Tehran University Medical Journal

Background: Iron deficiency in the body is the main cause of anemia, and iron supplementation is probably the best option for iron deficiency and iron deficiency anemia in women and young children. This study aimed to explain the challenges of national iron supplementation in female school’s base on the perspective of the stakeholders.
Methods: This study was a qualitative study of content analysis. The data of this study were conducted by focus group discussion, semi-deep interviews with the participation of the target community of students, parents of students, school principals and school health instructors, general manager of the Office of Community Nutrition (Department of Education) includes manager, deputy and school health officer, from October 2016 to January 2017 in city of Gonabad, Iran. Participants were selected through targeted sampling and data collection continued to saturation. Data were analyzed using contractual content analysis method based on five steps of Graneheim and Lundman. Data management was done with NVivo software, version 11 (QSR International, Victoria, Australia), but data analysis and interpretation were done manually.
Results: The findings from group discussions and semi-deep interviews with stakeholders were categorized into twelve themes. The main strength, perceived in "Perceived Individual Benefits" and "Perceived Executive or Management Benefits". The main perceived weakness was "Physical Disadvantages", "Tablets Disadvantages", "Disadvantages of Programming" and "Disadvantages of the Program". The main perceived barriers was "Educational and Information Barriers", "Barriers of Pill Consumption" and "Management and Administrative Barriers". "Modifying the Executive Program", "Individual Perception Modification" and "Reform the Shape of Pills" were suggested as a corrective mechanism from participants’ view point.
Conclusion: According to the results of this study, the most important challenges of the "Schools Iron Aid National Plan" were "Educational and Information Barriers", "Administrative barriers", and "Barriers to Pill Consumption". Therefore, in order to do better, the Iron Supplementation Program requires intervention at individual, interpersonal, inter-organizational, and intra-organizational levels to provide comprehensive support for the program and, ultimately, increase program productivity.

Background: Currently many hospitals around the country face increasing demands of their patients and readmission.The rate of readmission is a useful indicator for determining the performance of healthcare system and it shows the quality of services in the medical institutions. Readmissions have high economic, social and financial impact and studying the related factors seems to be high priority for healthcare systems.
Methods: This qualitative study performed by phenomenological method in three educational hospitals in Kerman from April to September of 2017. Data collection was performed through semi-structured interviews using targeted sampling among all patients who were hospitalized at internal medicine wards, nurses who were working in those wards, and in charge physicians. In total twenty patients, fifteen nurses, and five physicians were selected for interviews. The including criteria were for patients, the history of hospitalization at least once, during one month after the initial hospitalization, and for service providers, familiarity with the subject, work experience in the relevant department of at least three years for nurses and five years for physicians. A seven-step clustering method was used to analyze the data.
Results: The analysis of the interviews led to the identification of three main themes and 11 sub-themes. The main themes included patients' characteristics, manpower and clinical factors, hospital, and environmental factors. Some of the sub-codes included economic and living conditions, marriage status, insurance coverage, patients' beliefs and expectations, the presence or absence of underlying disease, education, lifestyle habits, dietary beliefs of hospitalized patients, lack of trust in medical staff, communication and cultural barriers, ignorance of service providers in treatment, lack of facilities, lack of motivation in medical staff, stressors and finally lack of hospital equipment.

Background: Health insurance literacy is a nascent concept that has emerged mainly after the implementation of the law known as Obamacare in the United States. This study seeks to identify the themes of health insurance literacy in Iranian society.
Methods: The study approach is qualitative. Data were collected using nine semi-structured interviews, ten focal group meetings with the presence of 86 experts of an insurance organization and a specialized meeting with fifteen academic experts, from September to December 2018 at the organization's location. MAX QDA10 software was used to organize the data. Qualitative data analysis was performed using continuous comparison analysis and in the form of directional qualitative content analysis based on the conceptual model (Paez et al 2014). Coding was performed independently by two researchers and then collected. Results were reviewed by an external observer. Finally, in a specialized meeting with the participation of representatives of specialized (groups secretaries) and academic experts(participants in the initial interviews), the findings of the study were re-examined and confirmed