Payesh
Year:2018 | Volume:17 | Issue:5 |Papers Count:11

Objective (s): Healthcare systems always are trying to improve accessibility, equity, service quality, and efficiency indicators within their limited resources. This study was aimed to provide a comprehensive overview of four-years achievements and challenges of Iran’s Health Transformation Plan (HTP), which began in 2014.Methods: "Thematic analysis" following interviews with health experts was carried out to identify positive and negative consequences. Subsequently, "Content analysis" was applied on published official reports. Finally, results were aggregated and analyzed through "Triangulation" method.Results: Positive outcomes of Iran’s HTP, identified in this study, included reducing inpatients’ out-of-pocket expenditures in public sector, protecting vulnerable patients, promoting natural childbirth delivery, improving public health sector’s tangible assets, and improving access to specialized services in remote areas. In contrast, negative consequences of this plan were increasing induced demand, increase in total health expenditures, higher number of referrals in public sector services, increase in share of health expenditure in household budget, increasing disruptions in pharmaceutical supply chain, and intensification of medical personnel’s complaints due to salary inequity. Additionally, lack of feasibility studies before starting the plan, lack of sustainable resources to maintain services provision, conflicts with macro policies and conflict of interest in policymaking, prioritizing treatment over prevention, inappropriate human resource management, and inefficient policies were identified as main drivers of HTP challenges.Conclusion: Despite some achievements, HTP is suffering from lack of holistic approach and acceptable economic measures that resulted to fall achieving the ultimate goals of the plan. As time passing some positive outcomes acquired by immense expenses of public budget have begun a revers trend, which necessitates a major revision of HTP. It seems that a major revision of HTP based on sound health economics measures is necessity.

Objective (s): Monitoring patients’ complaints may improve hospital performance indicators and increase patient satisfaction. This study aimed to determine the causes of patients’ complaints in hospitals affiliated to Tehran University of Medical Sciences.Methods: This was a descriptive study. In all 1003 patients’ verbal, written or telephone registered complaints in 5 public and one-specialty hospitals before and after implementation of health transformational plan were collected and was analyzed to explore the data.Results: There was no any significant correlation between the number of patients’ complaints and the time of implementation of health transformational plan. However, there was significant correlation between patients’ status (P=0.01), hospitals professionals (P=0.001), dead or alive patients (P=0.001), and type of hospitalization (P=0.001) before and after implementation of health transformational plan.Conclusion: The findings showed that patients’ complaints from physicians and nurses increased after implementation of health transformational plan and thus may suggest that there is need to improve patient-physician communication. As such implementation of training course on communication for physicians, and nurses is recommended.

Objective (s): The Internet of Things has been of interest to researchers as a global infrastructure for the information society. The importance of it by governments, organizations, and scientific communities has been characterized by increasing the production of scientific articles in this area in recent years. The purpose of the present study was to carry out a bibliometric and co-word analysis of Internet of Things on scientific articles production in MEDLINE during the period of 1999-2017.Methods: The current was carried out using bibliometric method and co-word analysis, which is similar to content analysis in scientometric. The source of data collection was the MEDLINE. To do this, the search formula in the advanced search box was used. Retrieved results were limited to the period from 1999 to 2017. Data analysis was performed using VOSviewer and Excel software. Then the co-word networks were plotted in the form of tables and charts.Results: The production of scientific articles in the "Internet of Things" area has grown exponentially over the period considered. Sensors Journal has published the most articles in this field. China has been the pioneer in producing scientific papers in this field. Tiago M. Fernández-Caramés and Paula Fraga Lamas have been the most prolific authors in the field. On the basis of the co-word matrix in the subject and title of the articles, the research areas active in this field were: Human, internet, wireless technology, women, men, algorithms, computer communication network, telemedicine, adults, middle aged, remote sensing technology, computer security, patient, smart home, objects internet programs, non-voluntary outpatient treatment, detection, wearable device, protocol, treatment, disease, internet device objects.Conclusion: The results of this study indicate that China is top of the list in terms of the number of authors and the contributions of its authors in international journals. Chinese journal named “Zhongguo Yi Liao Qi Xie Za Zhi” is one of the top 10 journals in this field. The most attention is paid to the establishment of the Internet of things application.

Objective (s): The maternal health program is one of the main primary health care domains worldwide due to its momentous impact on community health. Considering the importance of this program’s quality and the role of evaluation systems in its promoting, this study was done to investigate the strengths and weaknesses of maternal health programs evaluation tools in Iran.Methods: This was a comparative study. The data was obtained by reviewing documents and was analyzed through the comparison matrix. Firstly, the number of nine evaluation checklist and one clinical information system were identified. Then the identified tools were compared regarding to the comprehensive evaluation model (CIPP) and their evaluation measures. Finally, the strengths and weaknesses of identified tools were recognized and discussed. Results: The study results indicated that the evaluation tools have notable shortcomings. The main shortcomings are disregarding 50% of the main dimensions of the health program evaluation models and the lack of proper measures to assess the main components of care. Subjectivity and non-exclusiveness of evaluation measures with improper categorizing of measures were the other weaknesses of these tools.Conclusion: The findings showed that the current tools for evaluation of maternal health program in Iran could not improve either the quality or outcomes.

