Payesh
Year:2003 | Volume:2 | Issue:1|Papers Count:9

Objective(s): To compare anemia status between pregnant and non-pregnant women living in Gorgan villages. Material & Methods: This was a descriptive study. For the study purposes, 415 women aged between 18 and 35 from 20 Gorgan villages were entered into the study using cluster and simple sampling method. In all, 48 pregnant and 361 non-pregnant women were compared. After sampling, hematological examinations were carried out by Coulter Counter. Serum iron and TIBC were determined using spectrometry. In pregnant women serum iron, Hgb and T.S. less than 30 micg/dl, 11 g/dl and 16% respectively, but in non-pregnant women they were considered as anemic if the serum iron, Hgb and T.S. were less than 40 micg/dl, 12 g/dl and 16% was regarded as anemia respectively. Results: In pregnant women, the prevalence of anemia on the basis of serum, T.S. and Hgb was 24.2%, 42.4% and 18.2% respectively, but in non- pregnant women this was 21.2%, 34.55% and 20.98% respectively. There was no significant difference between two groups (P>0.05). However, there was a significant difference between the number of last deliveries and serum T.S (P<0.03). The mean of MCV, CMH and MCHC during 2nd stages of pregnancy was less than 1st and 3rd or non- pregnant women. Conclusion: The results showed although there was no significant difference between pregnant and nonpregnant women, anemia is one of the nutritional problems in women in rural Gorgan, so supplementary iron has to be administered during pregnancy period. 

Objective(s): Although menopausal symptoms are not life-threatening, its long-term effects such as osteoporosis, cerebrovascular accident and myocardial infarction can compromise the women's life. The purpose of this research was to study the effect of exercise on the occurrence of menopause. Material & Methods: The study was conducted on 90 menopausic women (45 athletes & 45 non-athletes). The subjects were selected through random and simple sampling methods. The data was collected by employing a questionnaire. The following statistical methods were used: t-test and Pearson's correlation. Results: No significant correlation was found between occurrence of menopause and exercise (p>0.05). Conclusion: The results indicated that exercise has no effect on the occurrence of menopause, but there is evidence that doing daily exercise by menopausic women could decrease menopausal complications.

Objective(s): Client-oriented approach has been recently introduced to health services as a basis for quality improvement. The main purpose of the study was to adapt a method for development of monitoring tools called "Self - assessment". In addition, staff opinions regarding simplicity, feasibility and workload have been investigated as part of a comprehensive assessment of this monitoring tool. Material & Methods: The first step for development of this monitoring tool was to consider quality elements in each health program based on client oriented and provider efficient approach. Then, preceding quality elements were used for developing a monitoring tool. This monitoring tool, i.e. Self-assessment, is focuses on assessment of activities by providers themselves. In addition, without any predetermined investigations; it can motivate staff for efficient service delivery by team building in health center. For assessment, four urban health centers were selected for intervention in Semnan. Three days workshop was hold for each center. The tutors in one center were authors and in the remaining centers were district staff. Data were obtained from 42 staff in health centers by open and ended questionnaires. Results: In three centers, which workshops were conducted by district staff, 87.5% (95% CI: 75.8 - 99.9) of staff agreed with "Self -assessment" model. The mean Point of weaknesses and strengths were 0.5 and 3.4, respectively. After a few rounds of "Self - assessment" comparing the results between centers having more versus less expertise indicated that coordination with upper managerial level is crucial. Conclusion: The "Self - assessment" monitoring method is highly focused on monitoring process and structural dimensions of quality. Looking for measuring outcomes must be considered as an essential part of a comprehensive assessment. Further evaluation of "Self - assessment" not only in comparison to other monitoring tools, e.g. "Routine supervision", but also long term effect is highly recommended before any wider implementation of this newly developed tool.

Objective(s): Quality assessment based on client oriented approach is one of the most effective methods in improving efficacy of services. The "Self-assessment" consists of four monitoring tools including "service assessment, client flow analysis, client exit interview and plan of action"; and can be performed by staff group forming in Service Delivery Points (SDPs). The main objective of the present study was to compare "Self-assessment" with "Routine supervision". Material & Methods: Eight urban SDPs have been allocated (by stratified random allocation) to the "Self-assessment" and "Routine supervision" groups, which had three and five SDPs, respectively. The following variables have been determined for comparison of two methods after one round of the Self-assessment: 1) monitoring performance by finding problems in SDP 2) job satisfaction of staff 3) staff attitudes towards their job 4) staff practice. Difference of pre and post intervention data of two groups have been compared by Man Whitney and t-test. Results: Most frequent problems which have been picked up by the Self-assessment were deficiencies in materials and instruments, problems in physical structure of SDPs and educational materials. In the other hand problems that raised by "Routine supervision" were usual administrational issue, deficiencies in materials and instruments, and finally roughly suggestions regarding service delivery, e.g. low quality of care. The Self-assessment had more in-depth approach in evaluation of technical aspects of services and client rights than routine supervision. In addition, although this was a short term evaluation, Self assessment showed regarding staff attitudes towards relations with their colleagues (P=0.05) and their overall satisfaction (P=0.04). It seems that these effects were contributed by team forming in SDPs. Conclusion: The Self-assessment affects staff participation, their attitudes towards client rights, innovation for problem solving and finally results in quality improvement. The important point is coordination and supportive role of central levels with this activity; otherwise its impact would be diminished after afew rounds.

