Mostafa Ghanei; Seyed Hassan Saadat; Alireza Najimi-Varzaneh; Mohammad Gholami Fesharaki
Volume 26, Issue 1 , 2024
Abstract
Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence ...
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Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence in-hospital death due to COVID-19 disease in iranian patients.Evidence Acquisition: Articles were identified through iranian searching databases including Health.barakatkns, IranDoc, SID, Civilica and MagIran and international searching databases including Scopus, Web of Science, PubMed and Elsevier . Additional search was also done by Google Scholar search engine. We reviewed systematically all studies reporting the prevalence of in-hospital death due to COVID-19 disease. In this study meta-analysis method with random effect model has been used to estimate the pooled in-hospital death.Results: 118 records were identified by the electronic search, of which 43 studies were identified as relevant documents that were meta-analyzed for the pooled in-hospital death due to COVID-19 prevalence. Overall, prevalence of death were 12.16% (95% CI: 10.72%-13.61%). The highest and lowest death prevalence has been reported in Northern Provinces (Gilan, 27.27% (95% CI: 8.66%-45.88%) and Mazandaran, 21.27% (95% CI: 18.14%-24.40%)) and Turkish-speaking provinces (Azerbaijan, East, 3.29% (95% CI: 2.11%-4.47%) and Zanjan, 3.42% (95% CI: 1.82%-5.02%)) respectively.Conclusions: Considering the death rate obtained in this study and its comparison with other countries, it can be said that the performance of the Iranian medical system in COVID-19 pandemic is acceptable.
Moslem Taheri Soodejani; Ali Karamoozian; Seyed Jalaleddin Mousavirad; Seyyed Mohammad Tabatabaei
Volume 26, Issue 1 , 2024
Abstract
Background: This study investigated the influence of age, gender and geographical region on the incidence of four types of injuries among pedestrians, cyclists, motorcyclists and motor vehicle drivers in Iran. The geographical correlation between the different provinces of the country was also examined.
Objectives: ...
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Background: This study investigated the influence of age, gender and geographical region on the incidence of four types of injuries among pedestrians, cyclists, motorcyclists and motor vehicle drivers in Iran. The geographical correlation between the different provinces of the country was also examined.
Objectives: The present study aimed to investigate 4 common type of road traffic injuries by provinces in Iran.
Methods: The data was taken from the Global Burden of Disease (GBD) study. The data were analyzed in terms of age group, gender and type of injury in different provinces, and the effect of geographical region on the incidence of RTIs were investigated through a multilevel analysis. Provinces were included in the model as random intercepts, and Moran's I test was used to examine geographic correlation and identify hot spots and cold spots. A significance level of 5% was used for all tests.
Results: Elderly people were the main victims of pedestrian accidents, and young people were most frequently injured in cycling accidents. On the other hand, adults were the most frequently injured age group in motor vehicle accidents. Men were injured more often than women in all four types of injury. Although the injuries were not related to the province where the accident occurred, the geographical distribution of injuries caused by cyclists showed a geographical correlation, with Sistan and Baluchistan (southeast) and Tehran (the capital) being the areas with the highest and lowest risk of these types of injuries, respectively.
Conclusion: According to the results of this study, the causes of different types of road traffic injuries are very different for different age groups, genders and geographical areas. Therefore, different plans should be developed for each type of injury in order to prevent road traffic accidents.
Sadegh kazemi; Mehdi Mokhtari; Aliakbar Vaezi; Ibrahim Salmani; Mohammad Hassan Ehrampoush; Hossien Fallahzadeh; Abbas Ali Dehghani Tafti
Volume 25, Issue 12 , 2023
Abstract
Introduction: Managing the challenges of healthcare waste produced after the earthquake is a vital issue. This study aimed to provide a comprehensive management plan for healthcare waste in Kermanshah and Varzaqan-Ahar earthquakes using two models: Strengths, Weaknesses, Opportunities, and Threats (SWOT) ...
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Introduction: Managing the challenges of healthcare waste produced after the earthquake is a vital issue. This study aimed to provide a comprehensive management plan for healthcare waste in Kermanshah and Varzaqan-Ahar earthquakes using two models: Strengths, Weaknesses, Opportunities, and Threats (SWOT) and Quantitative Strategic Planning Matrix (QSPM).
Materials and Methods: The present qualitative study was conducted through a content analysis approach using semi-structured interviews and a purposive selection of 16 experienced experts and managers in the field of healthcare waste management in an earthquake in 2021-2022. After recording and transcribing data, data analysis was done in MAXQDA software (version 18). Lincoln and Goba criteria were used to check the reliability of the data. The statements (strengths, weaknesses, opportunities, and threats of waste management) were summarized for each main category in the SWOT classification. Strategies for improving healthcare waste management were presented by comparing internal and external factors. Finally, the attractiveness table was compiled and weighted using the QSPM method for prioritizing strategies.
Results: The study found 18 strengths, 24 weaknesses, 18 opportunities, and 19 threats. The final scores for internal and external factors of healthcare waste management in earthquakes were 2.38 and 2.3, respectively. A total of 12 strategies were developed based on the findings. Finally, the strategy of "optimal use of the opinions provided by managers, researchers, and experts interested in the field of waste management for the development of guidelines and national regulations for the management of healthcare waste in an earthquake" was prioritized to be implemented based on the QSPM matrix.
Conclusion: The strategic priorities identified in this study are important steps towards achieving sustainable development goals and protecting public health and the environment in disaster situations. Moreover, using QSPM and SWOT models helps to provide appropriate solutions for improving the management of healthcare waste in earthquakes.
Parvin Mansouri; Mohammadreza Rahbar; Mohammad Ali Nilforouszadeh; Mohsen Shati
Volume 25, Issue 9 , 2023
Abstract
Background: Vitiligo is a common chronic disease associated with physical effects, psychological impacts, and impaired quality of life (QoL). Lesions in acral areas are resistant to treatments. Since these areas are exposed and visible, they have a profound effect on patients' self-confidence. Despite ...
