Payesh
Year:2014 | Volume:13 | Issue:6|Papers Count:10

Objective (s): The catastrophic medical payment is one of the most important concerns in low income and developing countries. Iran is one of the countries that out-of-pocket payment is a major method for health care, which may result in catastrophic expenditure. This study aims to identify factors that influence catastrophic health expenditures (CHE) by patients in of Tabriz, Iran in year in 2011-2012.Methods: 300 patients were selected from patients hospitalized in general hospitals. The information was collected by a questionnaire and the Stata software and Heckman model.Results: The results indicated that the proportion of households with CHE was 30%. The results of Heckman selection model indicated that factors such as age (elderly people), and gender (female patients) were associated with higher CHE. The results of the orderd-probit selection model demonstrated that elderly person, children, person with chronic diseases, admission to a private hospital and lower household wealth were major factors contributing to the increased probability of the CHE.Conclusion: The findings demonstrated that the use of expensive hospitalized care and lower economic status increased the households’ exposure to catastrophic expenditures.

Objective (s): To achieve a model to monitor and evaluate drug abuse treatment centers in Iran.Methods: This was a nationwide study. The data were collected through interviews with selected experts, experts working in drug treatment centers using a questionnaire, and interviewing technical officers (300 centers from 31 provinces), and existing documents. Then, based on ‘guiding principles’ it was decided to provide a model for monitoring and evaluating drug abuse treatment centers.Results: Overall we found 3 types of centers: complying with more than 80% of obligations, complying with 60% to 80% of obligations, and complying with under 60% of obligations. In addition to views of the university and staff experts who assume the current monitoring and evaluation system is incomplete and require further development, 70% of directors were dissatisfied or moderately satisfied with the current method of monitoring and evaluations. The analysis of the data indicated that in order to further develop the current situation, there is need to concentrate on improving horizontal and vertical coordination in supervising at national, provincial, and regional levels. In addition the findings indicated that there were several confusions in duties among staffs.Conclusion: As a result a style sheet and check list were provided to clarify duties in the centers at each level.

Objective (s): Recently, human reaction to life hardships and problems has drawn great deal of attention from the researchers.More emphasis on issues pertinent to stress, illness, and health led more attention to concepts such as adjustment and coping strategies. Scholars in different fields have introduced different theories regarding adjustment and mentioned specific aspects of the matter based on the paradigm of their field of expertise. They have tried to introduce their viewpoints within scientific and theoretical framework. The aim of this study was to recognize models and theories of adjustment to illness and disability; and evaluate their strengths as well as weakness.Methods: A literature search using Pub Med, ProQuest, Science Direct, Scopus, and Iran Medex was conducted using several keywords including adjustment, adaptation, coping, adjustment to diseases and models of adjustment to illness and theories of adjustment to illness. Literature was searched for both Persian and English papers.Result: Review of the literature showed different approaches and theories regarding adjustment to illness based on biologic, behavioral, cognitive, combination and and holistic views. Regarding adjustment theories and models with biologic approach, different aspects of diseases and complications were considered. Concerning behavioral approaches of adjustment, the patients’ behavior with disease and coping strategies were emphasized. Cognitive approach mainlydealt with cognitive evaluation of the disease by the patient and employing counter measure to fight the disease. The holistic biological approach considered human as a biological, psychosocial being with continuous interaction and reaction with internal/external environments.Conclusion: It seems that cognitive behavioral models and theories better explain how people cope with illness, health and disability to achieve effective adjustment.

Objective (s): Commercial drivers are considered as a high-risk group for road traffic injuries (RTIs) in Iran and a clear relationship has been demonstrated for drug misuse and RTIs. To present the epidemiology of drug dependence among public transport drivers in Iran.Methods: Using capture-recapture sampling method the prevalence rate of drug dependence was estimated. Overall, 1506 drivers were randomly selected proportionately by type of vehicles. To test the drug dependence, a multi-drug rapid urine kit (ACON 10 Panel Drug Screening Test) was employed. Trained interviewers accompanied by traffic police officers in selected roads asked the drivers to answer the questions and give a urine sample at the police check points.Results: Overall, 14.1 percent of drivers were test positive. The top three drug dependence was from opium (55.0%), morphine (21.3%) and methadone (8.5%). Using logistic regression model showed no statistical difference for type of drug dependence by educational attainment. Drivers of trailers (21.5%) and trucks (15.1) were more likely to be drug-dependent compared to other drivers (p<0.001). Many addicted drivers preferred to use drugs during the night time (44.3%) and drive long distances (26.8%).Conclusion: The prevalence rate of illicit drug use among Iranian commercial drivers is high Prevention of drugged driving among commercial drivers is an essential strategy for avoiding RTIs. Mandatory drug testing specially during the night time should be put in force for commercial drivers particularly for trailer, truck, and for long distance drivers.

