Payesh
Year:2018 | Volume:17 | Issue:3 |Papers Count:16

Objective(s): Health reform in Iran focuses on improvements in various areas health system such as different hospital indicators. This study aimed to investigate the effects of the new health transformational plan on the performance indicators.Methods: This descriptive study carried out in two stages, before (2013) and during implementation (2015) of health transformational plan in hospitals affiliated to Health Network in East Azerbaijan. Data were collected via the hospital system of information and statistics. Data related to the key performance indicators included average length of stay, bed occupancy, bed turnover interval, in-patient and outpatient.Results: The result indicated that in 15 county hospitals average of all performance indicators were increased. Average length of stay increased by 4%, bed occupancy increased by 11%, bed turnover interval increased by 9%, in- patient rate increased by10% and out- patient rate increased by 12% compare to before of the new health transformational plan.Conclusion: Implementation of the new health reform plan had considerable impact on hospital performance indicators. These differences were differed in different hospitals.

Objective(s): health transformational plan was executed as one the most important plans by the ministry of health and medical education in order to reduce admission fees. In order to evaluate the effectiveness of this plan, this study was conducted with the goal of determining the health expenditures by households after implementation of this new plan.Methods: This cross-sectional study was conducted in Zahedan, Iran in year 2015 and 2016. The study conducted on 816 families including both rural and urban households. They were selected randomly by clustering method. Data were collected by in-person interviews using the World Health Survey. The Data were analyzed using descriptive and inferential statistics.Results: In 93.1% of instances the head of household were men (n=760) and 78 families did not have any health insurance. After implementation of health transformational plan, 12.99 percent of families were still faced with catastrophic health expenditures. However, the rural families were facing more catastrophic expenditures compared to families living in urban areas. This catastrophic expenditures have a meaningful relation with many variables including dental care (OR: 4.99), drug fees (OR: 2.927), physiotherapy (OR: 2.927), outpatient expenditures (OR: 96.639), having a family member who needs to be taken care of at home (OR: 3.186), and a family member who needs to be taken care of at a hospital (OR: 1.866).Conclusion: The results showed that a relatively large proportion of people in families in Zahedan still are facing catastrophic health related expenditures and health transformational plan has not been able to reach its goals in this city.

Objective(s): Rapid social, economic and cultural changes along with intentionally or unintentionally consequences has provided the incidence and spread of social pathologies such as street children in large cities. Probability and non-probability sampling methods that are used to study this data are faced many problems such as coverage error and invalid statistical inferences, respectively.Methods: Respondent driven sampling method is an effective method to penetrate the hidden and hard to reach layers of the target population. The main objective of this paper was to introduce this method, obtain unbiased proportion estimates, as well as evaluate effectiveness of this method in a study of street children in Tirana, Albania (2010).Results: According to the results of this survey, success of respondent driven sampling method for studying street children lies on knowing the exact size of social networks for these children, availability of survey sites, reaching to equilibrium in interested variables and selecting appropriate incentives.Conclusion: Accomplishing accurate findings of street children without the presence of a representative sample would not be possible and it would not be achieved unless researchers use effective sampling methods to study these populations. Indeed driven sampling is recommended.

