Payesh
Year:2016 | Volume:15 | Issue:1|Papers Count:14

Objective (s): The aim of this study was to review literature on studies that estimate catastrophic health expenditures (CHE) for assessing equity in health financing in Iran.Methods: The PRISMA guideline was followed and several search engines including Google Scholar, Pubmed, Scopus, Magiran and SID were examined to restive relevant studies. We used health catastrophic expenditure, catastrophic payment, equity, health and Iran as keywords. Literature review was conducted without time limitation in Persian and English documents.Results: The initial search yielded 116 studies. After excluding duplicates and non-relevant studies, 38 articles were selected for full text analysis and finally 19 papers selected for this review. 21.1 % of the studies estimated catastrophic health expenditures in patients groups and others considered the whole populations in a distinct area. Estimation ranged from 2.5% to 72.5%.Conclusion: The range of estimations was very wide. It seems that CHE was influenced by the socioeconomic status of population studied, burden of diseases in different areas and sample size. The exact estimation of CHE is recommended in order to define and implement best solutions in improving the present situation.

Objective(s): In 2005, Iranian Ministry of Heath, Ministry of Welfare and Medical Services Insurance Organization conducted ‘Family Physician and Referral System’ (FPRS) as a major reform in heath system. The first step of the FPRS was carried out through all rural areas and small cities with population less than 20, 000. The aim of this study was to assess the providers’ (physicians and midwives) perspectives about the contracts and training conditions in this program.Methods: This was a cross-sectional study using a designed questionnaire including items on contracts and training.1780 physicians and 1772 midwifes were studied through out the country.Results: About 60% of physicians and midwives were working in rural centers. About 62% of physicians and 72% of midwives had a print version of their contracts. About 47% of physicians and 58% of midwives indicated that that the amount of payment was similar to the contracts. Only about 20% of physicians and 32% of midwives reported that payment was timely as indicated in the contracts. About 15 percent of providers indicated that they had no training course about the FRPS. Only about 60% of physicians and 41% of midwives had a print version of the program Conclusion: The findings suggest that for improving ‘family physician and referral system’ and its proper continuation and expansion, improvement of contract conditions and training courses are essential.

Objective (s): Embryo donation is one of the new technologies, which in recent decades has been used for the treatment of infertile couples. However, its usage, like other new biotechnology methods has made some ethical concerns. Since compatibility of such improvements with ethical standards against the misuse of new technologies should be guaranteed, the present study was designed to determine the ethics of embryo donation.Methods: This was a descriptive study of quality of services provided in 11 embryo donation infertility centers. Data were collected by interviews including 100 couples seeking embryo donation in the Tehran central forensic center. Also the embryo donation instructions of these centers were collected. The data were analyzed using descriptive statistics.Results: In more than 50%, brief information on different aspects of embryo donation process had been given to applicants and in 80%, the necessity of legal or jurisprudence expert advices had not been provided. In 64%, the applicants-embryo compatibility issues had not been studied. In 76%, the embryo donation process had been described strictly confidential and in 28%, there was a conflict of interests between doctor and patient in infertility centers selection. There were no restrictions or priority in service providing and in most cases the donated embryo health was not guaranteed.Conclusion: In most cases, ethics such as autonomy, justice, beneficence is met.

Objective (s): This study aimed to explain the needs of family members awaiting patients, surgery.Methods: A qualitative design using content analysis approach was used to collect data and analyze the experience of 17 family members who were waiting for their patients’ surgery.Results: Data analysis led to the development of 3 categories and 6 subcategories. They included: Emotional need (need to consolation, need for hope), Informational need) need to receive information about illness and surgery process, need to consulting and guidance (, Physical need) need to appropriate site, need to facilities and amenities).Conclusion: The finding might help healthcare professionals especially nurses to get a better understanding of the families, needs in this situation and as a result could be better planning and intervening for meeting of this needs.

