Payesh
Year:2009 | Volume:8 | Issue:4|Papers Count:14

Objective(s): Providing a simulation model for understanding process and patient flow in outpatient clinics and estimating patients' waiting time.Methods: This was a descriptive study. In this study outpatient clinics of general teaching hospitals in Tehran were grouped according to statistical distribution of patients' arrival time and a sample of each group was selected. Then the data of arrival time, service time and flow of patient at clinic for 357 patients were collected. At last a simulation model of outpatient clinics was provided and validated.Results: Simulation model outputs showed that the mean patient waiting time for examination by novice resident was about 58 minutes, for experienced resident was about 52 minutes and for attend was about 53 minutes. Review of examination process with simulation model showed that about 42-62 percent of patients' waiting time for examination was before physician arrival at clinic. There were no statistical differences between new and follow-up patients' waiting time and waiting time for primary and complementary examination by residents and attend.Conclusion: We found that the time gap between patient admission and arrival of physician was the most important factor in rising outpatient waiting time. Efforts to lessening this time will decrease total waiting time for examination about 60 percent.

Objective(s): To determine the prevalence of Ecstasy use and high risk behaviors among college students in Guilan; Iran.Methods: We conducted a cross sectional study of a representative sample drawn from college students (3958 students) of Guilan in 2005. The questionnaire was adapted from a number of the questionnaires used in the United States and the European countries. Data were analyzed performing c2 test and logistic regression.Results: Out of 3958 students, 3700 students (93.5%) responded, 1966 students from private colleges and 1734 students from state universities. The mean age of student was 224.2±3.5 years (ranging from 18 to 46 years); and 49% were male. The life-time prevalence of Ecstasy use was 4.2% (157 students). Ecstasy use was significantly associated with gender, other substances us, cigarette smoking, participation in friendly parties, sharing home with friends, alcohol consumption, type of university , educational level of family, family situation and history of educational abruption in last years (c2 test , p<0.0001) but not with age and university courses. However, logistic regression analysis indicated that the factors influencing Ecstasy use were use of other drugs, alcohol and cigarette smoking (P<0.0001).Conclusion: Ecstasy use appears to be a serious problem in college students. Whatever the causes behind the rise in Ecstasy use, personalized and informative educational programs should be conducted in all colleges.

Objective(s): To evaluate the effect of menopausal training for husbands on perceived social support by peri menopausal women.Methods: In this clinical trial, 102 women aged 45-60 years were randomly assigned in two groups in Gonabad, Iran. Demographic questionnaire and social support scale completed by all of the women and knowledge questionnaire completed by their husbands, then face to face education about menopause were scheduled for husbands in intervention group. One month later all of the women completed social support scale and their husbands completed knowledge questionnaire.Results: The mean knowledge score of husbands in intervention group was higher after training (10.40 vs 7.35) and the difference was statistically significant (P<0.001). Also, there was significant difference in mean of perceived social support by women befor and after training sessions (10.95 vs 8.62, P=0.006).Conclusion: Menopausal training for husbands increases perceived social support by menopausal women. It seems that training programs on menopause must be designed for husbands in order to inhance support in women.

Objective(s): To plan an educational program to prevent HIV/AIDS among university students based on Health Belief Model (HBM).Methods: This descriptive cross-sectional study was conducted in Tehran University in academic year of 2004-2005. The instrument used was a questionnaire including demographic information, knowledge questions, health belief model constructs (perceived severity, perceived susceptibility, perceived benefits and barriers) and attitude towards HIV/AIDS patients, high risk behaviors questionnaire and intention to take HIV test. The participants were selected through stratified and systematic methods. Data were analyzed performing Chi- square test, Pearson correlation and one way ANOVA.Results: In all 664 students participanted in the study. The mean age was 18.47±8/1. According to self report, %4.1 were smoker, %2.9 used substance drugs, %1.5 suffered from sexual transmitted disease and %58.1 intended to take HIV test. TV, news paper and magazines were the main sources of information about HIV/AIDS. %26.4 believed that their knowledge is insufficient. %71.1 believed in having low risk of being infected. Almost all of the participants were highly aware of HIV/AIDS. The results also indicated that there was a significant relationship between the participants' knowledge and their perceived severity and susceptibility and benefits in term of willing to take the test. Lack of HIV voluntary counseling and testing center and fear of the test results were the main barriers of HIV test.Conclusion: The findings suggest that we need to educate and raise the people consciousness about the perceived benefits of HIV test, the way of giving the test results, and the contact details and services for voluntary counseling and testing centers.