Objective: The aim of this study was to assess the safety and efficacy of treatment with insulin analog Novomix30 in Iranian patients with type 2 diabetes using the results of the A1chieve study.Methods: The A1chieve study was a 24 week, open-label, multicenter, observational study of people with type 2 diabetes. The study was conducted in 28 countries across four continents on 66, 726 people with type 2 diabetes, both insulin users and noninsulin users, to assess the safety and efficacy of Novomix30. This article reports the results of 919 Iranian patients with type 2 diabetes treated with insulin Novomix30.Results: After 24 weeks treatment with Novomix30, HbA1c reduced significantly (P<0.001). Despite a significant reduction in fasting blood sugar and postprandial sugars, the incidence of severe and nocturnal hypoglycemia was significantly decreased in prior insulin users. The mean arterial blood pressure decreased significantly and the quality of life improved in all patients.Conclusion: Insulin Novomix30 was well tolerated despite good glycemic control and the incidence of hypoglycemia was not increased in Iranian patients with type 2 diabetes.

Objective: The aim of this study was to assess the safety and efficacy of treatment with insulin analog Novomix30 in Iranian patients with type 2 diabetes using the results of the A1chieve study.Methods: The A1chieve study was a 24 week, open-label, multicenter, observational study of people with type 2 diabetes. The study was conducted in 28 countries across four continents on 66, 726 people with type 2 diabetes, both insulin users and noninsulin users, to assess the safety and efficacy of Novomix30. This article reports the results of 919 Iranian patients with type 2 diabetes treated with insulin Novomix30.Results: After 24 weeks treatment with Novomix30, HbA1c reduced significantly (P<0.001). Despite a significant reduction in fasting blood sugar and postprandial sugars, the incidence of severe and nocturnal hypoglycemia was significantly decreased in prior insulin users. The mean arterial blood pressure decreased significantly and the quality of life improved in all patients.Conclusion: Insulin Novomix30 was well tolerated despite good glycemic control and the incidence of hypoglycemia was not increased in Iranian patients with type 2 diabetes.

Objective (s): The European Organization for Research and Treatment of Cancer Quality of Life Spiritual Well-Being (EORTC QLQ-SWB) is a cross-cultural international module measuring spiritual well-being of patients with cancer, receiving palliative care. This article intends to address the process of providing Persian version of the module.Methods: All steps of providing Persian version of the measure were carried out based on the EORTC Quality of Life Group- Translation Procedure.After contacting the translation coordinator in the EORTC and receiving permission to translate the measure, forward translation from English into Persian using two qualified translators was performed. Then, forward translations were reconciled into a single version. Consequently, the version was provided for two other translators, not informed of the original questionnaire to do backward translation. After receiving backward translations and comparing them with original questionnaire, appropriate changes were made in provisional Persian version. Before pilot testing, a report was sent to the EORTC Quality of Life Study Group and necessary modifications were made. Then pilot testing was conducted and the related report was sent to EORTC. Approval by the EORTC yielded the final Persian version of the questionnaire.Conclusion: Following the EORTC Quality of Life Study Group guidelines in translating a standard measure of quality of life questionnaires could result in providing a version that conceptually is equivalent to the original questionnaire as we found it for the Persian version of the EORTC QLQ-SWB.

Objective (s): Endometriosis is a chronic and debilitating disease, which affects all aspects of the women’s life. The purpose of the present study was to explore the perception and experiences of endometriosis patients about femininity.Methods: A qualitative research was conducted to obtain data from 18 purposely selected endometriosis patients referring to a teaching hospital in Tehran, Iran. Data were collected by in-depth interviews and were analyzed using a conventional content analysis.Results: Seven categories and three main themes emerged from the participants' experiences. The themes were: 1) Feeling gynecologic disorders included three categories: menstrual disturbances, complaint of irritating cyst and pelvic infection problems, 2) Disruption in marital life included two categories: dyspareunia and infertility, 3) Disrupted social life included two categories: emotional and communicational disturbances and impairment in daily activities.Conclusion: The findings of present study showed that endometriosis affects femininity, which may have devastating consequences on individual, family and social life of affected person.