Payesh
Year:2009 | Volume:8 | Issue:3|Papers Count:14

Objective(s): To assess general hospitals of Shaheed Beheshti medical university in terms of emergency unit designing for access to its different parts.Methods: Imam Hussein, Loghman, Shohada Tajrish, Taleghani and Shaheed Modares general teaching hospitals of SBMU which had higher visit per year were assessed for 40 criteria of access to different parts of their emergency unit by a checklist. Data have been gathered by an emergency medicine resident through interview with related personnel. Collected data compared with standards which have been used in emergency medicine.Results: Only eleven to sixteen out of 40 criteria had been fullfilled in selected hospitals. Thirteen criteria have been missed and only five criteria were fullfilled in all the hospitals. Others missed in one or more. Some of the essential criteria like cardio respiratory resuscitation room being near the entrance, dissociation between ambulance and outpatient entrance, obvious entrance for emergency unit, easy access to laboratory and radiology from emergency unit, lack of markers for triage were missed in all and criteria for traumatic and psychological patients were missed in almost all. Easy visual access to patients through nursing station, use of elevator and waiting room in emergency unit were observed in all the hospitals.Conclusion: It seems that access criteria are not considered correctly in designing of the study hospitals. Designing hospitals need its requirements and emergency unit location should be considered at first stages of designing.

Objective(s): To calculate the costs of the radiology ward by step-down method in Amir Alam hospital, Tehran, Iran.Methods: By employing the Step-down cost accounting (SDCA) method, the current cost, overhead cost, capital cost and depreciation charge etc. of the radiology ward of Amiralam hospital and then considering the number of the rendered services the unit cost of such services have been calculated.Results: Costs of the service unit computed for a simple radiology services were Rls 50.064/-, for sonography, Rls 70.300/-, and for CT scan, Rls 245.142/-. The tariffs of the Ministry of Health and medical Educations only cover about fifty percent of the said costs. The personnel costs of the unit which were Rls 1.788.100.000/-, formed about 62% of the entire costs of the Radiology Ward.Conclusion: In order to compute costs and use analyses of costs in the management of the hospital, we need real and available accounting data. We further need to use an identical accounting method all over the country and to save accounting information according to the computation of the costs of the service units.We can finally determine real tariffs once we do multiple researches in different hospital, using the same method.

Objective(s): To determine Back Pain (BKP) associated factors in the First and the Second National Health Surveys in Iran (1st NHS and 2nd NHS).Methods: This study is based on the information obtained from the 1st NHS conducted in the year 1991 and the 2nd NHS conducted in the year 2000 .27752 and 36945 subjects aged 15 and over were interviewed in the 1st NHS and the 2nd NHS respectively, of whom 24589 subjects from the 1st NHS and 36488 subjects from 2nd NHS were included in this study.BKP was considered as dependent variable and number of the surveys (1st NHS, 2nd NHS), residential area, age gender, education, marital status, smoking cigarette, smoking hubble bubble, spinal fractures, mental health, skeletal deformation and Body Mass Index (BMI) were considered as independent variables.Logistic regression models have been applied for data analysis, using SPSS soft ware.Results: It is indicated that odds of BKP in the 2nd NHS is less than odds of BKP in the 1st NHS. Odds of BKP increase with increase in age and BMI and it decreases with increase in level of education. Odds of BKP are higher in women and married subjects. Smoking, mental disorder, spinal fracture and skeletal deformation increase the odds of BKP.Conclusion: The findings showed that higher level of education, lower BMI and quitting smoking can help controlling BKP.

Objective(s): To determine frequency of motorcycle accident and its hospital costs on injured persons referring to Shohada university hospital in Khoramabad, Iran.Methods: A descriptive study was conducted on all injured persons who referred to Shohad-e-Eshayer in Khormabad between June 2005 till July 2006. All demographic and some data related to cost of accidence of 375 individuals were collected. A 20-items questionnaire was designed for this study.Results: Of total, fifteen persons (4%) died. Approximately ninety percent were male. Individuals aged 16-25 years accounted for 56.8% all of injured. Head trauma was reason for 56.2% of mortality rate. Most of injured (92%) not used helmet. Total hospital cost of persons was 981572746 Rial (101194 $).these injured persons included 4.1% of total injured that referral to hospital. 14.7% of total injured traffic accidents were motorcycle injured accident.1.2% of total hospitalization in center included motorcycle injured persons. Based on Pearson coefficient test, there was a significant statistical relationship between length of stay in emergency department and number of rider (P=0.03) and also, total length of stay with total hospital cost (P<0.0001).Conclusion: The findings of this study indicate that motorcycle accident imposes direct and indirect cost on social and health system, therefore must be reduce it.

Objective(s): Transtheoretical Model is a behavior change model that incorporates the stages of change for the process of quitting smoking. The aim of this study was to determine these stages in smokers living in Bandar Abbass, Iran.Methods: This was a cross sectional study. Using cluster random sampling, 1810 subjects aged 15 years and over, were studied from April to May 2007 in Bandar Abbass, Iran. Economy Model Questionnaire was used to collect data regarding three stages of change including precontemplation, contemplation and preparation within current smokers to describe different levels of readiness to quit smoking.Results: In all, 1810 individuals were studied. Two hundred and twelve participants (11.7%) were smokers, among them 204 (96.2) were men. There were statistically significant differences between smokers and non-smokers in terms of gender, age and education (P<0.001). The stage of change distribution across precontemplation, contemplation and preparation was 50.9%, 46.2%, and 2.8% respectively. There were no statistical differences between stages of change in terms of gender, age and education.Conclusion: This study revealed the majority of smokers were distributed in precontemplation and contemplation stages. These findings should be considered in future studies.