Objective(s): To measure self-care behaviors inpatients and to investigate its associations with age, gender, marital status, duration of heart disease, co-morbidity with other chronic disorder and left ventricular ejection fraction.Methods: In a descriptive-analytic study, 250 participants were selected by random sampling. European Heart Failure Self-care behavior questionnaire used to collect data. Results: We found that 74 % of the participants had moderate and low scores of self-care behaviors. The self care behavior had a significant correlation with all variables studied.Conclusion: It seems that there is need for systematic self-care educational programs for patients with heart failure.

Objective(s): This study aimed to assess quality of life in patients with esophagus cancer who did not have esophagectomy surgery in Imam Khomeini hospital in Tehran, Iran.Methods: 70 patients were interviewed and completed the EORTC QLQ-C30 and EORTC QLQ-OES18 questionnares. Data were analyzed by performing ANOVA, Pearson Correlation and independent t-test.Results: The analysis indicated that cognitive functioning score was the highest and emotional functioning score was the lowest. In addition, there was linear correlation between quality of life and symptoms scores. Also, there was a significant correlation between quality of life scores and type of esophagus cancer. Symptom scores in patients with squamose cell carcinoma (SCC) were higher than patients with adenocarcinoma.Conclusion: These results represents that patients with esophagus canser need emotional support. In addition patients' symptoms especially in those with SCC should properly be managed.

Objective(s): To investigate pre-marriage educational needs of couples to plan support services.Methods: In a cross-sectional study, a self administered questionnaire was used to collect data from 2117 participants in pre-marriage consulling sessions in Isfahan city. The questionnaire included educational needs in different subjects of reproductive health field, spousal relationships and Islamic rules and rights. The educational priorities in different fields are as fallows: women cancers and safe sex in reproductive health, communication techniques and ways to solve problems with the spouse in the spousal relationships and legal rights related to sex and the advices of Islam about spousal relationships in the field of Islamic rules and rights respectively.Results: The average age of women and men were 22.8±4.2 years, 26.2±4.3, respectively. Significant association was observed in the field of reproductive health between the educational needs and women's job (P=0.022), men's job (P=0.009), women's age (P=0.033) and the level of education (P=0.001), in the field of spousal relationships between the educational needs and women's job (P<0.001), men's job (P=0.043), age of both women and men (P=0.001), and in the Islamic rules and rights field, between the educational needs and women's job (P<0.001), age of both women and men (P=0.044) and the level of education (P=0.007).Conclusion: In men with higher educational level, demands for learning increase however in women it reduce. By increasing the age, needs for education in both sexes reduce. Employed women had lower needs for education compared to other groups and employed men had more needs. There was no significant difference between rural and urban residents.

Objective(s): To assess quality of life of thalassemic patients and compare the findings with the same age group of healthy people.Methods: 250 thalassemic patients referring to the department of thalassemic of Dastgheib hospital and 100 healthy people in the same age group participated in a cross-sectional study in Shiraz, Iran. They were selected by convenient sampling. The SF-36 was used to measure quality of life. It consists of 36 questions that measure 8 health-related domains namely: physical functioning, role physical, bodily pain, general health, role emotional, mental health, social functioning and vitality.Results: The results showed that control group had higher scores than thalassemic patients in physical measures but there were no significant differences between patients and the healthy people in mental component measures. Female patients had higher scores than male patients in social functioning. Patients with milder disease had better scores than patients with sever disease in physical functioning.Conclusion: The findings revealed that patients with thalassemia experience a relatively poor quality of life.