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Background: Vitiligo is a common chronic disease associated with physical effects, psychological impacts, and impaired quality of life (QoL). Lesions in acral areas are resistant to treatments. Since these areas are exposed and visible, they have a profound effect on patients' self-confidence. Despite the high prevalence of these conditions, information in this field, especially for Iranian patients, is scarce.Objectives: To study the clinical profile of patients with vitiligo lesions in the acral areas, assess the burden of QoL impairment, and investigate the association between patient's characteristics and their QoL outcomesMethods: A total of 84 patients with non-segmental vitiligo who had involvement in resistant treatment areas were recruited in this study. Clinical characteristics and disease outcomes, with a special emphasis on the quality of life (QoL), were investigated using the Dermatology Life Quality Index (DLQI) questionnaire. Furthermore, the extent of the disease was calculated by utilizing the Vitiligo Area Scoring Index (VASI). Descriptive and comparative analyses were conducted using SPSS software (version 29).Results: The most common comorbidity observed among the patients was various types of immune diseases. The mean total score of DLQI was 8.1, indicating a moderate effect of the disease on the patient's life since the score falls within the range of 6-10. The Kruskal-Wallis non-parametric test illustrated a significant difference in QoL among different age groups (P=0.020). The results indicated a positive, direct, and significant relationship between the extent of the disease and DLQI (r=0.269,;P=0.013). Nonetheless, the relationship between the engagement of the genital area in married patients and difficulties in sexual relations was not found to be statistically significant at ?=0.05.Conclusion: The involvement of end-extremities based on existing studies is a frequent occurrence in vitiligo. These affected areas hold considerable significance in terms of the patient's quality of life (QoL) due to their prominent visibility and resistance to available treatments. Considering the high prevalence of psychological consequences, diversity in skin phototypes, and social acceptance, regional studies are necessary for more efficient and responsive medical management integrated with psychosocial assistance.
Heshmatollah Asadi; Mehdi Khakian; Hossein Safari Palangi; Fariba Hosseinpour; Pirhossein Kolivand; Khalil Alimohammadzadeh; Maryam Azadi
Volume 25, Issue 7 , 2023
Abstract
Background: Population has long been known as the most important pillar of governments and societies. However, in recent years, the rate of infertility is increasing rapidly due to various reasons.
Objectives: This study aimed to identify the factors and challenges affecting the implementation of insurance ...
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Background: Population has long been known as the most important pillar of governments and societies. However, in recent years, the rate of infertility is increasing rapidly due to various reasons.
Objectives: This study aimed to identify the factors and challenges affecting the implementation of insurance coverage program for infertility services in Iran for the policymakers and implementers of the program. Accordingly, the correct implementation of this program provides the possibility for infertile couples to benefit from the services of this program.
Methods: This qualitative study was conducted in 2022. Purposive sampling was used for selecting a total of 20 Iranian scientific and executive experts of health system with work experience, especially in the field of infertility. The interviews were conducted in a semi-structured manner and analyzed using the content analysis method and MAXQDA 2020 software.
Results: The results showed that the challenges of this program include 6 main themes along with 39 sub-themes. The main themes are challenges of upstream laws and legal requirements; provision of health services; human resources; the service package and its pricing; financial issues, budgets, and methods of service cost reimbursement; and information technology challenges.
Conclusion: Although the service package is defined and announced, the implementation of this plan faces many challenges due to not taking into account the implementation conditions and requirements. By examining the problems of infertility insurance coverage, the present study provides a comprehensive and practical picture of these problems. Accordingly, the factors that can make the program successful in the future consist of inclusion of a part of the services related to infertility treatment in the package of insurance services, the awareness of managers and policy makers about the challenges of implementing this program, providing financial, electronic, and human resources needed by the program, and development and modification of standards of the program.
Matin Ghazizadeh; Fatemeh Hadavandsiri; Maryam Ghazizadeh; Mohammad Esmaeel Akbari
Volume 25, Issue 5 , 2023
Abstract
Background: Cancer is a leading cause of death in the 21st century. Sinonasal malignancies comprise less than 0.5% of all cancers. There are limited epidemiologic studies on them.
Objectives: The current study aimed to estimate the patient demographics, as well as the incidence rates of nasal cavity ...
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Background: Cancer is a leading cause of death in the 21st century. Sinonasal malignancies comprise less than 0.5% of all cancers. There are limited epidemiologic studies on them.
Objectives: The current study aimed to estimate the patient demographics, as well as the incidence rates of nasal cavity and paranasal sinuses (NC-PNS) cancers, using a population based registry.
Methods: The current study was a descriptive cohort using the Iranian national population based cancer registry (INPCR) data in 2016. The incidence rate of NC-PNS cancer and its distribution considering age, gender, geographical location and histopathology were determined.
Results: A total of 258 cases (62.4 % males) were included in the study. Age standardized incidence rate (ASIR) of NC-PNS cancer was 0.36 per 100,000 population. ASIR had the highest value in the 7th, 8th, and 6th decades of life, in descending order. Squamous cell carcinoma (SCC) was the most common histopathologic subtype (23.64%). The most frequent non-epithelial cancer were hematopoietic and lymphatic malignancies (12.40%). The most prevalent site of involvement was the nasal cavity (43.02%), followed by the maxillary sinus (24.81%). The geographical distribution of NC-PNS cancer did not follow any particular pattern. The highest crude incidences were detected in Chahar-Mahal-Bakhtiari, Kerman, and West Azarbaijan in decreasing order.
Conclusion: As evidenced by the obtained results, NC-PNS cancers are rare malignancies. Men in their fifties and older are at a higher risk of involvement. Epithelial cancers are more prevalent, among which SCC is the most common histopathologic subtype.
Reza Ghanei Gheshlagh; Mahdie Ghalenoee; Hamid Sharif Nia; Abbas Ebadi; Naser Parizad
Volume 24, Issue 12 , 2022
Abstract
Background: Self-care during Coronavirus Disease 2019 (COVID-19) helps people follow self-care strategies to reduce the spread of the virus. To control the disease, people need to engage in self-care behaviors, which should be investigated by a valid and reliable instrument to yield valid and credible ...
