Payesh
Year:2011 | Volume:10 | Issue:2|Papers Count:19

Objective(s): To study health-related quality of life of a general population over 40 years old in Mazandaran province, Iran.Methods: This was a cross-sectional study. A sample of the general population aged 40 and over were studied. Quality of life was measured using the Iranian version of SF-36. Data were analyzed in a descriptive fashion.Results: In all data from 1183 individuals were analyzed. Of these, 46.87 % rated their health as excellent or very good. There were significant differences in quality of life scores between males and females and among urban and rural populations. However, vitality score was higher in those who were living in rural areas. Conclusion: The finding suggest that there are inequalities in health status among different genders and urban and rural populations. The need for policies to reduce this seems necessary.

Objective(s): To evaluate quality of life in adult patients with leukemia in Shiraz, Iran.Methods: This was a cross-sectional study of 100 patients attending hematology center of Namazi hospital in Shiraz and 100 healthy employee and students of Shiraz University of Medical Sciences. Quality of life was measured using Iranian version of SF-36. Also demographic questions were collected.Results: Patients reported poorer health-related quality of life than controls in almost all measures. Howevere there were no significant differences among patients who were differed in type of leukemia and the disease duration.Conclusion: The need for supportive intervention for this patient population seems necessary.

Objective(s): To develop a safety climate questionnaire for use in Iran, and examine its validity and reliability.Methods: A 31-item safety climate questionnaire was developed after a scientific literature review and consultation with occupational health and safety experts. 410 workers in several industrial sectors responded to the questionnaire. A 20-item questionnaire measuring safety climate was extracted from the original 31items. Exploratory factor analyses and inter-item consistency were applied to examine construct validity and reliability. Comparisons of safety climate scores among various groups by age, years of work experience and accident history were used to test discriminant validity.Results: The analysis showed that the safety climate questionnaire loaded on seven different factors: management commitment, safety communication, safety environment, manager’s responsibility, risk perception, job satisfaction and safety awareness. These factors explained the 71.5% variance. Coefficients of inter-item consistency met psychometric requirement. Significant differences on some safety climate scales and accidental involvement and job history were detected.Conclusion: Management commitment, safety communication, safety environment are important factors in safety climate measurement in Iranian workers. Safety climate measurement among Iranian workers with this 20-item questionnaire is a valid and reliable maesure.

Objective(s): To determine consistency between death certificate and medical records in two hospitals in Kerman, Iran. Methods: Check list was used to collate data on hospital medical records and a questionnaire from viewpoint of certifiers. To analyze the data percentage of each question was calculated and compared.Results: The results indicated that knowledge of physicians in completion of death certificate and registration of underlying causes of deaths was not good. The rate of registration of other information was relatively good. Conclusion: The finding of the study revealed that there is need to educate physician now to complete a death certificate.

Objective(s): To assess relationship between anxiety and quality of life in students living in dormitories of Tehran University of Medical Sciences.Methods: A sample of two hundred female students who were living in dormitories of Tehran University of Medical Science was studied. Quality of life and anxiety were measured using the WHOQOL and Spilberger's anxiety questionnaires, respectively. Results: A strong, reverse relationship was found between stress level and the quality of life (P<0.05, r= -0.66).Conclusion: Reducing the stress level in students’ life might improve their life quality and consequently help them in their academic progress.

Objective(s): Unsafe abortion is the main problem of women during their reproductive age. This study was carried out to explore the reasons behynd illegal abortion in Iran.Methods: This was a qualitative study. Twenty-seven participants were interviewed during March and September 2006 about illegal abortion process. All participants had an experience about illegal abortion or their occupation was relevant to the one aspect of illegal abortion. Interviews were analyzed using a content analysis method.Results: Five main themes emerged from analysis: motivations for ending unwanted pregnancy (social factors, familial factors, personal factors), the assessment of situation (reactions, religiousand individual beliefs, socio-politics restrictions), definite decision, changing the mind, doing abortion by the help of fassilators (the role of partner, previous experiment, doing abortion in general or private centers, doing abortion by herself) and abortion outcomes (physical outcome social outcome, mental outcome, juridical outcome).Conclusion: Illegal abortions are usually performed by unskilled practionnaires. Since, in Iran abortion is illegal, finding ways to protect women against malpractice needs urgent attention.