Objective(s): To translate and to test reliability and validity of the Newsha Hearing, Language and Speech Development Scale in Iran.Methods: The first version of Newsha scale was prepared in four developmental milestones of "hearing", "receptive language", "expressive language" and "speech" in 13 age groups from birth to 72 months via much survey on different related resources. After a pilot study on 75 children and performing necessary corrections, the test was conducted on 593 normal children of both sexes in nurseries and health centers of Tehran province from July 2006 to August 2007. The teat-retest reliability, inter-rater reliability, content validity and construct validity of the test were determined.Results: More than 95% correlation was shown in both test-retest and inter-rater reliabilities (P<0.001). The content validity revealed "perfect" and "too much" options of seven choices Likert scale in more than 90%, and construct validity exhibited the effect of age on the test results. Accepting minimum or higher score was considered as the criteria of Newsha findings interpretation in all age groups of each developmental milestone. For the cases who can not accept this criterion, completion of scale in lower age(s) group to define any probable developmental delay is necessary. The sex difference was shown just in 3 items among all the 373 items of the scale (P<0.02).Conclusion: The "Newsha Developmental Scale" is an integrated and a comprehensive scale to evaluate development process and identify any delay in developmental abilities of children with Persian language from birth to 6 years of age that has good reliability and validity.

Objective(s): To compare body image between patients under hemodialysis treatment and renal transplantation.Methods: Randomly one hundred fifty patients who had hospitalized in renal units affiliated to Tehran and Iran universities of medicals sciences.  The method of data collection was interviewing. An interview from including 2 sections and 38 questions has been arranged.Results: Our study showed that 33.3% of hemodialysis patients have had quite negative body imaging, while only 2.7% patients with renal transplantation had negative image about their body. This difference was statistically significant (P<0.0001).Conclusion: Nurses as a group that has close contact with these patients should have special attention to pateints psychic health.

Objective(s): To determine obesity familial risk factors in school children in winter 2006.Methods: In a cross-sectional study 1471 students aged 6-12 years old selected by two stage cluster sampling. Height and weight of students and their mothers were measured and BMI was calculated. Obesity was defined as having a BMI³ 95th percentile of Iranian reference. Thereafter, 114 pupils were selected as obese children and the control group was chosen from students having 15th £BMI£85th percentiles. Two groups were matched by age, school and classroom. Twelve non-obese students left the study because of not willing to corporate (n=102 students). Mothers were categorized based on BMI to 3 groups: “<25.0 kg/m2 = normal weight”, “25.0-29.9 kg/m2= overweight”, “³30 kg/m2= obese”. Demographic questionnaire was completed by interviewing the mothers.Results: Fifty five percent of obese pupils and 12.9% of control group had overweight mothers (P<0.001). There was a significant association between childhood obesity and mothers' age, parental occupation and education (P<0.001). Sixty eight percent of obese students had family history of obesity, while only 2.0% of control group had similar background (P<0.001). More than 21.1% of obese children were categorized as good economic status, but 2.0% of second group were in this rank. Family size was significantly different in two groups (P<0.001).Conclusion: In this study, mothers' obesity, family history of obesity, family size, economic status, mothers' age, parental education and occupation were the risk factors of obesity in Neishabour school children.

Objective(s): Lethal area 50 (LA50) index reflects quality of resuscitation process and medical care better than mortality rate of burn injuries. The present study is to evaluate annual LA50 for evaluation and further modification of burns medical care.Methods: Medical records of 1326 hospitalized patients who immediately referred to Shahid Motahari burn hospital following burning during October 2004 to September 2005 were included. Data including gender, age, types of burn, percentage of burn and patients’ survival were recorded for all subjects. Frequency of age, gender, types of burn percentage of burn and patients’ survival, and mean age, gender distribution of burns were measured and LA50 (percentage of burned body surface lethal to 50% of patients) was calculated with Regression test.Results: Patients' mean age and mortality rate were 27.6 (±18) years and 28.8% respectively. Thermal burn was the most common type of burning. After significant correlation mortality rate with percentage of burnt surface area (Pearson test, P<0.05, R square=0.756), we determined annual LA50 was 52.38%. Thermal burn is the most lethal cause with LA50 equal to 52.77. Moreover, LA50 is a little lower in female than male patients.Conclusion: LA50 and burned patients' survival have improved in Iran, but are still much lower than those in developed countries, probably due to lack of skilled staff and facilities, exposure to infections and more complicated patients.

Objective(s): To measure quality of life in bilateral lower limb amputees due to the Iran-Iraq war.Methods: A group consisting of 327 male (from all 576) war related bilateral lower limb amputees was surveyed. The 36-item short-form health survey (SF-36) questionnaire was used to measure quality of life. Socio-demographic data were collected by using another questionnaire.Results: The average age of the amputees was 42.05 (std. D.: 6.3) years. About 20% (n=63) had history of hospitalization during the preceding year of the study. Salary dissatisfaction was reported in Half of the patients 50.5 % (n=165). The highest and lowest mean scores in the study population were found for social function (66.67±26.74) and bodily pain (47.97±24.02) respectively. The quality of life in the cases in all eight SF-36 domains including: physical function, physical role limitation, bodily pain, mental health, role emotion, vitality, social function and general health were significantly lower than Iranian normal population. Smoking, unemployment, phantom pain, history of hospitalization, salary dissatisfaction were significantly accompany with lower quality of life. In regression analysis hospitalization and salary satisfaction played an important role on physical and mental component scales respectively.Conclusion: The findings revealed that the bilateral lower limb amputees suffer from a poor quality of life. This also indicates the need for additional rehabilitation and health services.