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Background: Self-care during Coronavirus Disease 2019 (COVID-19) helps people follow self-care strategies to reduce the spread of the virus. To control the disease, people need to engage in self-care behaviors, which should be investigated by a valid and reliable instrument to yield valid and credible results.
Objectives: This study aimed to validate the Persian version of the Self-Care in COVID-19 Scale (SCOVID Scale).
Methods: The sample included 582 participants from Tehrans general population, selected through convenience sampling in 2021. They were divided into two groups, one for exploratory factor analysis (EFA) and the other for confirmatory factor analysis (CFA). Cronbachs alpha coefficient and McDonalds omega were used to assess the internal consistency. Standard error of measurement and the interclass correlation coefficient were also employed to examine absolute and relative stability, respectively.
Results: In the EFA, three factors, including Precaution, Routine Activities, and Lifestyle, were extracted, explaining 32.31% of the total variance in COVID-19 self-care. Internal consistency of the whole scale using both Cronbachs alpha coefficient and McDonalds omega was above 0.7. The goodness of fit indices of the second-order CFA were in the acceptable range (x2=262.365, df=82, P<0.001, RMSEA=0.062, PCFI=0.725, PNFI=0.703, IFI=0.930, and the CFI=0.929).
Conclusion: The Persian version of the SCOVID Scale is a valid and reliable instrument that can be used in studies on COVID-19.
Nesa Cheraghbeigi; Somaieh Bosak; Mehdi Sayyah; Erfan Javanmardi; Dariosh Rokhafrooz
Volume 24, Issue 11 , 2022
Abstract
Background: Specific conditions arising from the COVID-19 pandemic may affect the mental health of nursing students.
Objectives: This study aimed to investigate the mental health of nursing students and associated factors during the COVID-19 pandemic at Ahvaz and Kermanshah Universities of Medical Sciences ...
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Background: Specific conditions arising from the COVID-19 pandemic may affect the mental health of nursing students.
Objectives: This study aimed to investigate the mental health of nursing students and associated factors during the COVID-19 pandemic at Ahvaz and Kermanshah Universities of Medical Sciences in Iran.
Methods: This cross-sectional study was conducted on 384 nursing students at Ahvaz and Kermanshah Universities of Medical Sciences in Iran from May 10, 2021, to June 26, 2021. The required data were collected using a web-based questionnaire via social networks, such as WhatsApp and Telegram. Symptom Checklist-25 (SCL-25) was used to measure mental health. Descriptive statistics and stepwise linear regression were used to analyze the data.
Results: The mean total mental health score was 47.48±16.03, and 235 (61.0%) students had good mental health, 124 (32.2%) cases had suspected mental disorders, and 26 (6.8%) respondents had severe mental disorders. Using the stepwise regression method, four variables, including gender, history of mental illness, history of coronavirus infection or being suspected of having coronavirus, and level of trust in statistics about the incidence and mortality rate of COVID-19 had the greatest impact on mental health modeling.
Conclusion: In general, the COVID-19 pandemic may have a negative impact on the mental health of nursing students. Therefore, it is very important to identify and consider the factors that can reduce their mental distress.
Fatemeh Tajari; Ghahraman Mahmoudi; Fatemeh Dabbaghi; Jamshid Yazdani-Charati
Volume 24, Issue 8 , 2022
Abstract
Background: Electronic referral system (e-Referral system) in Iran was launched to increase access to care and improve interaction.
Objectives: The present study aimed to design an appropriate model for evaluating the performance of the e-Referral system in Iran.
Methods: This study was conducted in ...
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Background: Electronic referral system (e-Referral system) in Iran was launched to increase access to care and improve interaction.
Objectives: The present study aimed to design an appropriate model for evaluating the performance of the e-Referral system in Iran.
Methods: This study was conducted in three stages: 1) review of literature related to electronic referral systems, 2) qualitative phase, and 3) quantitative phase. Participants in the qualitative phase included 42 managers, policymakers of the Ministry of Health, medical universities, service providers, and recipients who were purposively selected for this study. Data were analyzed through content analysis. In the quantitative phase, the target group consisted of 604 staff of medical universities implementing the e-Referral system. Data were analyzed using the EQS (version 6.3) and SPSS (version 20) software. Chi-square test, degree of freedom, the goodness of fit index, root mean square error, adjusted goodness of fit index, and the Friedman test were used to investigate the suitability of the model.
Results: Fourteen main themes were identified and classified for the model design Based on the results of the present study. The components of developing rules and regulations, stakeholder advocacy, economic evaluation, and quality of health services had average ratings of 13.99, 13.00, and 11.35, respectively, regarding their role in designing the evaluation model for the e-Referral system in Iran.
Conclusion: The results of structural equation modeling showed that the components play an essential role in designing the performance evaluation model of e-Referral in the Iranian health system. This study addressed various aspects affecting the e-Referral and provided the possibility of performance evaluation in the health sector in a principled and systematic format. Health managers and policymakers can use the present study findings to discover the strengths and weaknesses of the e-Referral performance.
Samira Mohajer; Li Yoong Tang; Mei Chan Chong; Mahmoud Danaee; Seyyed Reza Mazlum; Nasser Bagheri
Volume 23, Issue 12 , 2021
Abstract
Background: Professional self-concept (PSC) is an important issue concerning the nursing profession and is reflected as the key concept in nursing professionalism. Although previous studies investigated this concept and its related factors among nursing students, their results showed no consensus.
Objectives: ...
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Background: Professional self-concept (PSC) is an important issue concerning the nursing profession and is reflected as the key concept in nursing professionalism. Although previous studies investigated this concept and its related factors among nursing students, their results showed no consensus.
Objectives: This study aimed to assess PSCs among senior nursing students and examine their relationship with gender and Grade Point Average (GPA).