Objective(s): Due to the capabilities of alternative metrics and their speed in evaluating scientific outputs, and the importance of social media in establishment of scholarly communication and findings’ dissemination, the aim of this study was to investigate the use of social media by health literacy researchers, and to identify top articles based on altmetric score and the association between altmetrics and citation indicators.Methods: The current descriptive research was conducted through scientometrics method and using altmetrics data. The study population consisted of health literacy articles that were published in year 2015, had digital object identifier (DOI), and were indexed in Web of Science. The initial number of retrieved articles was 649 papers. Since the digital object identifiers was required in altometric studies and the use of data from the Altmetric Institute, the documents that did not have the identifier were removed and thus the research population was reduced to 615 record. To collect alternative indicators, each individual article was matched by altmetric.com manually. Spearman correlation was used for analyzing the data.Results: Mendeley and Twitter were the most used social media by health literacy scholars for sharing scientific outputs, ranked first and second by number of 492 and 487 articles respectively. The results revealed statistically significant relationship between most alternative metrics and the number of citations in Web of Science. From the reviewed articles, Iranian researchers wrote 9 articles on health literacy. Of these, 6 had a digital object identifiers. After searching on the altmetric site, it became clear that these six articles have been used in Mendeley's social media and Twitter compared to more than other social media and had 134 readers in Mendeley and 64 tweets in Twitter respectively.Conclusion: Social media can have a positive impact on the citation rate of articles. Therefore, health literacy researchers can make use of social media in order to better inform peers on the Internet and increase the citation to their scientific productions. For this purpose, they could share their work in various social media.

Objective(s): Teachers play a critical role as health promoters. However, little is known on health literacy among students of Farhangian university which is responsible for training the future teachers. The aim of this study was to assess health literacy and related factors in students of this university.Methods: The Health Literacy for Adults (HELIA) was administered face-to-face in a sample 932 students during May 2015. The questionnaire contained 33 items tapping into five dimensions: health information, reading, understanding, appraisal, and behavioral intention. Each item was rated on a 5-point scale giving a total score ranging from 0 (the worse) to 100 (the Best). Data were analyzed using descriptive statistical tests.Results: The mean age of participants was 26.03 (SD=9.6) years and almost 70% were female. Overall, the health literacy (HL) score of the students was 67.28 (SD=13.21). Among all students 10.5% showed inadequate HL, 34.4 % problematic HL, 45.1% sufficient HL, and 10% excellent HL. HL was significantly associated with age, gender and marital status.Conclusion: As the prevalence of high limited health literacy among future teachers is a barrier against enhancing the health literacy of students at schools, there is a need to design, implement and evaluate different educational interventions to address limited health literacy among this population.

Objective(s): Domestic violation against women is one of the serious problems of public health. The Women Abuse Screening Tool (WAST) is able to identify the abused woman. The aim of this study was to assess validity and reliability of the Persian version of Women Abuse Screening Tool.Methods: This was a cross-sectional study. The English version of Women Abuse Screening Tool was translated into Persian using forward-backward procedure. The final Persian version was completed by 80 married women in 2017. Exploratory factor analysis was used to assess construct validity. Relaubility of the tool was assessed by Cronbach's alpha coefficient and test-retest analysis.Results: Exploratory factor analysis confirmed two-factor structure for the scale. The Cronbach's alpha coefficient for the scale was 0.84 and intra-class correlation was 0.81 indicating that the scale had appropriate reliability.Conclusion: The findings of the study showed that the Persian version of Women Abuse Screening Tool is a valid and reliable measure for screening abused women in Iran.

Objective(s): Mentalization based therapy (MBT) and cognitive-analytical therapy (CAT) are special methods for the treatment of borderline personality disorder (BPD). The purpose of this study was to compare the effectiveness of MBT and CAT on improving the object relationship of people with BPD.Methods: This was an experimental study using pretest- posttest design with a control group. Thepopulation of this study consisted all the men with BPD admitted to two psychiatric hospitals in Ardabil, Iran. In all 45 men with BPD were selected by convenience sampling and were assigned randomly to two experimental groups and one control group. The first experimental group received 20 sessions of MBT, the second experimental group 16 sessions of CAT, the control group did not receive any intervention. Data were collected at baseline and posttest using structured clinical interviews, Millon Clinical Multiaxial Inventory and Object Relations Scale. Data were analyzed by covariance and Tukey analysis.Results: After controlling the effects of pretest data, there was a significant difference between the mean post-test scores of the experimental groups and the control group in the object relations and its components (P<0.001). In addition it was found that MBT was more effective compared to CAT in improving insecure attachment and social inefficiency (p<0.05), However, there was no significant difference in the improvement of the object relations between the two interventions.Conclusion: Both treatment methods are effective interventions to improve the object relationships of people with BPD.