Objective(s): To determine the knowledge, attitude and practice about self-medication among mothers in Arak, Iran.Methods: This was a cross-sectional study that was carried out with random sampling on 300 mothers referring to health centers in Arak. The data was collected by a questionnaire and a checklist. For analyzing the data we used the chi-square test, analysis of variance, Pearson correlation and considering significant values of P<0.05.Results: The mean age of mothers was 34.5±6.6 years and 61.2% of mothers had poor knowledge, 28.6% average and 10.2% had good knowledge about correct consumption of drugs. In this study 15.2% of mothers had poor attitude, 48.5% moderate and 36.3% had positive attitude about self-medication. In this study, the prevalence of self-medication in mothers was 56.5%. There was a significant relationship between knowledge and practice about self medication (P<0.01). Self-medication was more common in women having more knowledge than the others. More self-medication was seen among mother with a job and higher education level.Conclusion: The prevalence of self-medication among the mothers was very high and necessarily there should be a program for changing the attitude and the habits of mothers to refer to physician when they are ill.

Objective(s): To investigate the individual factors which lead to the occurrence of high risk behaviors among HIV/AIDS patients and vulnerable people.Methods: This was a qualitative study approach carried out in 10 month in tow public counseling clinic in Tehran. Data were obtained from 102 in depth and semi-structured interviews. A convenience sample of HIV/AIDS patients, clients and specialist took part in the study. Interviews were transcripted and then open coding and axial coding were performed.Results: In all 69 HIV/AIDS patients and 19 high risk clients, 6 family members and 8 experts were interviewed. The majority of participants were male and single. Sexual high risk behaviors and drug use were the commonest ways of HIV/AIDS transition.Individual factors predisposing HIV/AIDS high risk behaviors included:1. Predisposing perceptions2. Personal factors3. Decision and willConclusion: The results indicated that the beliefs, decision and individual factors might be the most underlying contributing to high risk behaviors.

Objective(s): To analyze the process of priority setting at different levels of Iran’s health system. Methods: In this qualitative study, 19 Experts of different levels of health system were interviewed. The semi- structured interview guide was designed based on literature review and four initial in depth interviews.Framework analysis method was used for the analysis of qualitative data. Results: Eight themes and 22 sub-themes regarding health priority setting were identified: Health priority at macro-level; Priority setting between and within medical universities; Priority setting criteria; Measuring costs and outcomes; Resource shift; Public participation; and Resource allocation decision rule. Health sector share of public budget was unrealistic and was based on historical patterns. Political factors and lobbying influenced resource allocation between and within medical universities. Resource allocation was mainly structure based and health factors were least influential. Although resource shifting was possible within programs but it was impossible within them, Public participation in priority setting was not sufficient and systematic, decision making on resource allocation was mainly based on needs and judgment. Conclusion: Some priority setting activities are in progress, but they do not tend to be either comprehensive or systematic. In order to improve priority setting, developing an approach which enables stakeholders' involvement is suggested.

Objective(s): To explore nursing staff's perspectives about spiritual mode of job satisfaction. Methods: This was a qualitative study. Data was obtained through interviews, which were recorded and subsequently transcribed. The analysis was carried out by the qualitative content analysis. Results: Five mater themes emerged from the data analysis: spiritual joy & interest, patients as bless of God, spiritual assurance, spiritual remuneration, and spiritual repugnance. Conclusion: Spirituality as an important and integral aspect of nursing profession was supported in this study. Spirituality is the inner, intangible dimension that motivates staff nurses to search for meaning and purpose, and establish positive and trusting relationships with patients and God.

Objective(s): To determine the prevalence of obesity, underweight and their associations with physical activity and diet patterns among 12-14 year old adolescent boys in Sabzevar, Iran. Methods: This cross-sectional study was performed on 650 boy students aged 12-14 years in Sabzevar (2009). Subjects were selected via random Sampling. Underweight, overweight and obesity was defined based on the 5th, 85th and 95th percentiles of body mass index (BMI) for age and sex, respectively, as proposed by CDC 2000. Physical activity levels were assessed by the Physical Activity Questionnaire for Older Children (PAQ-C).Dietary intakes (energy intake and macronutrient) were assessed by means of a food frequency questionnaire (FFQ). Sedentary behaviors and socioeconomic status of subjects assessed by means of a designed questionnaire.Results: The overall prevalence of overweight and obesity was 9.8% and 7.1%, respectively. Also prevalence of underweight was 11.1%.Physical activity levels were significantly lower (P<0.01) in overweight-obese subjects than normal-weight and underweight subjects. Television viewing were higher (P<0.05) in overweight-obese subjects than normal-weight subjects. There was no statistically significant difference in the reported energy intake and macronutrient between overweight-obese and non-overweight subjects. After adjusting for body weight and BMI, the overweight-obese subjects had the lowest energy intake (P<0.01). Overweight-obese subjects were less likely to eat breakfast than non-overweight (P<0.05). There was significant positive correlation between education level of parents and BMI of subjects. Education level of parents was significantly higher in overweight-obese subjects than normal-weight subjects.Conclusion: These data indicate that prevalence overweight and obesity is relatively high among 12-14 yearold adolescent boys in Sabzevar. The findings suggested that a decrease in physical activity levels and increase in sedentary behaviors (television viewing and not using computer) are related with obesity and overweight, but not diet pattern.