Methods: This cross-sectional study included 157 nursing students selected by a convenience sampling among senior nursing students in the seventh semester in January 2020 at Mashhad University of Medical Sciences, Mashhad, Iran. The data were collected using Cowin's 36-item Nursing Professional Self-Concept questionnaire, which measures nursing self-concept in six dimensions.
Results: Undergraduate nursing students were 22-24 years old (22.58±98). Moreover, two-thirds of the students were female (66%) and married (71%). The nursing students reported a total mean score of PSC to be 161.1±3.27. The highest mean score of the PSC dimensions belonged to communication (27.7±1.17), and the lowest mean score was observed for self-esteem (25.52±1.06). In addition, there was no significant difference among gender, total PSC, and its dimensions, and there was no relationship with GPA, except for the staff relations (r=-0.198, P<0.05) and leadership (r=-0.210, P<0.05), which showed a negative and significant correlation; however, the correlation coefficients were not strong (P<0.3).
Conclusion: Due to a moderate level of total PSC and the lowest dimensions in self-esteem among nursing students, it is recommended that nursing students' PSC and its dimensions, specifically in self-esteem, be taken into account, which can boost their nursing professionalism.
Alireza Molaei; Mohammad Gholami Fesharaki
Volume 23, Issue 11 , 2021
Abstract
Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) ...
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Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) was estimated by multilevel poison regression method and then this estimation was compared to the historical trends to obtain total deaths related to COVID-19. Additionally, the geographic distribution of EMR has also been presented for Iran.
Methods: All-cause mortality rates of each province of Iran from March 21, 2013 to September 22, 2021 was downloaded from National Organization for Civil Registration (NOCR). The data of COVID-19 pandemic period (spring 1399 SH (Mar 20, 2020) to summer 1400 SH (Sep 22, 2021)) was removed from the data and then the multilevel poison model was applied to estimate all-cause mortality in this period. Then, EMR= (real deaths-expected death)/(real deaths) ratio was calculated.
Results: The results of this study showed that Irans EMR in COVID-19 pandemic was 36% (Male=35%, Female=36%, P-value=0.798). Our findings also revealed four category of EMR including low (EMR?30%, n=9), moderate (30 %< EMR?35%, n=8), high (35 %< EMR?40%, n=10) and very high (40 %< EMR, n=4) in different provinces.
Conclusion: Due to the diverse EMR in different provinces of Iran, the type of disease management of provinces with low and moderate EMR can be used as an appropriate model to control EMR in provinces with high and very high EMR.
Alireza Ahmadi; Soroush Ardeshiri; Vahid Rajab Nezhadi; Aida Pajoohesh; Touba Narimani Moghadam; Mohamad Sabaghan; Jaffar Fatahi Asl; Javad Zarei; Kambiz Ahmadi Angali
Volume 23, Issue 9 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) has become a global health challenge with high transmission and mortality rates.
Objectives: This study aimed to identify the risk factors for mortality in hospitalized patients with COVID-19 in Behbahan, Southwestern of Iran.
Methods: In this cross-sectional ...
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Background: Coronavirus disease 2019 (COVID-19) has become a global health challenge with high transmission and mortality rates.
Objectives: This study aimed to identify the risk factors for mortality in hospitalized patients with COVID-19 in Behbahan, Southwestern of Iran.
Methods: In this cross-sectional study, information of 800 patients with COVID-19 admitted to Shahidzadeh Hospital in Behbahan, Southwest of Iran, were investigated from March 20, 2020, to January 20, 2021. Subsequently, the demographic characteristics, clinical symptoms, vital signs, pharmacotherapy, laboratory findings, and the patients' underlying diseases were extracted from their medical records. Multivariable Cox regression with proportional hazard assumption was used to investigate the risk factors of death.
Results: The present study included 800 patients with COVID-19 with a mean age of 57.51±16.83 years at the time of diagnosis. Overall, 447 (55.8%) male and 353 (44.1%) female patients were included in this study, respectively. Among the total patients, 116 (14.5%) and 684 (85.5%) cases died and recovered, respectively. Based on the multivariable Cox regression analysis, age (HR=1.04; 95% CI: 1.03-1.05; P<0.001), cardiovascular diseases (HR=2.46; 95% CI: 1.63- 3.70; P<0.001), and renal failure (HR=2.77; 95% CI: 1.43- 534; P<0.001) were found to be associated with the death hazard in patients with COVID-19.
Conclusion: According to the findings of this study, the patient's age at the time of diagnosis, cardiovascular diseases, and renal failure were indicated to be the risk factors of high mortality rate in patients with COVID-19. Identification of these risk factors can be helpful in the timely intervention of patients at high risk of death for health care providers.
Nahid Hatam; Yegane Partovi; Seyed Reza Najibi; Milad Ahmadi Marzaleh; Seyede Maryam Najibi
Volume 23, Issue 7 , 2021
Abstract
Background and objective: Universal health coverage is considered a prerequisite for human health and security. Therefore, the current study aimed to evaluate and compare the healthcare system functions in Iran with those in successful developing countries in terms of universal health coverage (UHC).
Methods: ...
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Background and objective: Universal health coverage is considered a prerequisite for human health and security. Therefore, the current study aimed to evaluate and compare the healthcare system functions in Iran with those in successful developing countries in terms of universal health coverage (UHC).
Methods: In this comparative study, three developing countries, namely Turkey, Thailand, and China, were selected based on former studies, and the model presented by the World Health Organization in 2000 was used to compare and analyze the data. The required information from the selected countries was collected through searching the Pub Med and Scopus databases using the following keywords: "Health system review", "Health system transition", "International profiles of healthcare systems", "Financing", "Resource generation", "Service provision", "Universal health coverage", and "Health system reform".
Results: The evaluation of the healthcare system's function in four countries showed that the public sector's share of total health spending was much higher than the private sector in both Thailand and Turkey. The issues of integration of insurance funds and risk accumulation and the existence of a strong buyer organization should be considered. The comparison of the payment system in the studied countries showed that the per capita method was used in all primary cares, and the inpatient diagnostic group (diagnosis-related group), fee for service, and salaries and rewards were more focused in the context of hospitalization. The majority of hospitals in the studied countries were state-owned; however, the important point was the presence of different non-university public hospitals in these countries, compared to Iran.
