Payesh
Year:2015 | Volume:14 | Issue:4|Papers Count:13

Objective(s): This study aimed long-run relationship between mortality of infant under one year old and poverty, urbanization and GDP per capita in Iran over the period of 1969 to 2010.Methods: The impulse response and variance decomposition based on vector auto regressive and Johansen-Juselius method was used to analyze the data.Results: The results indicated that the coefficients of all variables were significant and based on theoretical foundations. Findings also showed that, in the long run, one percent increase in the poverty increases the mortality of infant under one year old by 0.61 percent and one percent increase in the urbanization and GDP per capita lead to 2.04 and 0.43 percent decrease in the mortality of infant under one year old, respectively. The results based on error correction model also indicated that to achieve long-term balance, about 0.07 of short-run imbalances is adjusted in each period.Conclusion: Poverty increases mortality of infant under one year old. The findings also showed that urbanization and increase in GDP per capita could decrease mortality of infant under one year old.

Objective(s): Computerized physician order entry system has been introduced as an effective tool to reduce errors and to increase patient safety. This study was conducted to investigate the acceptance rate of the system if implemented.Methods: This was a descriptive study. The study was conducted in three teaching hospitals in Kerman, Iran in 2013. All physicians were invited to participated in the study. Data was collected using a questionnaire consisting of three parts: the description of CPOE, respondents’ demographics and questions about the study objectives. Data was described by median and quartiles and was analyzed using nonparametric methods.Results: In all 633 physicians were studied. Fifty-seven percent of physicians agreed with CPOE ease of use, 45% with CPOE usefulness and 32% with its positive effect on clinicians’ workflow. There were significant relationships between system ease of use and usefulness with physician’s age and gender.Conclusion: The results showed that physicians would accept CPOE system to a good extent, if it were implemented. Younger doctors have a greater readiness to accept the system.

Objectives: Recent advances in health geography helped to understand more on the role of the geographical distribution and settings of diagnostic and therapeutic centers in the communities. The present study aimed to investigate on modeling geographical access to medical laboratory services in Iran.Methods: This study conducted in 2014. Study units included medical laboratories, which were active by the end of March 2013 and located within the selected city borders. These laboratories were located in a clinic or in a hospital or were an independent laboratory. The cities were selected by sampling included Takab, Shushtar, Shiraz, Qom and Hamadan. Data analyses performed using expert opinions and using Geographic Information System (GIS). Spatial analysis performed using ArcGIS. The stages of studies were “identifying the urban capacity for medical laboratories”, “determining the land-use compatibility of medical laboratories with other urban land uses and creating mapped information layers in GIS for each of the land-uses”, “determining main criteria for site selection of new medical laboratories and weighting mapped information layers in GIS for each of the criteria”, “determining the optimal site forthe new medical laboratories with overlapping mapped information layers of the main criteria in GIS”, “determining the number of new laboratories with considering the site selection of laboratories” and “design a geographical accessibility model to medical laboratory services”. Main challenges for conducting such studies require infrastructures including layer of urban blocks (field of population) and urban land use fields for each city. In addition, many criteria are involved in choosing the optimal location for the establishment of medical laboratories, so it is recommended to use Geographic Information System to facilitate analysis.Conclusion: Since the results of such studies are useful for policy making and planning in the health system and urban planning, recognizing methodolical challenges can facilitate similar studies in the future.

Objective(s): Medication errors lead to the deaths of patients and reduce patient safety. This study aimed to investigate on factors influencing the incidence of medication errors, in Qazvin, Iran.Methods: A cross-sectional study was conducted in year 2013 in Qazvin teaching hospitals. A sample of nurses were asked to participate in the study. The survey tool was a standard questionnaire containing two sections: demographic, and factors influencing of incidence of medication errors.Results: In all 204 nurses were studied. The average age and experience of nurses was 32 and 8.5 years, respectively. 87% of nurses were female and 13% were men. The mea score (from 1 to 5) for factors influencing the incidence of medication errors in nursing domains was fatigue caused by extra work (3.15) and not having enough time (2.94). In the area of department the mean score was 3.33 for high density work and 3.14 for the noise in department. For the administration domain, the mean score for lack of enough nursing personnel was 2.48 and for illegible medication orders it was also 2.48.Conclusion: Interactions with nurses, proper management, adequate staffing, training, and appropriate reporting system can reduce many errors and promote patient safety in hospitals.

Objective(s): Withdrawal could increase the unwanted pregnancy. The aim of this study was to determine effect of a Theory of Planned Behavior (TPB) and Social Cognitive Theory (SCT) in changing withdrawal contraception use to decrease unwanted pregnancy.Methods: This study had three phases. The first and the second phases provided an educational program based on TPB and SCT. Participants recruited from women who were attending to clinics of public health services in Tehran, Iran. Criteria for inclusion were: current withdrawal users, married, sexually active, did not intend to be pregnant, no identifiable risks to the participants beyond OCs use. The intervention group received an educational program while the control group received routine procedures. Evaluation was performed before, one and three months after intervention. The data was analyzed by SPSS software Repeated measure, Wilcoxon and t test were used to analyze the data.Results: The results showed that after intervention there were significant differences in the mean behavioral and normative beliefs scores between two groups indicating an increase in believing to use oral contraception. In addition, there was significant association between intention to use OCP and perceived behavioral control.Conclusion: The current study provided evidence for the effectiveness of a belief-based intervention for preventing pregnancy prevention.