Objective(s): The purpose of this study was to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) on the incidence of anxiety in patients with anxiety disorder.Methods: This was a semi-experimental study with pretest and post-test evaluation and with control group. The study used a multistage cluster random sampling method to recruit 28 patients (14 patients for experimental group and 14 patients for control group). The experimental group received the ACT while the control group received the normal care. The following questionnaires were used to collect data: Beck Anxiety Inventory (BAI) and Interpersonal Sensitivity Scale (IPSM).Results: The results of the covariance analysis showed that acceptance and commitment therapy could reduce the overall anxiety in the experimental group at a significant level. Decreases in mental anxiety, physical, panic, shyness, separation anxiety, and the need for patient approval were highly desirable.Conclusion: The findings suggest that the acceptance and Commitment Therapy (ACT) can be used as an adjunct therapy to reduce the incidence of anxiety symptoms in patients suffering from anxiety disorders.

Objective(s): Media are the most important source of people's health information. This study was conducted to compare people's trust to health messages in the national media and Persian-language satellite networks.Methods: This was a cross-sectional study carried out in Tehran, Iran. A valid and reliable questionnaire was used to collect data. Data were analyzed using Wilcoxon and Kruskal-Wallis tests using SPSS software.Results: In all 493 individual took part in the study. The results showed that the use of the national TV with some exceptions was higher in both genders, age, educational and occupational groups as compared to satellite networks. Similarly the level of trust to the national TV was higher among participants with different socioeconomic backgrounds compared to satellite networks. While 65% stated that trust the national TV very and very much, only 32.2% reported that they trust satellite networks.Conclusion: The findings suggest that the national TV should see the use and trust as positive opportunity and take action in order to strengthen the quantity and quality of health-related programs.

Objective(s): Information about ideal number of children enhances the development of realistic and effective population polices. This study aimed to estimate ideal number of children contingent on actual and ideal living conditions among young married individuals.Methods: The study was based on representative data from the 2012 Tehran Survey of Fertility Intentions (n=2267), conducted in the population of married women and men aged under 36 years who lived in the 22 districts of Tehran, Iran. Ideal numbers of children in actual and ideal living conditions were estimated for the study population and socio-economic subgroups of the population.Results: According to the results, the ideal number of children in actual and ideal living conditions were reported 1.6 and 2.2 children respectively. The ideal number of children declined with the rise of education, age at marriage, income, and being less religous. The ideal number of children varied by place of residence, where those lived in the southern districts of the city of Tehran reported higher number of ideal number for children.Conclusion: The results of this study suggest that the ideal number of children of young couples is affected by their living conditions. So, the success of any pronatalist population polices depends on the improvement of couples' living conditions.

Objective(s): This study aimed to investigate the relationship between social support and the intention of childbearing among Iranian women.Methods: This study was conducted on 822 fertile women (15-49 years), referring to 26 public and private healthcare facilities. They were selected using a multi-stage cluster sampling method from the 5 metropolitan areas of the north, south, east, west and center of Tehran, Iran. Data were collected by a valid and reliable questionnaire.Results: About 67.3% (n=553) of women mentioned their childbearing intention in the next three years and 32.7% (n=269) reported no intention of childbearing. Multivariate regression analysis showed no significant relationship between social support and intention of childbearing. Also, there was a direct and significant relationship between age and the intention of childbearing (OR=1.20, 95% CI: 1.05-1.36); P-value=0.005). In addition, variables such as the level of education (OR=0.92, 95% CI: 0.85-0.99; P-value=0.03) and household economic status (OR=0.53, 95% CI: 0.31-0.92); P-value=0.02) showed a reverse relationship with the intention of giving birth to a child.Conclusion: Demographic factors, including age, education and household economic status were strong determinants of childbearing intention among women living in Tehran.