Conclusion: In general, one way to reach the UHC is to utilize the experiences of successful countries in establishing and maintaining this issue.
Simintaj Sharififar; Maryam Moradi; Milad Ahmadi Marzaleh
Volume 23, Issue 5 , 2021
Abstract
Background: The illness caused by the novel coronavirus is an emerging disease, and for this reason, the international community is encountered with its unknown nature, such as clinical features, treatments, and long-term complications. Experience suggests that humans are affected by the psychological ...
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Background: The illness caused by the novel coronavirus is an emerging disease, and for this reason, the international community is encountered with its unknown nature, such as clinical features, treatments, and long-term complications. Experience suggests that humans are affected by the psychological and social effects of epidemics and pandemics of infectious diseases. Accordingly, it is a new experience to care for patients with this disease that has to be more explored. The present study aimed to detect the challenges with which nurses are faced in the process of caring for patients with coronavirus disease 2019 (COVID-19) in Iran using a qualitative method.
Methods: This qualitative study utilized in-depth semi-structured interviews with 19 key informants selected via targeted sampling. The obtained data were analyzed by thematic analysis to identify the challenges to which the nurses have encountered in the process of caring for patients with COVID-19 in Iran.
Results: Challenges of the nurses in the caring process for patients with COVID-19 are listed in five categories of stress and psychological issues, equipment-related challenges, increased events of errors, medication and treatment problems, and hospital management. It should be mentioned that at the same time, 35 other subcategories were also identified in this study.
Conclusion: Since nurses are at the forefront in fighting the COVID-19, there must be plans to increase their preparedness. Deficiencies in health systems, including equipment, medicine, and personal protective gear should also be addressed so that nurses can better respond to these incidents. Psychological and mental support is a key component of the nurses appropriate response; therefore, along with nurses' responses, individuals, groups, and family psychological supports should be facilitated to increase performance and effectiveness in response to COVID-19.
najmeh khodadadi; aidin aryankhesal; MohammadReza Maleki
Volume 23, Issue 4 , 2021
Abstract
Background: The existence of partnerships between the health system and other organizations, especially city councils and municipalities, which have inherent and legal duties in this regard, is of particular importance in the promotion of public health.
Objectives: The present study aimed to assess ...
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Background: The existence of partnerships between the health system and other organizations, especially city councils and municipalities, which have inherent and legal duties in this regard, is of particular importance in the promotion of public health.
Objectives: The present study aimed to assess the status of Health System cooperation with City councils and municipalities in Iran based on rules and documents.
Methods: Altheides document analysis model (sample selection, data collection, data organization, data analysis, and reporting) was used to prepare and analyze the documents pertaining to the status of Health System cooperation with city councils and municipalities. The documents were classified at three levels of national rules, policies, and guidelines; Ministry of Health (MOH) and city council approvals; and eventually Tehran municipalitys measures.
Results: A total of 78 documents were analyzed, including 17 documents at the level of national rules, policies, and guidelines; 8 documents at the level of Ministry of Health and city council approvals; and 53 documents at the level of municipalitys measures.
Conclusion: There are adequate legal capacities for designing, planning, executing, as well as creating interaction and cooperation between the health system and other organizations, especially city councils and municipalities. Moreover, the motives behind creating purposeful and scheduled cooperation and participation are evident among the officials of the health system and city councils and municipalities. Some mechanisms have been established for cross-sectoral cooperation between the health system and other health-related bodies. Nonetheless, these structures lack the necessary competence, appropriateness, and adequacy to create the desired partnership. Moreover, sufficient attention is not devoted to existing capacities in municipalities and the city council. Accordingly, it is necessary to have a fundamental review on the available structures and enough attention has to be paid to the evident and hidden legal capacities in city councils and municipalities, as well as the Ministry of Health, to design an appropriate structure, create competent interaction, and provide more cooperation between the two organizations.
Ahmad Soltani; Farshid Alaedini; Navvab Shamspour; Milad Ahmadi Marzaleh
Volume 23, Issue 1 , 2021
Abstract
Background: Iran is a disaster-prone country, which is subjected to various hazards, such as floods, earthquakes, fire, and traffic accidents.
Objectives: This study aimed to determine the priority and risk of various hazards threatening the public in different provinces of Iran in 2019.
Methods: This ...
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Background: Iran is a disaster-prone country, which is subjected to various hazards, such as floods, earthquakes, fire, and traffic accidents.
Objectives: This study aimed to determine the priority and risk of various hazards threatening the public in different provinces of Iran in 2019.
Methods: This cross-sectional study was carried out from March to September 2019 using data related to 31 provinces of Iran. The assessment was conducted using hazard assessment tools presented by the Iranian Ministry of Health. A total of 70 natural, man-made, and complex hazards were analyzed in this study. The data were collected by holding sessions and conducting individual and group interviews with the officials of provincial Red Crescent Societies as well as reviewing the databases of the Red Crescent Society and the Disaster Management Organization. The participants consisted of operation analysis experts.
Results: In terms of the frequency of occurrence, earthquake (12: 38.7%), traffic accidents (7: 22.6%), and flood (6: 19.4%) obtained the highest priority in different provinces in descending order. Furthermore, regarding the total scores of hazards in all provinces, flood (78.6), earthquake (75.3), traffic accidents (71.9), drought (60.1), and building collapse (58.1) had the highest priority in descending order.
Conclusion: Given the extreme vulnerability of Iran to various disasters, authorities should develop strategic plans to reduce the risks associated with high-priority disasters. In addition, crisis and disaster management policymakers must develop separate detailed disaster response plans for each hazard in order to increase the preparedness at organizational and community levels. Public training can also raise awareness among the public and help people cope better with various hazards.
