Payesh
Year:2016 | Volume:15 | Issue:4|Papers Count:17

Objective (s): Life expectancy is one of the most important summary measures and the main indicator of health. Accordingly, the objective of this research was studying the effect of inflation, health expenditure and urbanization on life expectancy in the Middle East and North Africa Countries (MENA).Methods: This research was a causal-analysis by using panel data over the period of 2000 - 2012 for the countries of Middle East and North Africa.Results: Coefficients for each of the variables in the model were consistent with the theoretical bases. So that, one-unit increase in the inflation has decreased life expectancy by 3.17 units and also one-unit increase in each of the variables of health expenditure and urbanization, have increased life expectancy by 0.12 and 0.37 units respectively.Conclusion: Given the positive impact of health expenditure and urbanization on life expectancy, special attention to the health sector and increasing public awareness on using insurance services is recommended. Also, with respect of the negative impact of inflation on life expectancy, it is suggested that by using appropriate policies, the policy makers prevent excessive price increases to provide the least purchasing power of people and therefore their physical and mental health.

Objective (s): Waits and delays are symptoms of disrupted patient flow that has a negative effect on patient satisfaction, staff retention and referrals. This research aimed to study on psychiatric outpatients’ flow of a medical center in Tehran (name withheld) and their waiting time improvement in the summer of 2014.Methods: This was a cross-sectional study and convenience sampling method was used. The mean waiting time at each service station was calculated with Minitab software and bottleneck was found. To find the relationship between other variables and waiting time in the bottleneck, linear regression analysis was used. Root causes were identified with Root Cause Analysis (RCA) then preventive measures were proposed and their impact on waiting time was tested by Delphi method which used in the “Do” phase of the cycle of planning, implementation, study and act (PDSA), and action plans were proposed in the “Act” phase to improve waiting times.Results: Time measurement showed interview station has the highest average waiting time of 27.37 minutes. Linear regression analysis showed that the number of patients waiting, impact the waiting time. In this study the lack of funding, lack of job satisfaction, vague job descriptions and non-compliance with the standard timeframe for meeting patients, were identified as the root causes of long waiting times.Conclusion: Since the interview station was known as a bottleneck of the process, implementation of strategies such as realistic staff employment, providing opportunities to personal improvement, staff encouragement based on performance evaluation results, making a friendly environment in workplace, will improve waiting time in bottleneck.

Objective (s): The aim of current study was to design and deliver a curriculum for school health for bachelor degree.Methods: This study was an applied qualitative research. We studied all national documents including the last approved school health program published by the Institute of Standards and Industrial Research of Iran. In addition we studied school health programs in other countries including the United State of America, Britain, Malaysia, Egypt and the Persian Gulf states.Finally we carried out semi-structured interviews with 12 curriculum specialists and health professionals who have been purposefully selected; based on the model of Graves' prescriptive.Results: A pragmatic curriculum was provided that contained objectives, content, teaching and evaluation methods of delivering at bachelor level. The results showed that the curriculum with key elements (objectives, content, teaching methods and evaluation), was appropriate to the country's higher education system.Conclusion: It seems that the bachelor curriculum of school health in higher education system, could improve students' personal and social health.

Objective (s): Health literacy usually refers to personal competencies for access to, process and use of health information and services to make sound decisions and maintain good health. The aim of this study was to develop and evaluate the psychometric properties of Health Literacy Measure for Adolescents (HELMA).Methods: This study consisted of two qualitative and quantitative phases. In the qualitative part, in-depth interviews with 67 adolescents aged 15-18 were performed to generate initial item pool. Then content validity and face validity of items were assessed through expert panel review and interview with adolescents. In quantitative part, to describe psychometric properties of the scale, validity, reliability (internal consistency and test-retest) and factor analysis were assessed.Results: In qualitative stage, an item pool with 104 items was generated which after content validity decreased to 47 items. In quantitative part, 582 adolescents aged 15-18 participated in the study with mean age 16.2 year. 51.2% of participants were females. In principal component factor analysis, 8 factors loaded that accounted for 55.06% of observed variance. Reliability has been approved by a=0.93 and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (ICC=0.93). Final questionnaire had been approved with 44 items in eight domains of gain access to, reading, understanding, appraise, use, communication, self- efficacy and numeracy.Conclusion: The Health Literacy Measure for Adolescents (HELMA) is a valid and reliable instrument for measuring health literacy of adolescents aged 15-18 that can evaluate different level of functional, interactive and critical health literacy in adolescents.