Objective(s): To assess researchers’ impression of their own knowledge translation.Methods: The survey questionnaire was completed by 208 researchers in Tehran University of Medical Sciences (TUMS). They were asked about knowledge translation activities in one of the projects they had completed. They were also asked to score themselves on a scale of 0 to 10, where a higher score meant more activity. The correlation between these two variables and its determinants were assessed by performing multiple linear regressions analysis.Results: Although the researchers had only gained an average of 19.5% of the maximum score of knowledge translation activities, they scored 58.6% of the total score in self-assessments (the difference was significant, P<0.001). Pearson’s correlation between the score of self-assessment and that obtained for the efforts made was 0.43, which indicates an average correlation between the rate of activity and self-assessment. Linear regression analysis showed that the difference between activities and self assessment scores increased with the increase in the number of years working as a professional (P=0.004).Conclusion: Researchers overestimate their knowledge translation activities. Therefore educating and familiarizing researchers with all the aspects of knowledge transfer and methods of assessing these activities can help in the application of research and also in utilizations of its results.

Objective(s): In the wake of a natural disaster, dealing with dead bodies is one of the most difficult issues in the early response phase, requiring careful planning in advance. It follows that the risk analysis phase for any natural disaster should include a study of the history of similar events and a thorough review of the measures taken as well as the difficulties faced by those involved in the disposal of dead bodies.Methods: This was a qualitative study comprising the following stages: 1) data collection through in-depth interviews with over 30 people- including those in managerial positions- who were involved in the response phase after the Bam earthquake, 2) data analysis based on the grounded theory, 3) data extraction and identification of key variables, and 4) development of a theoretical model based on these variables.Results: In the response phase after the Bam event, key issues regarding the management of human corpses were identification, confirmation of death, and burying the bodies. The most prominent issues fell into the following categories: 1) problems with the procedures and structures employed in corpse management, 2) problems with identification, 3) acceptability to the community of the procedures used in corpse management, and 4) inadequate attention to specific technical details as regards confirmation of death and burial.Conclusion: In the event of another disaster, the present structures and procedures cannot mount an adequate response with regard to corpse management. Experience from other countries has shown that the disruption caused by major disasters can provoke hasty, injudicious decisions with irremediable adverse consequences. Problems do exist, but they must not serve as an excuse to compromise standards and ignore basic requirements for death confirmation, corpse identification, and proper burial.

Objective(s): This study was designed to investigate the relationship between planned physical activities and quality of life in women reside in the west of Tehran, Iran.Methods: The Short Form Health Survey (SF-36) was applied to measure quality of life and demographic and other related information were additionally collected. Three parks from western areas in Tehran were randomly selected. A group of volunteer women aged 35-55 years were randomly selected by the researcher in parks and divided into active and non-active groups (walking & not walking). Using SPSS 15, Mann-Whitney and Kruskal-Wallis statistical tests were performed to analyze data.Results: In all 148 women were studied and the mean age of women in active and non-active groups were 42.1 (SD=5.7) and 41.7 (SD=5.6) respectively. The results of Mann-Whitney test showed that women in the active group had higher mean scores in all quality of life scales and except two (physical functioning and role-emotional), there were statistical significant differences (P<0.05).Conclusion: The results confirmed that planned physical activities by walking have been effective on promoting quality of life in women. The results suggest that educational programs would be designed to motivate women having daily physical activity.

Objective(s): Iranian Ministry of Health and Medical Education (MOHME) decided to implement Family Physician Program (FPP) all across the country in 2005. Workforce supply is among essential factors in most implementation projects. The aims of this study were to estimate General Practitioner Supply in Iran, and workforce adequacy analysis of FPP.Methods: This study estimates "General Practitioner Supply" based on stocks and flow model and "Required General Practitioner" based on the policies, health care delivery programs and population.Results: Implementation of FPP for whole population of Iran requires 32769 practitioners while according to the results of this study supply of general practitioners are about 28200.Conclusion: General practitioner supply is especially important in implementation of FPP. Currently, the program is implemented at rural level and in the cities with less than 20000 populations and the following step is expanding it throughout the country.The results of this study show that there is an obvious shortage around 4600 in general practitioners. Moreover the current experiences demonstrate that the recruiting and maintaining of general practitioners have not been successful in recent years. However, FPP expansion needs reassessment of population patterns receiving the service, and requires innovations to recruite and maintain practitioners.