Abolfazl Nikpour; Mohammad Gholami Fesharaki
Volume 22, Issue 9 , 2020
Abstract
Background: There have been a limited number of studies on the relationships between time and occupational and demographical variables with the mean changes of low-frequency hearing (LFH) and high-frequency hearing (HFH).
Objectives: This study investigated the rate of occupational noise-induced ...
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Background: There have been a limited number of studies on the relationships between time and occupational and demographical variables with the mean changes of low-frequency hearing (LFH) and high-frequency hearing (HFH).
Objectives: This study investigated the rate of occupational noise-induced hearing loss (NIHL) due to working in the steel industry and associated effective factors.
Materials and Methods: This historical cohort study was conducted within 2000 to 2010. Two LFH and HFH definitions of NIHL were used in this study. The average changes of LFH and HFL were considered the response variables. In addition, time and occupational (i.e., shift work and work experience) and demographic (i.e., age and educational level) variables were regarded as the independent variables. For data analysis, Bayesian multivariate multilevel modeling using skew distribution and OpenBUGS (version 3.2.2) and R (version 2.13.2) software were used in this study.
Results: The present study was performed on 1,959 male workers with a mean age of 36.64±3.92 years. Among these subjects, 913 (46.6%), 134 (6.8%), and 912 (46.6%) participants were day workers, weekly-rotating shift workers, and routinely-rotating shift workers, respectively. The obtained results showed that age, work experience, educational level, and shift work had significant relationships with the changes of LFH and HFH.
Conclusions: Overall, the findings of this 10-year historical cohort study demonstrated a relationship between time and demographic and occupational variables with the changes of LFH and HFL. Therefore, it is recommended to design preventive measures to reduce the deleterious effects of such variables on LFH and HFL.
omid garkaz; Sahar Paryab; Hamid Reza Mehryar; Hamid Reza Khalkhali; Shaker Salari Lak
Volume 22, Issue 8 , 2020
Abstract
Background and aim: Car crashes are among the prevalent incidents seriously threatening public health. This study aimed to assess the survival and quality of hospital care for patients of car accidents in Western Azerbaijan, Iran.
Methods: This cross-sectional study was conducted on 1,697 trauma victims ...
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Background and aim: Car crashes are among the prevalent incidents seriously threatening public health. This study aimed to assess the survival and quality of hospital care for patients of car accidents in Western Azerbaijan, Iran.
Methods: This cross-sectional study was conducted on 1,697 trauma victims admitted to Imam Khomeini hospital in Urmia, Iran, during 2016. The data, including systolic pressure, Glasgow Coma Scale, respiratory rate prior to admittance, severity of injuries based on surgery description, limbs and brain computed tomography scan, and diagnostic ultrasound by an specialist, were collected from medical records. The survival chance of patients was estimated using Trauma and Injury Severity Score (TRISS). To evaluate the quality of hospital service, Z and W statistics were utilized.
Results: Out of 1,697 admitted victims, 1,226 (72.3%) and 471 (27.7%) subjects were male and female, respectively. The patients were within the age range of 15-54 years, including 901 (75%) male and 296 (25%) female subjects. The predominant educational levels were under diploma and illiterate in male and female patients, respectively. The mean values of the Revised Trauma Score for the recovered and deceased patients were 7.75±0.38 and 6.19±1.59, respectively; however, the mean values of the Injury Severity Score for the recovered and deceased patients were 14.57±13.72 and 52.03±27.02, respectively, indicating a statistically significant difference between the two groups. The number of observed mortalities was 69; nevertheless, the expected mortalities were 60 cases. Furthermore, the quantified W and Z statistics were -9 and 0.02, respectively.
Conclusions: The results showed that the observed mortality exceeded the expected morality indicating the low quality of hospital care.
Ali Ashraf Mozafari; Mohammad Ali Mansournia; Kourosh Sayehmiri; Bahareh Ghiasi; Mehdi Yaseri; Golnaz Azami
Volume 22, Issue 7 , 2020
Abstract
Background: Lipid disorders are a well-documented risk factor for chronic kidney disease (CKD), but the impact of lipid abnormal- ities in the progression of the disease remains mixed.
Objectives: The current study aimed to extend the existing knowledge about the effect of lipid disorders in disease ...
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Background: Lipid disorders are a well-documented risk factor for chronic kidney disease (CKD), but the impact of lipid abnormal- ities in the progression of the disease remains mixed.
Objectives: The current study aimed to extend the existing knowledge about the effect of lipid disorders in disease progression from moderate to severe stage using Flexible parametric survival models.
Methods: This retrospective cohort study included 308 moderate CKD patients who received the nephrologist follow-up visits at the nephrology clinic, Ilam (Iran), from 2012 to 2019. The survival time was determined based on the time medically diagnosed with moderate stages (GFR = 59 - 55 mL/min per 1.73 m2) to the time of progression to the severe stage (GFR = 29 - 25 mL/min per 1.73 m2) hazard using flexible parametric survival models.
Results: In univariate analysis, high levels of TG, LDL, and cholesterol were important risk factors which affect the CKD progression. The hazard of patients with TG > 200 mg/dL was 1.69 times higher than patients with desirable TG levels (P = 0.09). Moreover, for patients with LDL > 160 mg/dL, the hazard was 2.12 times higher than patients with desirable LDL levels (P = 0.01). The hazard of patients with total cholesterol levels > 240 mg/dL was 2.10 times higher than patients with desirable cholesterol levels (P = 0.003). The adjusted model was shown to better fit the PH model. Cholesterol levels > 240 mg/dL remains a significant risk factor for CKD progression (P = 0.03).
Conclusions: Effective treatment programs should pay closer attention to screening and treatment of hyperlipidemia in patients diagnosed with moderate CKD.
Hossein Mirzaei; Behzad Damari
Volume 22, Issue 3 , 2020
Abstract
Background: Health survey is one of the important and valuable methods in producing health indicators and has become a part of health information system. Health surveys planned and performed properly can be used in assessing population health, policy-making, planning, health monitoring, evaluating, ...
