Payesh
Year:2009 | Volume:8 | Issue:1|Papers Count:16

Objective(s): To determine One-month survival after CABG in Shariati Hospital.Methods: We followed 340 patients who underwent Isolated-CABG in Shariati Hospital and used survival analysis to compare common coronary risk factors and to assess surgical factors related to survival after CABG.Results: Smoking was more prevalent in males than in females but prevalence of hypertension, diabetes and hperlipidemia was greater in women. Female subjects were older, had greater Body Mass Index (BMI) and left ventricular ejection fraction (LVEF) and had undergone more non-elective surgery compared to males. Most patients had received 3 or 4 grafts (range 1-6 grafts). There was no difference in aortic cross clamp and anesthesia time between the two genders. Females were hospitalized for longer periods after surgery and their mortality rates were greater. One-month survival ratio estimated by the Kaplan Meier method was 97.1% and 88.4% in males and females respectively. The overall survival rate was 95.3%.Conclusion: The factors related to poor survival were: female gender, non-elective surgery, lengthy aortic cross clamp and anesthesia time and the history of: hypertension, hyperlipidemia, previous CABG and CCU hospitalization.

Objective(s): To estimate accuracy of Crude Death Rate (CDR) for the country using mortality data from Gorgan, Iran.Methods: Three sources of mortality information in Gorgan were used for estimating the undercount in mortality data.There are some methods for estimating undercount in mortality data. In this study, we estimated it by three different ways of capture-recapture methods. We use Peterson-Chapman, log linear and coverage estimators.Results: The rate of undercount in mortality data by estimate of Peterson and Loglinear was 16.3 and by estimate of coverage method was 18.3. According to these rates the CDR for country is estimated 5.57 and 5.7 in 1000 respectively.Conclusion: Estimated crude death rate for Iran in this study is not significantly different from International Organizations such as UNDP and UNICEF estimation. Their estimation is 5.5 and 5 respectively.

Objective(s): After two decades of expansion of medical universities and increasing the number of students as one of the most attainable solutions for the problem of substandard status of Iranian community health, recently, quality-based policies in medical education have taken priority over most of the national health plans. In this study, we stratified educational services of schools providing a two-year degree course in health sciences in Iran to determine their differences.Methods: To measure the educational performance of the course nationwide, a benchmarking tool, consisting of 47 indicators, was devised. Their weights were defined through consensus developing methods. Each school was asked to introduce a representative who would complete a questionnaire, which was designed to collect schools’ information. In the next step, all the divisions were visited by one of the project's members and the school’s representative. Then, data retrieval was performed and verified at the project’s office.Results: Schools providing the course were stratified based on their individual scores. Furthermore, all schools were also ranked in each indicator. Among schools providing the course School of Health Sciences of Iran University of Medical Sciences gained the first rank, with the score of 86.53 out of 100.Conclusion: This study defines the educational strengths and weaknesses of health sciences programs in Iran that could be used as a measure for authorities to devise practical strategies for qualitative and quantitative improvement.

Objective(s): To determine awareness of managers of private hospitals about patient rights and its effective factors in Tehran, Iran.Methods: This cross-sectional study was conducted among all managers of private hospitals in Tehran (N=35), using a questionnaire including 32 questions. Data were analyzed using descriptive and analytical statistical procedures.Results: The results showed that 23% of managers had good level of awareness. However, 54% and 23% of them had intermediate and low level of awareness regarding patient rights, respectively.There were four effective factors on awareness of the managers about patient rights including educational degree, discipline, academic institute and training in management.Conclusion: 77% of the managers had less than good level of awareness regarding patient rights. As awareness could be a proxy of consequent behavior, therefore it could be predicted that the managers might perform inadequately in their responsibilities related to patient rights.It seems that there is need to promote awareness on patient rights among hospital managers.