Objective (s): The aim of this study was to compare empathy components and cognitive emotion regulation strategies in students with and without vulnerable and grandiose narcissistic traits.Methods: In this cross sectional study, a sample of 90 students was selected using the Pathological Narcissistic Inventory. The Baron-cohen Empathy Quotient Scale and Cognitive Emotion Regulation Questionnaire were also used to collect data. The data were analyzed using MANOVA.Results: The results showed that both students with grandiose and vulnerable narcissistic traits were significantly different in using 'self-blame and catastrophizing' emotion regulation strategies, comparing to non-narcissistic students. Non-narcissistic student significantly use 'positive appraisal' strategies more than vulnerable students. There was a significant difference in cognitive empathy and emotional reactivity, between grandiose and non-narcissistic students. Vulnerable and grandiose student were significantly different only in cognitive empathy.Conclusion: The findings provide support for this idea that grandiose and vulnerable narcissism are different expressions of the same pathology, and their expression depends on the individual defensive structure.

Objective: Cancer causes some unpleasant physical and psychological impact on patients leading to anxiety and mental health problems. Using drawing is a good way as a method of therapy for dealing with mental disorders in cancer patients. The aim of this study was to evaluate the effect of painting on anxiety in children with cancer.Methods: A sample of children with cancer was selected and those who showed symptoms of anxiety were entered into the study. Then the anxious children were divided into two groups in block random. The intervention included sixth sessions of painting during the second, third and fourth days of admission to hospital in the morning and evening and each lasted for 1 hour. Children completed the post-intervention questionnaire.Results: A significant reduction in anxiety was observed (P= 0.0001). The mean obvious anxiety score in pre-intervention was 69.45 ± 10.75 and after the intervention, it was 48.30 ± 2.13. Average hidden anxiety before the intervention was 64.15 ± 6.12 and after the intervention it was 48.6 ± 4.17.Conclusion: Painting could reduce anxiety in inpatient children with cancer.

Objective (s): The aim of this study was to describe the prevalence of overweight and obesity and associated factors among 7- to 12-years old children in Hamedan, Iran, during year 2013.Methods: In this cross sectional study, 795 students (50.6%1 females) aged 7-12years were assessed over a period of 6 months. Multi stage stratified cluster random sampling was used for choosing the sample. Stratification was according to socioeconomic status of students and their sex. The children were subjected to a complete anthropometrics measurement. A questionnaire was also used to obtain information on demographic and some risk factors associated with obesity.Results: The mean age of participants was 9.67 ± 1.55 years. The prevalence of obesity and overweight according to WHO, CDC and IOTF criteria were (15.4% 8.1%), (9.7%, 9.8%) and (5.7%, 13.3%) respectively. There was no significant difference between boys and girls and different age groups in terms of BMI. There was a significant relationship between BMI and birth weight, socioeconomic status and consumption frequency of fast foods.Conclusion: There is an urgent need to target children and young adolescents for obesity prevention.

Objective (s): Carrying a heavy backpack may cause musculoskeletal disorders among students. The objectives of this research were to determine the relationship between the way students carry the bags and musculoskeletal symptoms in Ilam, Iran.Methods: This study was performed in 16 girls’ primary schools. 244 students were randomly selected. The appropriate questionnaire was used to collect required data. Height and weight of students, the weight and model of their bags, and reported disorders related to the way they carried the bags were collected and analyzed.Results: About 4.5% of the primary students reported discomforts in their knees, 5.3% in back, 0.8% in elbows, 3.2% in neck, and 35.5% of them reported musculoskeletal discomfort in the shoulders. %22.5 of primary school students carried bags with %10-%15 of their body weight and students were experiencing the shoulder optosis.Conclusion: The most important disorders were shoulder optosis among students and many of them carried bags with weight more than 10% of their body weight. The way of carrying the bags can be considered as the most important risk factor for musculoskeletal problems among school students.The results of some studies showed that the way students carry school bags may increase the musculoskeletal complaints among school students.