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Background: Health survey is one of the important and valuable methods in producing health indicators and has become a part of health information system. Health surveys planned and performed properly can be used in assessing population health, policy-making, planning, health monitoring, evaluating, and observatories.
Objectives: The present paper is the product of a project to establish a calendar for health observatory studies, which has to compatible with Iran's Sustainable Development Plans.
Methods: The main question of this qualitative study was: "what are the reasons and solutions for having up-to-date, sufficient, quality information, and how could we ensure they are being carried out?" Data collection methods included interviews, reviewing documents and records, and interviewing focus groups of Iranian experts and health policy-makers.
Results: Thirty-one health observatory studies, concurrent with Iran's five-year Socioeconomic Development Plans, passed the consensus of stakeholders. The span of time to conduct each study was determined based on five-year Development Plans and national and international organizations' requests for certain information.
Conclusions: If the policy-makers are constantly pleased with up-to-date, sufficient, and quality information, sustainability of sticking to this calendar can be secured. The effective factors in successful implementation of this calendar is timely financing, defining health observatory survey and study protocols, apportioning duties among valid research centers, training interviewers not affiliated with health system, maintaining of experienced Iranian and international legal observers, assessing performance method of each survey, and implementing the results and findings in the future.
Abbas Ostadtaghizadeh; Hamidreza Aghababaeian; Mona Khaleghy Rad; Ladan Araghi Ahvazi; Maryam Kiarsi
Volume 21, Issue 9 , 2019, Pages 1-5
Abstract
Background: In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018.Objectives: This ...
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Background: In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018.Objectives: This study aimed to address this issue from the public health perspective. The study further aimed at reporting the mortality and morbidity associated with mushroom poisoning and ascertaining the reasons behind the increase in the numbers of the affected persons.Methods: This report was based on the review of official reports and a field assessment in the areas affected by mushroom poisoning in the western part of Iran.Results: There were 1151 mushroom poisoning cases, out of which 1133 (98.4%) were hospitalized, and unfortunately, 18 (1.56%) died. Kermanshah province had the highest rate of mushroom poisoning casualties, out which seven people died. A total of 12 provinces were affected.Conclusions: Lack of knowledge of local people about the types of mushroom and their inability to differentiate between the toxic and non-toxic mushrooms, as well as lack of a swift and convenient immediate warning system has caused this incident of massive mushroom poisoning. However, planning and proper management can help to resolve these problems.
Amir-Mohammad Armanian; Ashraf Mousavi; Majid Mohammadizadeh; Nima Salehimehr; Akbar Hassanzade
Volume 21, Issue 9 , 2019, Pages 1-7
Abstract
Background: Gastrointestinal (GI) dysmotility is a common problem among preterm neonates with very-low-birth-weight and is manifested as feeding intolerance, and in this situation, total parenteral nutrition (TPN) is needed for several complications. Ery- thromycin is a prokinetic antibiotic that neonatologists ...
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Background: Gastrointestinal (GI) dysmotility is a common problem among preterm neonates with very-low-birth-weight and is manifested as feeding intolerance, and in this situation, total parenteral nutrition (TPN) is needed for several complications. Ery- thromycin is a prokinetic antibiotic that neonatologists widely prescribe for the treatment of GI dysmotility in high and low doses.Objectives: This study aimed to evaluate the effects of an intermediate dose of Erythromycin in the treatment of feeding intolerance in preterm neonates.Methods: This study is a randomized clinical trial on preterm neonates admitted in two university-affiliated hospitals in Isfahan, Iran, during 2016 - 2017. Feeding is started for all neonates with 20 mL/kg/day doses and if they tolerate it, 20 mL/kg/day is added daily to receive toreach 150 mLcc/kg/day. The infants were divided into two groups, which received either Erythromycin (5 mg/kg/dose every 6 hours) or placebo for eight days. These outcomes were evaluated: time duration to reach 75, 110, and 150 mL/kg/day feeding volume, lavage count after the intervention, time duration of oxygen dependency and hospitalization, the incidence of necrotizing enterocolitis, intraventricular hemorrhage, patent ductus arteriosus, chronic lung disease, cholestatic icterus, sepsis, and hyper- trophic pyloric stenosis.Results: Sixty-four neonates (female 38 (59.3%) and male 26 (40.6%)) with the mean gestational age 30.10 ± 2.49 weeks were evalu- ated. The mean time duration to reach 75, 110, and 150 mL/kg/day feeding volume was significantly lower in the Erythromycin group (4.19 vs. 6.84 days, P < 0.001, 6.35 vs. 9.08 days, P < 0.001 and 9 vs. 11.46 days, P < 0.001 in the Erythromycin vs. placebo groups, respectively). Also the number of lavages were significantly lower in the Erythromycin group (0.35 ± 0.56 vs. 3.03 ± 3.08 in the Eerythromycin and placebo groups; P < 0.001).Conclusions: Intermediate dose of Erythromycin can reduce the time duration to reach full feeding volume and is safe for preterm neonates.
Maya Babai Kochkaksaraei; Hami Kaboosi; Ezzat Allah Ghaemi
Volume 21, Issue 8 , 2019, Pages 1-9
Abstract
Background: Genotyping of Mycobacterium tuberculosis (M.tub) is an essential step for several purposes, including the epidemi- ological studies and the tuberculosis (TB) control programs. Golestan province in the Southeast of the Caspian Sea is the second Iranian high burden TB province.Objectives: This ...