Objective(s): To assess nurses' attitude toward spirituality and spiritual care in the care of psychiatric patients / clients.Methods: A cross sectional study was conducted to assess the attitude of nurses of Razi psychiatric center on spirituality and spiritual care and providing an educational plan. Samples consist of 107 nurses of Razi psychiatric center. Data were collected using the Spirituality and Spiritual Care Rating Scale (SSCRS). Data were analyzed with statistical software (SPSS) with using descriptive methods and statistical tests.Results: Results showed mean score of attitude on spirituality and spiritual care was 63.40 (SD±4.57). Majority of participants scored between 33-92 which was highest scores for the questionnaire. It shows that attitudes of nurses of Razi psychiatric center to spirituality and spiritual care were positively high.Conclusion: Nurses’ attitude for spirituality and spiritual care is positive and they believe that nurses must give spiritual care for their patients.

Objective(s): To determine average consultation time and evaluate its determinants in general practitce in Gorgan, Iran.Methods: 620 consultations from 62 general practitioners were evaluated. In addition physician consultation time was measured with a stopwatch. After the consultation, a questionnaire was completed for all patients. Data was analyzed by SPSSv11.5 software.Results: The average consultation time of general practitioners in Gorgan was 6.9±2.6 minutes. Consultation time was directly correlated with patient’s interruption, educational level of patient and prescribing volume of physician.Conclusion: This study showed that consultation time in Gorgan is lower than many developed and developing countries. High number of patients in waiting rooms and high prescription volume might explain shorter consultation time in Gorgan.

Objective(s): To compare CBDM in various selected countries in order to design a model for Iran.Methods: A descriptive-comparative study was conducted in six steps in which few countries have been chosen based on their contribution to issues such as policy making, planning, coordination, and control. The related information then was assessed.Results: The results show that in order to achieve a successful disaster management, there is a need for the participation of the community in various disaster management cycle, although the type of this contribution may differ according to the characteristics of each specific country.Conclusion: This paper proposes a model emphasizing on contribution of community in the local level in the villages and neighborhood areas.

Objective(s): Puberty is a critical period of life. Considering the importance of this event and its effects on adolescents' future and healthy generations, research in this field and its challenges is very necessary and important.Methods: In this study, knowledge, attitude and practice of the adolescent girls in puberty health were assessed in Tehran. For this purpose, 386 students studying in educational districts in five areas of Tehran (North, South, West, East and Center) were randomly selected by clustered sampling. Puberty health data was gathered through knowledge, attitude and performance questionnaires and was statistically analyzed using descriptive statistics as well as analysis of variance.Results: This study showed that the mean age of Menarche was 12.5 years. There was no significant difference between mean ages of menarche in the students of five education districts in Tehran. 45.5% of students believed that puberty is not pleasant and found it troublesome and 36.7% believed that it was a physiologic event. 10.4% of cases were scarred in the first menstrual period and only 17.1% of the students were previously ready for it. The knowledge of 50.3% of students was high. 54.4% had positive attitude about puberty health and the performance of 57% of students was moderate (most frequencies). The correlation between mothers level of literacy and students knowledge and practice regarding puberty health were statistically significant (P<0.05).Conclusion: Results suggest that considering the totally high (and very high) level of students knowledge(57.5%) as well as totally positive (and very positive) attitude regarding menstrual health (60.9%), the practice was supposed to be better (just 38.9% had correct and very correct practice). Therefore education in the field of puberty health especially menstrual health is necessary to improve knowledge, attitude and practice of the students. Furthermore, since the family is preferred as the main source of education (in 73.4% of cases) as well as consultation (in 76.5% of cases), informing and training the families and especially mothers is recommended.