Objective (s): Texting while driving (TWD) is of the dangerous causes of accidents. As such, in order to determine an appropriate instrument to investigate the psychosocial factors related to the issue of (TWD), the reliability and validity of the Farsi-translated questionnaire was explored by utilizing the Theory of Planned Behavior (TPB) model among drivers.Methods: The present study was done among students of 18 years old and above at Tehran Medical Sciences University, Shahid Beheshti University, and The University of Iran in 2014. The study sample included 470 students, 260 males and 210 females, through a several-stage clustering strategy.Results: During the investigation of content validity of the questionnaire, question number 14_related to possessing a cell phone_ and three subcategories of questions number 23, 24, and 25 were omitted due to their similarity in meaning with the other questions. Also, three options were added to the questionnaire so as to guard against ambiguities. the index of Cronbach's alpha to investigate internal consistency in two scales of "sending" and "receiving" was 0.79 and 0.71, respectively. The intra class correlation in two scales of "sending" and "receiving" was 0.83 and 0.79, respectively, showing a high degree of test-retest reliability.Conclusion: The Persian translated questionnaire of Texting While Driving (TWD) by using the TPB model is a valid and reliable instrument and could be used in related studies.

Objective (s): This study aimed to translate and validitethe 20-item Geriatric Anxiety Inventory (GAI) in Iran.Methods: After receiving permission from the designer, the Persian version of the GAI wa provided. Then face and content validity, construct validity were performed. Known group cpmaprsion and by using the SF-36, criterion validity also was performed. Internal consistency was used to examine reliability.Results: In all 100 elderly participated in the study. Significant differences between none-abused and abused groups observed (P=0.0001). The criterion validity showed high and significant correlation between most GAI and SF-36 subscales. Cronbach's alpha for the total scale was 0.957.Conclusion: The findings revealed that the Persian version of GAI is a valid instrument to measure anxiety in eldrly populations in Iran. We recommend that the future studies examine factors structure of the questionnaire in a larger sample size.

Objective (s): This study aimed to translate and validate a Persian version of the CASP-19, in Iran.Methods: The existing CASP-19 (English version) was translated into Persian version according to the World Health Organization protocol for translation and adaptation of instruments. The operational measure (CASP-19) consists of 19 Likertscaled items that cover four theoretical domains: control, autonomy, self-realization and pleasure. Data were collected from 100 older people. Reliability (internal consistency, test- retest reliability) face validity, content validity, known groups comparisons and criterion validity of the CASP-19 and the SF-36, were examined.Results: The mean age of the participants was 69.6 (standard deviation±7.32) years, and more than half (54%) were female. We observed satisfactory internal consistency (Cronbach’s a 0.70-0.88) for the subscales. Test-retest reliability (ICC) of the questionnaire with two weeks interval was 0.96(p<0.001). The result of known- groups comparisons showed that the questionnaire discriminated subgroups of elderly people who differed in neglect. Criterion validity was assessed by comparing SF-36 and CASP-19 (Persian version). Relationship between translated scale and the SF-36 subscales showed significant correlation in most dimensions.Conclusion: The findings suggest that the CASP-10 is a valid measure for assessing quality of life in elderly populations in different settings.

Objective (s): Educating women about vaginitis and self-care seem very essential. This study aimed to identify the common sources of information, educational needs in self-care and training methods among women at reproductive age with vaginitis.Methods: In a descriptive cross sectional study, utilizing simple random sampling based on purpose of study, 224 nonpregnant, 15-49 years old and sexual active females complaining vaginitis attending three gynecologic clinics in Tehran, Iran were investigated. Method of data collection was questionnaire containing demographic characteristics, disease condition and the needs assessment sections.Results: The most educational needs were the sexual health self-care behaviors. Doctors, midwives and health care workers with 107 (47.76%) and the web 73 (32.58%) were the most common sources of women’s information about the vaginitis. Booklet, CD/DVD, mobile (cell) phone was chosen as the most favorite training methods for designing and implementing educational programs respectively.Conclusion: The findings showed that the women of reproductive age with vaginal infections need education on vaginitis and its related self-care behaviors.