Objective(s): To assess the quality of care in patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) through comparison of provided care with recommendations of an evidencebased guideline.Methods: The index of quality of care (IQC) was defined as the percent of applicable grade A, B or C recommendations of the National Institute for Health and Clinical Excellence (NICE) guideline for each case. Then we made a data check list for patients' information according to guideline. A list of cases with COPD exacerbation who admitted in Rasool Akram or Firoozgar academic hospitals was provided and 101 cases were randomly selected.One of the investigators read all clinical records and compared the provided care with recommendations of the guideline. The IQC was estimated for all cases and compared in different subgroups.Results: The average IQC was 88.4% (standard deviation: 14.8%). Considering applicable recommendations for each case, concordance rate between practices and recommendations was 90.7% for grade A (95%CI: 87.8-93.6%), 84.9% for grade B (95%CI: 75.3-94.5%) and 79.1% for grade C (95%CI: 71.5- 86.7%). The IQC was statistically higher in patients who discharged alive compared to deceased cases (87.4 vs.74.6, P<0.05).Conclusion: Considering greater IQC in patients who were discharged alive, it seems using evidence-based guidelines has better outcomes for patient with COPD exacerbation; using such guidelines seems to be logical in academic hospitals.

Objective(s): Cesarean section rate has been increasing dramatically in the past decades in Iran. The objective of this study was to show the trend during an eight-year period.Methods: The records of cesarean section in a hospital affiliated to Shahed University were compared at two different time periods.Results: Overall the cesarean section rate was 88%. The results showed that the cesarean section rate in nulliparous women was 90% and it would be 85% in her third pregnancy if it occurs. Conclusion: There is a dramatic increase of cesarean section rate comparing to the results of the same study eight years ago. Although arguments for decreasing cesarean births are acknowledged by obstetricians, translating them into practice on a daily basis is tempered by the constraints of time and the burden of medicolegal concerns. It needs a great concern of medical policymakers to resolve it as soon as possible. It seems plummeting of elective cesarean section without medical indication can protect the public from the devastating impact of this malpractice.

Objective(s): Decrease of quality of life and undesirable sleep quality in individual with bronchiolitis due to chemical exposure reported in previous studies. This study was applied to assess relationship between sleep quality and quality of life in chemical warfare victims with bronchiolitis obliterans.Methods: In this descriptive correlative study, 93 chemical warfare victims with bronchiolitis obliterans referred to respiratory clinic of Baqyatallah hospital were selected by convenience sampling method. Quality of life and sleep quality was measuring the St George’s Respiratory Questionnaire and Pittsburgh Sleep Quality Index (PSQI).Results: Pearson correlation coefficient was showed a positive and significant correlation between sleep quality and quality of life. Also it was revealed significant relationship between psychological disorders and undesirable sleep quality (P<0.05). Conclusion: The findings suggest there is need to improve sleep quality in this population in order to enhance their heathed-related quality of life.

Objective(s): To assess challenges of determining basic health insurance package in Iran. Methods: We interviewed a purposeful sample of 20 participants from 7 main stakeholders in Iranian health insurance system in 2009. We asked about main challenges of determining basic health insurance package in Iran and used the framework method for the analysis.Results: Agreement on General Principle, determining Criteria to define Basic Health Insurance Package, Organization, Financing, Payment System, Regulations, Benefits range, Composition and manner of population coverage, Coordination, Behavior, Policy Making, Surveillance and Control had been introduced as main Challenges of Determining Basic Health Insurance Package in Iran.Conclusion: Determining an appropriate health insurance package in Iran needs a systematic view and a long term plan. The plan should aim to respond to the above concerns.

Objective(s): To study the relationship between Job satisfaction and organizational commitment in nursing staff in medical university hospitals.Methods: In a cross-sectional study, all 750 nursing staff working in hospitals affiliated to Golestan university of medical sciences were entered into the study. Job Satisfaction Questionnaire and Meyer Organizational Commitment Scale used as research instruments. Data were analyzed using descriptive statistical tests and Pearson correlation coefficient.Results: The mean age of participant was 32.6±7.4 years and 72.7% were female and married (74%). Job satisfaction in 37.7% of nurses was low and only 2.2% of them had very high level of job satisfaction. Organizational commitment in 49.6% of subjects was low and just 4% of nurses had high level of organizational commitment. There was a statistically significant relationship between job satisfaction and organizational commitment (P<0.05). Conclusion: There is a significant relationship between job satisfaction & organizational commitment.