Objective(s): To determine the weight to age growth chart and some of its risk factors in 5 years old children in South Health Center in Tehran, Iran.Methods: This was a cross-sectional study. We collected data on sex, birth weight, the age of introducing food supplement, tube of milk which consumed during the first 6 months of life by child, the time of complete weaning, birth order, family size, maternal education, maternal job, interval between the child birth and the birth of the previous child at family, the regulation of child care at the health center and the condition of weight to age growth chart at 5 years old child. There were 27 health centers and from each center 45 children were chosen randomly. Data collection was performed from the family file of each child.Results: 1150 children were studied. There were 567 (49.3%) male and 583 (50.7%) female. The mean birth weight of children was 3200 g with SD: 568.84g. The minimum and maximum age of food supplement introducing to child were 2mo and 14mo respectively (mean: 6mo, SD: 1.9mo). 845 of children were fed only with breast milk during the first 6 months of life. The mean age of complete weaning was 19mo with SD: 7.93 mo. About 50% of children had first birth order. The family size of 79.42% of children was 3. 87% of mothers were educated and the remaining was illiterate. 96% of mothers were housewives and others were employed. Birth Interval of 41.37% and 9.9% of children with the previous siblings were less than 2 years or more than 2 years respectively and the other children was the first child of the family. 8.46%, 26.6% and 67% of children considered to be good, moderate or bad regarding to regularity of child care at the health center. In general 963 children (83.74%), 19 children (1.65%) and 7 children (0.61%) had normal, under 3 percentile or over 97 percentile weight to age growth chart at the last visit to the health center respectively. There were 40 (3.48%), 82 (7.13%) and 39 (3.39%) slowness, flatness or descending of the weight to age growth chart. There was significant statistical relationship between the weight to age growth chart and birth order (p<0.02). Generally 187 cases (16.16%) showed abnormal weight to age growth chart. Moreover the higher birth order increased the probability of abnormal weight to age growth chart at 5 years of age.Conclusion: The findings were similar to existing reports. However, further prospective studies are recommended to confirm such findings.

Objective(s): To examine effect of an educational intervention on depression and quality of life in patients with coronary artery bypass grafting surgery.Methods: This was a quasi-experimental study of 54 patients after bypass surgery in the Isfahan Cardiovascular Research Center. The patients randomly assigned to intervention and control groups. Primarily Cardiac Depression Scale was used to measure depression. In addition, a PRCEDE-based educational questionnaire and the end SF-36 questionnaire were used. The intervention group received a PRCEDE Model educational package up four months.Results: After education the mean score of Predisposing factors, Enabling factors, Reinforcing factors and self-helping behaviors increased significantly in the intervention group as compared to the control group (P<0.001). The mean score of depression in control group (M=104.5, SD=30.4) and intervention group (M=112.8, SD=21.9) decreased significantly, but this effect was more pronounced in intervention group (M=66.2, SD=22 vs M=89.2, SD=27.8). Also the significant differences in quality of life between two groups were seen in physical functioning (P<0.04), role emotional (P<0.01) and mental component summary (P<0.04).Conclusion: The findings of this study indicated that the PRCEDE Model was effective educational intervention in reducing depression and enhancing quality of life in patients with coronary artery bypass surgery.

Objective(s): To determine the relationship of worry domain with quality of life (QOL) in Tehran University of Medical Sciences (TUMS) Students.Methods: In this descriptive correlation study, 400 medical university students (231 women, 169 men) from 7 different schools related to TUMS completed corresponding versions of QOL (SF-36) and worry domain questionnaires. In this process, after the participants gave informed consent, they were administered the WDQ, and QOL in random order and in the same time period (8 Am. to 12 md.). A demographic survey that solicited information about the participants' age, gender, and the other necessary demographic information was also completed.Results: The results of the present study indicated that worry was in a severe level in 4.8% and in medium level in 34.3% of students. The results also indicated that worry and quality of life were negatively direct related. A regression analysis revealed that Quality of life was significantly negatively related to worry level (P<0.0001, r= 0.682).Conclusion: It appeared that it is important for university policy makers to plan for reduce worry domain and increase the QOL of students in order to improve student's health.