Objective (s): Only a minority of infants is breastfed for the recommended 6 months post partum. One possible modifiable variable is breastfeeding confidence. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is a 14-item measure designed to assess a mother’s confidence in her ability to breastfeed her baby. The study aimed to translate the BSES-SF into Persian and assess its psychometric properties among pregnant women.Methods: This was a cross-sectional study carried out in Ahvaz, Iran, 2014. A random sample of 220 low-risk pregnant women referring to private and public health centers was recruited. The BSES-SF was translated into Persian using forward-backward translation and pilot tested. A series of self-reported questionnaires was administered on the third trimester of pregnancy including: a questionnaire on socio-demographic variables and breastfeeding intention status, the translated BSES-SF, the Persian adaptation of the General Self-Efficacy Scale (GSES) and the Persian adaptation of Perceived Stress Scale (PSS). Data were analyzed using SPSS, version 16.Results: The mean age of participants was 23.95 ± 4.7 years. The findings of content and face validity showed almost perfect results (CVR = 1 and CVI = 1). The translated BSES-SF presented a one-dimensional structure with factor loadings of >0.40. Convergent and divergent validity showed statistically significance correlation with the GSEE and the PSS, respectively (p <0.05). Internal consistency as measured by the Cronbach’s alpha coefficient was found to be 0.91.Conclusion: The results indicated that the Persian version of BSES-SF is a valid and reliable measure of maternal breastfeeding self-efficacy in Iran.

Objective (s): A population-base study was conducted to measure health literacy among Iranian adult aged 18-65.Methods: The Health Literacy for Iranian Adults (HELIA) was used to assess health literacy. The questionnaire contained 33 items on access to health information, reading, understanding, appraisal, and behavioral intention. Each item was rated on a 5-point scale giving a total score ranging from 0 (the worse) to 100 (the best).Results: In all 20571 individuals entered into the study. The mean age of participant was 34.92 (SD = 11.80) and 51% were female. The mean year education of participants was 11.96 (SD = 3.79). Overall the mean score for health literacy was 68.32 (SD = 15.16) and that 44% of participants had limited health literacy. Further analysis of the data indicated that health literacy significantly was associated with age and education.Conclusion: In general the findings suggest that health literacy among Iranian adults was relatively acceptable. However, about half of participants had limited health literacy and this was more evident among vulnerable groups. Indeed planning and implementing educational interventions are recommended to improve health literacy among Iranian adults.

Objective (s): Iran is among countries with high road traffic accidents. The use of safety belts is known as the most effective in preventing severity of injuries and deaths caused by road accidents. However, many drivers do not wear seat belts while driving. To encourage drivers to use seat belts, providing appropriate messages based on scientific theories is very important. The purpose of this study was to use the extended parallel process model (EPPM) in developing an effective educational program to promote safety belt use among drivers in Tehran, Iran.Methods: This was a quasi-experimental study and conducted on drivers who were stopped by police officer because of driving without using seat belts. The site and participants of survey were selected by multistage random sampling. The message and educational intervention was developed after analyzing pre-test results.Results: Among all 209 drivers, 80.4 percent were male and the mean age of participants was 41 (SD =1.3) years. Measuring the Risk Behavior Diagnosis Scale, based on EPPM, the findings showed that drivers were in fear control position indicating that they had a lower level of perceived efficacy comapired to perceived threat. Multiple regression analysis before educational intervention showed that perceived susceptibility and perceived self-efficacy were predictors of self-reporting use of seat belt among drivers (R2=0.38, P< 0.05). After intervention, participants were moved to danger control position indicationg that they were in a position to adopt protective behavior. Self-reporting seat belt wearing increased about 24% after intervention.Conclusion: The findings suggest that focusing on messages with high efficacy contents; can promote seat belt wearing among drivers.