Objective (s): The study aimed to assess the effectiveness of Pilates on patients with type 2 diabetes Methods: A randomized controlled trial was carried out in forty patients with a diagnosis of diabetes type 2. Patients were randomly assigned to one of two groups: experimental group (EG) that in addition to the usual care performed eight weeks of pilates exercises and the control group (CG) that continued to receive the usual care and did not undergo any other intervention. Participants evaluated before and one week after the intervention completed. The quality of life questionnaire (CASP-19) and the short-term test (AMTs) were used to collect data.Results: The groups were homogeneous at baseline. According to the statistical analysis, no significant improvement was observed in the EG.Conclusion: The study did not show benefit for pilates group compared to control group. It is suggested that in the future, this study should be carried out with bigger sample size, increasing the intervention time and a specific questionnaire for assessing the quality of life of the elderly.

Objective (s): Diabetes is a disease with high and increasing prevalence rate that can affect all aspects of patients’ life. The aim of this study was to evaluate quality of life of diabetic patients (type I and II) and compare it with non-diabetics patients in Illam province.Methods: This was a comparative study. A sample of 122 diabetic patients and 122 non-diabetic counterparts in Abdanan, Ilam province, Iran were selected by stratified random sampling method. The quality of life of was assessed using the SF-36. Data were analyzed by descriptive statistics in order t compare quality of life in diabetics and non-diabetics patients. Results: There was no significant difference between the two groups in terms of demographic variables (P>0.05). The results showed that diabetic patients had significantly lower scores in terms of physical functioning, role physical, role emotional, vitality, social function, bodily pain and general health (P<0.05). However, the difference was not significant for mental health (P>0.05).Conclusion: The results indicated a low quality of life in diabetic patients compared to comparison group. Therefore, it is essential that these patients receive educational, counseling, appropriate care and support services aimed at improving quality of life.

Objective (s): The study aimed to assess the effect of a transtheoretical model based education nutritional behavior of middleaged women in Ahvaz, Iran.Methods: This was a semi-interventional study on a 126 middle-aged among 30-59 years old. All women were selected by simple random sampling in two groups (intervention and control),. Data were collected a questionnaire including items on transtherotretical constructs and nutritional behavior. According to primary analyses in two group, first the intervention group divided into 4 groups (based on stages of change). The educational intervention was conducted in three sessions through group discussions and lectures. Nine weeks later, two groups were assessed for post-test. The independent t-test, paired t-test, and one-way analysis of variance and chi-square were used to analyze the data.Results: The mean age of participants in the intervention group was 37.71 (6.8) and in the control group it was 38.57 (7.71) years. Before the intervention, the two groups were scrutinized regarding the homogeneity of demographic variables and the structures of the nutrition pattern and behavior. There were no significant differences between the two groups (p>0.05). After the intervention, the scores [mean score (SD)] for stages of change including the process of change (from 21.34 (6.7) to 34.03 (11.3), decision-making balance (18.44 (4.15) to23.14 (5.11), and self-efficiency (from 22.74 (6.64) to 25.39 (6.18) showed significant changes compared to before the intervention (p<0.05). Moreover, nutrition behavior was increased from 21.34±6.7 to 34.03±11.31 which indicated a significant difference (p<0.05).Conclusion: The findings suggest that a Transtheoretical model based educational intervention might be effective in improving nutritional behavior among middle-aged women.

Objective (s): Health messages should be able to create behavioral intention and remembering in the context of the health recommendation given in a message, along with the reduction of unrealistic optimism. The purpose of this study was to examine the influence of health messages framing on optimism, behavioral intention and remebering.Methods: A sample of students (550) screened based on the motivational systems from Zanjan University by stratified cluster sampling and 72 students (38 with behavioral activating system, and 34 with behavioral inhibition system) were selected as the final sample.Results: Data analysis showed that the impact of stress-relief message framing on optimism, behavioral intention, and memory of audiences after controlling for working memory scores was influenced by their motivational systems. The behavioral activating group was most influenced when they received the gain-framed message. The inhibition group was most influenced when they received the loss-framed message. However, these effects were not observed in dental floss messages.Conclusion: The results showed that consideration of the correspondence between the type of audience's motivational system and the message framing, and the novelty of the topic, are two important factors in the effectiveness of a health message. Indeed I seems that the topic and novelty in both gain-framed and loss-framed frameworks could make the most impact on the audience.

Objective (s): Lack of attention to nutrition and having non-healthy nutritional habits, is one of the influencing factors for noncommunicable diseases. In recent years, nutritional literacy, as a abilities to access, understand, appraise, and apply necessary information to make decision related to healthy nutrition, is considered to be a very important health-related issue. This study aimed to investigate the effect of an educational intervention on nutritional literacy of elementary school teachers in Yasuj, Iran.Methods: In this quasi-experimental study, 110 teachers of the elementary schools in Yasuj, who were randomly selected in two areas of the city (intervention and control group) were included in the study. Nutritional literacy was measured by using a validated tool for Iranian society, and after analyzing the data, the educational content and structure were developed to improve the nutritional literacy. Intervention consisted of two training sessions, sending two SMS and providing educational pamphlets. Data were analyzed before and three months after the intervention by using Spss16 software.Results: There was a significant difference in terms of nutritional literacy, reading comprehension, food units (P<0.001), nutritional knowledge (P=0.001), computational literacy (P=0.034) and nutrition label (P=0.005) before and after the intervention among intervention group. The difference between the mean score of nutritional literacy in the two groups also was significant.Conclusion: The results indicaterd that the educational intervention was useful in increasing nutritional health literacy among primary school teachers.