative content analysis of the interviews with the elderly and qualitative content analysis of the health team comments.
Results: The outpatient care model of the elderly included an organized clinical process consisting of 6 phases. The mean age of the health team members was 45.7±15.11 years. The difference between the health team satisfaction total scores before and after participating in the educational program was statistically significant (P≤0.05). Further analysis of the data showed, based on the interviews with the elderly, the main categories to be "assessment of cognitive function, mood and behavior", "physical assessment", "appreciation of the health and dignity of the elderly" and "satisfaction of the elderly and their companions". Analysis of the comments of the health team revealed their satisfaction with the implementation of the model.
Conclusion: The introduced model can make possible rapid identification of health problems and timely intervention in the elderly population. This implementation model will help disease prevention and complications at different levels. The findings of this study can help service providers to provide better care and health services for the elderly.
