Payesh
Year:2019 | Volume:18 | Issue:4 |Papers Count:13

Objective (s): For decision making and health policy planning it is quite important to know causes of death for every community. This study aimed to investigate death statistics in Ilam province, Iran. Methods: Data were extracted from the Ilam death registry developed by the Iran's Vital Registration Organization. Deaths in 20 groups of causes according to the international classification of diseases-10 [ICD-10] were analyzed. The percentage of each cause is determined by gender and age. The sex ratio index and years of life lost due to premature death also were estimated for each group of causes. Results: There were about 2500 death records annually in the registry system. Majority of deaths occurred due to chronic noncommunicable diseases. Accidents and respiratory disorders had a high proportion in the mortality transition in Ilam province. Three main causes of deaths included neuropathic diseases. At older age, non-communicable diseases such as cardiovascular and among youth the social problems, including unpredictable events, violence by others and suicide were the main factor in the loss of human capital. Conclusion: Epidemiological transition occurred in causes of mortality in Ilam province, Iran. The major contribution of noncommunicable diseases and emerging social problems to deaths requires through examination of health policies that address social, psychological and preventive factors.

Objective (s): The recent Health System Transformation Plan in Iran has become a major priority for the Ministry of Health and Medical Education as a strategic change plan. To manage successfully this plan and prevent its failure, the risks should be managed. Therefore, the purpose of this study was to introduce the risk management model for the Health System Transformation Plan. Methods: This qualitative research was carried out based on the grounded theory approach. The study population was faculty members and managers of medical universities of Iran. Purposive sampling technique was used to select the sample. In this research, 20 participants were interviewed to reach theoretical saturation. Results: In all 6 categories of risks of the Health System Transformation Plan were identified: behavioral risks, attitudinal risks, executive risks, management risks, financial risks, and reputational risks and their causes and consequences. Conclusion: Given the identified risks and the causes of the risks and consequences of each one, the findings suggest that solution for preventing risk factors can be achieved.

Objective (s): The management of most clinics and other outpatient centers are by clinicians. However, most clinicians do not educate any management courses and are not familiar with this field of science. This study aimed to study and describes training needs and priorities related to medical office management for clinicians. Methods: This was a cross-sectional study. All physicians affiliated to Academic Center for Education, Culture and Research (ACECR) with experiences of running a medical office in Tehran were invited to took part in the study. The data were collected using a self-designed questionnaire. Descriptive statistics and Friedman test were applied to analyze the data. Results: In all 37 physicians participated in the study. The general needs of medical office management categorized to 27 topics and 7 headlines: financial management, human resources management, medical risk management, non-medical risk management, process management, evaluation and informatics. Respondents were most aware on medical risk management and the least was on informatics. The most important educational needs and priorities for clinicians were 'Medical office informatics', 'human resources management', 'financial management' and 'evaluation'. Conclusion: The study results showed that physicians with experiences of medical office management identified that they need courses on management. Indeed priorties could be indentified with a study bigger sample size and better design.

Objective (s): This study examined the pattern and trend of living alone among elderly during the last five censuses in Iran. Methods: Data were obtained from two main sources: published Iranian population and housing census (1986, 1996, 2006, 2011 and 2016), and the individual data of 2% census in 2016. Then the characteristics of the sole elderly are described and the extent to which living alone is related to socioeconomic and demographic characteristics is determined. In order to investigate the relative importance of different correlates of the elderly living alone, a set of logistic regression models using STATA software for individual data of 2016 census has been used. Results: The proportion of the elderly who lived alone was 13. 9%, 9. 9%, 9. 9%, 14. 5%, and 14. 9% in 1986, 1996, 2006, 2011 and 2016 respectively. Living alone was associated with residence in urban, being male, having a secondary and high school education, being widowed, divorced, single, being housewife, having income with no job, age 60-69, and age 70-79. The variables included in the analysis were able to explain 43% of the variation in living alone in the whole sample (48% for men and 35% for women). Conclusion: In Iran, living alone increased with age, life in urban areas, being a woman, being single, divorced, widowhood, being low educated, housekeeper and unemployment. If the ageing and the lack of supporting organizations continue to increase, then more difficult conditions will be created for elderly the future. Thus, considering the vulnerability of elderly people who live alone, the need for more appropriate policy and planning is required.