Objective(s): Nearly all women consider child as the main part of the marriage in Iran. Women define child as "taste of the life" and a communication tool which binds them to other women. In fact, a woman's personality and identity is not completed unless she has child. This study aimed to explore the experience of infertile woman in Iran.Methods: Grounded theory was the method that guided this research. Twenty-one infertile women were selected using theoretical sampling. Data were collected through semi structured in-depth interviews at Royan Institute, Tehran, Iran.Results: The core category we observed was "pressure on infertile women". Stigmatization was the main source of pressure, regardless of financial problems. When this pressure internalized in patients and coincides with social expectations of woman, they felt that they failed leading to ignores other dimensions of their life. Nevertheless, every infertile woman identified that they imagine of having child in their mind.Conclusion: When all social spaces are full of pressure and anxiety for infertile women, isolation is a natural consequence. Our study showed that most pressure was from fertile women to infertile women.

Objective(s): Posttraumatic growth is defined as subjective positive psychological changes following the struggle with highly challenging life events. The Posttraumatic Growth Inventory (PTGI) is one of the most credible tools for measuring these changes. The aim of current study was translating the PTGI into Persian and validating it in Iranian cancer patients.Methods: This research validated the Persian version of the PTGI using 402 patients with cancer who referred to the oncology wards of two main hospitals in Tehran, Iran. The PTGI was translated into Persian and back-translated into English and the comments of its developers were applied. The scale’s content and face validity, construct validity, and internal consistency and test-retest reliability were then assessed. SPSS 15 and LISREL 8.8 for Windows were used to analyze the data Results: The mean PTGI score of the participants was 68.68±14.68. In confirmatory factor analysis, all fitness indexes, except goodness of fit index (0.88), confirmed the five-factor structure of the PTGI. Cronbach’s alpha for the total 21 items of the PTGI and its five subscales was calculated as 0.87 and 0.57-0.77, respectively. Test-retest correlations (r=0.75) suggested the acceptable repeatability of the Persian version of the PTGI Conclusion: The findings of the current study support the applicability of the Persian version of the PTGI for measuring perceived growth following cancer diagnosis.

Objective(s): Heart failure has implications for the quality of life for any age range. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is the most commonly used instrument for evaluating quality of life inpatients with heart failure. It comprises 21 items and 3 dimensions: the physical, emotional and the total. The aim of this study was to translate and evaluate the reliability and validity of the Persian language version of the (MLHFQ) for use in heart failure patients before using this version in clinical practice.Methods: After permission, the questionnaire was translated. One hundred HF patients (mean age: 59±15 years; 61% male) were interviewed between December 2013 and April 2014. Reliability was evaluated using Cronbach’s alpha and intraclass correlation coefficients (ICC).Validity was tested with correlations between the MLHFQ scores and the SF-36 scores, in order to evaluate the construct validity, known-groups comparison (New York Heart Association [NYHA] Classes) was performed.Results: The internal consistency of both total and subtotal scales was greater than 0.80. Cronbach’s alpha was 0.95 for the 3 MLHFQ scores and the ICC was also large 0.8. In addition, MLHFQ scores varied significantly with functional class (P<0.001), and there were intermediate-to high correlations with the assumed corresponding SF-36 dimensions (0.71-0.4).Conclusion: These results support the use of the MLHFQ in patients with heart failure and it can be considered as a disease-specific instrument to measure health outcomes in research and clinical settings. Further studies are recommended to assess the responsiveness to change of the Iranian version of the MLHFQ.

Objective(s): Health literacy is a relatively new emerging concept in public health. It is also a new area for research with links to communication. It has been suggested that poor health literacy poses a major barrier to public’s health and might represent a major cost to health care system. The aim of this study was to review instruments that measure health literacy.Methods: A review was undertaken of all the full publications in the English language biomedical journals between 1993 and 2012. The search included the combination of keywords ‘health literacy’, and ‘tool’, or ‘instrument’, or ‘scale’, or ‘questionnaire’, or ‘measure’, that appeared in the titles/abstracts of the publications. In addition, a manual search was performed to include additional papers of potential interest.Results: In all 1788 citations were identified. After screening, 1265 duplicate citations were excluded. The remaining 523 citations were further examined and 438 citations were found irrelevant. Finally the full texts of 85 papers were assessed. Of these 42 papers were found to be relevant and were included in this systematic review We identified 23 instruments that were used to measure health literacy. These all were introduced.Conclusion: Lack of comprehensive instrument to measure health literacy was evident. Thus, developing a new instrument seems necessary. A new tool should be simple, short, and inclusive.