Objective(s): To study the association between life events and depression in medical residents. Material & Methods: This was a cross-sectional study and 233 medical residents were assessed. First, a brief interview was carried out to collect information on age, marital status, number of children) and past psychiatric and family history. Then, they were assessed through the following questionnaires: The Hamilton Depression Inventory, The Beck Depression Inventory, The Holmes & Rahe Life Events Scale and The Minnesota Multiphasic Personality Inventory (MMPI). Results: The mean score of the BDI was 5.77 (SD:5.74) and the mean score of the HDI was 5.21 (SD:4.38). The incidence of depression was 19% (as measured by the BDI) and 24.5% (as measured by the HDI). There was a significant correlation between the BDI and the HDI. There was no significant correlation between depression with age, sex, marital status, number of children and religion. Males were more sensitive to work and financial problems, and females were more sensitive to personal and marital problems. Conclusion: Depression in medical residents is correlated with number and type of life events.

Objective(s): To assess frequency of physical violence during pregnancy by women's husbands and to study its maternal complications and birth outcomes. Material &Methods: We used data from 406 women who delivered infants in a postpartum ward at Akbarabadi Hospital in Tehran. Data on physical violence and pregnancy outcomes were collected via a questioner that contained 30 items. Outcome data included labor and delivery complications, LBW and preterm births. Statistical tests including chi- square and odds ratio were performed to determine differences between two groups and severity of associations. Results: The frequency of physical violence was 10.7%. There were associations between domestic violence and maternal low education and drug abuse arid cigarette smoking. Also hospitalization during pregnancy and inadequacy of prenatal care and unwanted pregnancy and LBW, preterm delivery were higher in women who had experienced domestic violence. Conclusion: There are associations between physical violence and maternal complications and birth outcomes. Screening for domestic violence during early pregnancy is suggested for all women.

Objective(s): To assess knowledge, attitudes and lifestyle in unstable angina patients. Material & Methods: A descriptive study was conducted among patients hospitalized in C.C.U in Mashhad . In all 180 subjects were entered into the study. They answered to an 82-items questionnaire consisting of questions on demographic factors (4 items), knowledge (5 items), attitude (56 items) and lifestyle (17 items). Results: The findings indicated that the global level of knowledge about cardiac risk factors, available treatments, compliance to treatment, was insufficient but it was very low about pain inducer behaviors. Patients' attitudes toward perceived threat (severity and susceptibility) of the disease and internal Health Locus of Control were relatively low. Conclusion: There is a strong need to promote angina patient education and this should be delivered by health professionals.

Objective(s): To evaluate the nutritional messages in Iranian newspapers. Material & Methods: A content analysis study was conducted on 192 issues of 8 largest national daily newspapers using a systematic monthly content analysis from March 1999 to March 2000. A coding form was devised to tabulate information. All messages related to food and nutrition was recorded by 5 trained nutritionists and double-checked by a senior nutritionist and a communication expert. Results: In total, 122 nutritional messages were found with a mean of 0.65 messages per issue and total printed surface of 0.3%. In terms of style, 64.8, 1.6, 4.9 and 28.7% of messages classified as news, reports, articles and as others, respectively. The most frequent topic was food safety (35.3%), followed by nutrition related disorders (17.6%) and food properties (14%). While about 70% of messages were scientific-based, 17% identified as ambiguous. About 40% of messages were written by a nutritionist or an allied expert. The target audience for 75% of messages was the general public. Only 1 message was written in a non-popular language. About 30% of messages contained promotional statements, while 47.5% presented bleak news. Messages cited from different resources, from which Islamic Republic of Iran News Agency (18.9%), four major news agencies (UP, AP, Reuters and France Press) (1.6%), international and national organizations (23%) and Internet (1.6%) were foremost. Conclusion: According to this study, it seems that both quantity and quality of nutritional messages in most popular newspapers are not public - oriented.