Objective (s): Considering the increasing population of the elderly in developing countries such as Iran, attention to the needs of this group is essential. One of the important needs of the elderly is appropriate nutrition. Failure to recognize malnutrition in a timely manner will result in deprivation of appropriate nutrition, illness, and decrease in quality of life. The aim of this study was to investigate the prevalence of malnutrition and its related factors among the elderly covered by the Social Security Organization hospitalized in Mashhad hospitals. Methods: This cross-sectional study was carried out in 2018 on 200 elderly 60 years and older covered by Social Security Organization, hospitalized in two hospitals in Mashhad, Iran. The relationship between nutrition status and demographic, anthropometric and individual-health variables was investigated. Data were collected through a general information questionnaire and MNA questionnaire. SPSS version 24 was used for data analysis. Results: The mean age of the elderly was 70. 1± 7. 86 years. 25% of the elderly were at risk of malnutrition and 6% were malnourished. Malnutrition rate was higher in women and the elderly with lower BMI. The use of more than three drugs (OR=2. 251 CI95%=1. 015-4. 989), acute disease/psychiatric stress (OR=16. 152 CI95%= 6. 048-43. 140), neuropsychiatric problems (OR=3. 908 CI95%=1. 479-10. 325), mobility limitation (OR=6. 399 CI95%=1. 446-28. 317) and older age (OR=2. 371 CI95%=1. 007-5. 582) and BMI of less than 23 (OR=9. 823 CI95%=3. 747-25. 754) were risk factors for nutritional disturbance. Conclusion: Considering the importance of nutrition status and its impact on the health and quality of life of the elderly, it seems that the continuous screening and evaluation of the nutrition status of the elderly covered by the Social Security Organization is of great importance and is recommended to be placed on the agenda by the Social Security Organization.

Objective (s): Inadequate intake of fruits and vegetables might cause severe problems for pregnant women and fetus. The present study aimed to investigate the effectiveness of a training program based on social cognitive theory on the intake of fruits and vegetables in pregnant women. Methods: This was a semi-experimental study on 90 pregnant women who were randomly assigned to intervention and control groups. The data were collected using a questionnaire consisting of demographic information, questions related to socialcognitive theory and the Food Frequency Questionnaire (FFQ) (the 20-item food frequency check list) which was completed before, immediately and 3 months after the intervention. data were analyzed by SPSS software. Results: After the educational intervention, the level of awareness, self-regulation and outcome expectation increased significantly in the intervention group (P<0. 05). Also in the intervention group the amount of fruit and vegetable intake immediately after training increased significantly compared to before training (p<0. 05). Conclusion: Designing and implementing an educational program based on social cognitive theory can have a positive effect on the pattern of consumption of fruit and vegetable in pregnant women. One of the most effective theories used to predict and express nutritional behaviors is Albert Bandore's social cognitive theory.

Objective (s): This study aimed to assess the relationship between nutrition literacy and diet with obesity. Obesity is believed to be the most common health problem worldwide. Methods: This was a cross-sectional study. The population included 20-30 years old women and men in Tabriz, Iran. The data collected on nutrition literacy, diet and obesity as appropriate. Then, the relationship between dependent variable (obesity) and independent variables including nutrition literacy and diet was examined using logistic regression analysis. Results: A sample of 400 individual participated in the study. The findings indicated that the prevalence of obesity among women was 72. 2% and in men it was 27. 8%. The diet had an inverse relationship with obesity and nutritional literacy was directly related to obesity. Also, the results obtained from logistic regression analysis showed that nutrition literacy and diet can significantly predict the obesity. These variables explained 52% of the variance of dependent variable (obesity). Conclusion: The findings confirmed that healthy lifestyle, especially appropriate diet could play an important role in preventing obesity and its consequences.

Objective (s): To translate and validate the Caregiver Burden Inventory: (CBI) in Iran. Methods: The questionnaire was translated from English into Persian and face and content validity were determined qualitatively. Quantitative validation was performed using construct validity (known groups comparison and criterion validity). The Beck depression inventory and Beck anxiety inventory were used for criterion validity. Reliability was assessed by estimating internal consistency and test-retest analyses. Results: In all 150 Alzheimer patients’ caregivers completed the Persian version of the CBI. The results obtained from known groups comparison showed that the pressure burden care of caregivers with moderate health level was significantly lower than other caregivers (p = 0. 0001). Criterion validity showed a significant correlation between Persian version of CBI with Beck depression inventory (r =0. 508) and Beck anxiety inventory (r = 0. 686). The internal consistency (Cronbach’ s alpha) was 0. 930. Test-retest reliability (ICC) of the questionnaire with interval time of two weeks was 0. 960. Conclusion: The findings indicated that the Persian version of Caregiver Burden Inventory (CBI) is a valid instrument and now could be used for measuring caregivers’ burden in research and clinical practice.