Objective (s): Birth of a premature infant can create emotional crisis for the mothers and encounter them with a variety of problems. The purpose of this study was to identify the perception of mothers with premature infants hospitalized in the neonatal intensive care units (NICU).Methods: This was a qualitative study. In all 25 mothers were selected through purposive sampling, and a face-to-face semi structured interview was conducted with each participant. For the analysis of the data, the content analysis was applied containing verbatim transcription, reading interviews several times to obtain a sense of the whole, division of the text into meaning units and coding them, categorization of the codes into sub- categories and categories, and finally formulation of the latent content into categories.Results: In general, 2 categories and 5 sub-categories were identified. Categories encompass the followings: ‘living with tension, and ‘empowerment’. Living with tension has 2 sub-categories consisting of ‘fear of future’ and ‘damage to family’. Empowerment has 3 sub-categories consisting of ‘seeking for learning of unknowns’, ‘participation in treatment’ and ‘preparation for discharge’.Conclusion: Understanding of mothers’ premature infant’s perceptions can help health care team to provide better services.

Objective (s): Physical inactivity is one of the biggest public health concerns. Due to various reasons such as pregnancy, women are more at risk of physical inactivity. This study performed to determine the influence of an educational intervention on promoting postpartum physical activity based on BAZNEF model, among women referred to health centers.Methods: This was a quasi-experimental study which conducted on 168 women referred to health centers during six weeks to one year after delivery. Samples divided in two groups; intervention and control by using a random allocation. Data collected by BASNEF questionnaire and International Physical Activity Questionnaire (IPAQ). The educational intervention was designed in four sessions. Control group received no intervention except postpartum routine care. Three months after intervention, the questionnaire was completed again in two groups.Results: Pretest results revealed no significant differences in demographic characteristics and BASNEF model constructs in both groups (p>0.05). However, after intervention there was a significant differences between two groups in terms of BASNEF model including knowledge, attitude, normative believes, enabling factors and intention (P<0.001). Women’s physical activity who were in moderate and vigorous levels, had a significant increase (P<0.001).Conclusion: The findings suggest that the educational intervention based on BASNEF model can improve postpartum physical activity.

Objective (s): Different people respond to a question differently. But do they value the same when they choose a response category to respond to a given question. For instance when they choose ‘excellent’ do they have the same evaluation in their mind. This study aimed to investigate people’s evaluations of different response categories usually used in health-related questionnaires.Methods: A population-based study was conducted in Tehran, Iran. A representative sample of adults aged 18 to 65 years were entered into the study and were asked to respond to a questionnaire. The questionnaire contained different visual analogue scales (from 0 to 10 with 0 being at lowest and 10 at highest extreme) in order to evaluate different verbal response categories presented in different types of adverbs Results: In all 1109 respondents completed the questionnaire. The mean age of participants was 34.36 (SD=11.82) and they were relatively well educated (mean formal education=11.99, SD=3.93 years). The analysis of the data indicated that in most instances the participants showed almost similar evaluations for adverb of degree (sometimes also referred to as adverb of quantity). For ‘very much’ the mean point was 8.35 (SD=1.09) while for ‘much’ it was 7.10 (SD=1.22). When respondents were asked to indicate the values for adverb of time (sometimes also referred to as adverb of frequency) , it was found that the mean value for ‘always’ was 8.99 (SD=1.46), whereas for ‘often’ it was 6.65 (SD=1.69), and for ‘not at all’ it was 0.25 (SD=0.65). The most important finding was the fact that there were no significant differences in people’s responses with regards to age, gender, education, marital and employment status.Conclusion: Overall, the findings showed promising results indicating that people had almost similar evaluations of response categories when responding to a questionnaire. The findings suggest since people perceive similar meaning for verbal response categories it is safe to ask people to rate different response categories and then report aggregate results as statistical figures such as percentage or mean scores.