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Background: Genotyping of Mycobacterium tuberculosis (M.tub) is an essential step for several purposes, including the epidemi- ological studies and the tuberculosis (TB) control programs. Golestan province in the Southeast of the Caspian Sea is the second Iranian high burden TB province.Objectives: This study aimed to determine the genetic diversity of M.tub isolates in Golestan province located in the north of Iran.Methods: In this cross-sectional study, all non-repetitive confirmed M.tub isolates, which were collected from patients with TB in Golestan province in 2016, were used for genotyping. After DNA extraction, PCR was done for 15 loci of mycobacterial interspersed repetitive unit-variable-number of tandem repeats (MIRU-VNTRs) for the 162 M.tub isolates. Then genetic diversity and genetic re- lationships between them were assessed by best match analysis using tools on MIRU-VNTRplus database. Antibiotic susceptibility patterns of M.tub isolates was determined by the proportional method. Statistical analysis was done by SPSS and R software.Results: Out of 162 M.tub isolates, 156 genotype patterns were obtained, which 150 of which were unique. Nine of 15 loci were highly discriminative. The clustering rates were 3.7%. The prevalence of polyclonal infection was 2.46%. Also, HGDI and AHGDI were 0.999 and 0.979, respectively. The New-1 (22.2%) and Beijing (13.6%) sub-lineages had the highest prevalence in this region. Although there was no significant correlation between demographic criteria and M.tub genotypes, still Beijing isolates showed more treatment failure (18.2% vs. 0.7%) and resistance to streptomycin (40.9% vs. 7.8%) compared to others (P < 0.05). The assessment of the minimum spanning tree showed that the members of the clonal complex were limited except for members of Beijing. The PCA analysis showed that the combination of Qub11b and Mtub30 loci was diagnostic for Beijing sub-lineage.Conclusions: Owing to the high genotypic diversity of M.tub isolates in this region, relying on tuberculosis control program just based on close contact treatment is not sufficient, and we require to apply another approach
Masoumeh Sadeghi; Kiyan Heshmat-Ghahdarijani; Nizal Sarrafzadegan; Mohammad Talaei; Minoo Dianatkhah; Mehrbod Vakhshoori; Hamidreza Roohafza
Volume 21, Issue 6 , 2019, Pages 1-8
Abstract
Background: Trends of major cardiovascular risk factors are less investigated in Middle-Eastern countries.Objectives: This study aimed to assess the trend of major cardiovascular risk factors among Iranian individuals.Methods: This Longitudinal population-based study was performed by multistage random ...
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Background: Trends of major cardiovascular risk factors are less investigated in Middle-Eastern countries.Objectives: This study aimed to assess the trend of major cardiovascular risk factors among Iranian individuals.Methods: This Longitudinal population-based study was performed by multistage random sampling on 6504 participants aged at least 35 years for 12 years initiating in 2001 until 2013 in three phases. Cardiovascular risk factors including systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), waist to hip ratio (WHR), body mass index (BMI), fasting blood sugar (FBS) and lipid indices were measured for each subject in 2001, 2007 and 2013 and were analyzed using repeated measure analysis of variance using Bonferroni correction.Results: Mean value of SBP, DBP, BMI and FBS increased significantly in both genders during follow-up (SBP: 119.3 ± 18.7 to 128.4 ± 17.5 mmHg, P value < 0.001, DBP: 76.7 ± 11.8 to 82.8 ± 12.5 mmHg, P value < 0.001, BMI: 27.4 ± 4.4 to 28 ± 4.6 kg/m2, P value < 0.001, FBS: 86.7 ± 29.6 to 106.5 ± 38 mg/dL, P value < 0.001). Lipid profiles including total cholesterol (TC), triglyceride (TG), low- density lipoprotein cholesterol (LDL-C) and TG/ high-density lipoprotein cholesterol (HDL-C) showed favorable downward patterns in population (TC: 219.5 ± 51.3 to 200.1 ± 40.9 mg/dL, P value < 0.001, TG: 200.2 ± 110.3 to 155.1 ± 85 mg/dL, P value < 0.001, LDL-C: 132.6 ± 42.4 to 111.7 ± 27.8 mg/dL, P value < 0.001, TG/HDL-C: 4.5 ± 2.8 to 3.9 ± 2.8, P value < 0.001) with an exception of HDL-C showingless desirable results. In spite of controversial results in terms of WC and WHR changes relative to gender, total population changes of those variables were not significant.Conclusions: Although favorable patterns were observed in most lipid indices, other risk factors showed an inverse or insignificant trend. Several health-promoting strategies are required in order to improve lifestyle in a way that those raising cardiovascular risk factor trends would decline.
Milad Ahmadi Marzaleh; Rita Rezaee; Abbas Rezaianzadeh; Mahnaz Rakhshan; Gholamhassan Haddadi; Mahmoudreza Peyravi
Volume 21, Issue 5 , 2019, Pages 1-8
Abstract
Background: The emergency department is the entrance gate of patients to a hospital. Hospitals are confronted with major chal- lenges in radiation, nuclear accidents, and nuclear terrorism. Iran is also at risk of disasters, accidents, and threats, so, the possibility of nuclear and radiation accidents ...
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Background: The emergency department is the entrance gate of patients to a hospital. Hospitals are confronted with major chal- lenges in radiation, nuclear accidents, and nuclear terrorism. Iran is also at risk of disasters, accidents, and threats, so, the possibility of nuclear and radiation accidents cannot be neglected.Objectives: The present study aimed to extract the effective factors in emergency department preparedness of hospitals for radia- tion, nuclear accidents, and nuclear terrorism in Iran.Methods: This qualitative study was conducted using in-depth semi-structured interviews with 32 key informants selected through purposive and snowball sampling. Experts were from seven different specialties. Data were analyzed using the thematic analysis method in order to extract the effective factors in emergency department preparedness of hospitals for radiation, nuclear accidents, and nuclear terrorism in Iran in 2019. The interviews were held in the cities of Bushehr, Tehran, Shiraz, and Isfahan from September 2018 to February 2019.Results: Effective factors in emergency department preparedness of hospitals were categorized into staff preparedness, equipment preparedness, and system preparedness with 20 subcategories. The experts emphasized that training courses and exercises could enhance the preparedness and response to these accidents.Conclusions: This study showed that the emergency departments of hospitals in Iran have many challenges. When the country moves towards having nuclear technology, must also provide the infrastructure of the preparedness. There must be an attempt toreduce these challenges by providing financial and structural support. Identifying effective factors in preparation can be helpful in setting up programs for emergency department preparedness of hospitals against nuclear and radiation accidents.
