Payesh
Year:2024 | Volume:23 | Issue:4|Papers Count:13

2Objective(s): Systematic reviews are a valuable resource for policy makers, managers and health workers for evidence-based policy making, planning and delivery of health services. However, some systematic reviews are poorly conducted and reported. This study aimed to explain the methodology of systematic review in the health system. Methods: This study was conducted using a scoping review method. Published articles on systematic review methodology in the health system until April 19, 2024 were searched in 3 databases, including PubMed, Scopus, and Web of Science and Google Scholar search engine. Overall, 109 articles were selected after screening and analysed using narrative analysis method. Results: A systematic review is "an explicit and systematic secondary study to identify, critically appraise, and synthesize primary research evidence to answer a specific research question." Systematic reviews help policymakers, managers, health workers, patients, and the public to apply the best current evidence to practice at a lower cost. Moreover, systematic review is used to develop a new theory or evaluate an existing theory. A simple and comprehensive protocol for conducting a systematic review was proposed. It includes seven steps of formulating research question, searching the literature, screening and selecting studies, appraising the quality of studies, extracting data from included studies, analysing and synthesizing data, and interpreting findings and presenting a conclusion. In addition, the structure of writing a systematic review article was explained and a checklist for evaluating systematic review articles was presented. Conclusion: Methodological limitations of systematic reviews affect the conclusions of these studies. In this study, a suitable model for conducting a systematic review was presented.

2Objective(s): Health tourism is a branch of the tourism industry that is of interest to many countries of the world due to its high demand and good income. Therefore, considering the importance of health tourism and the existing potential in Mazandaran province, this study was conducted with the aim of identifying and analyzing the factors affecting the development of the health tourism industry in Mazandaran province. Methods: The present study was conducted using a qualitative method with a content analysis approach. For this purpose, 17 health tourism industry experts and health tourists were selected using the purposeful sampling method. Semi-structured interviews were used to collect data. The interviews were conducted until we reached a point of theoretical data saturation. Results: The findings showed that the health tourism industry in Mazandaran province is affected by structural, process and contextual factors. The structural factors included issues related to infrastructures, potentials/attractions, institutional factors, and expert human resources for health tourism destination. The process factor included issues related to drivers of health tourism, provision of health services and destination situational factors. The contextual-field factor included issues related to sociocultural contexts, potentials and attractiveness of tourism, and economic capacity. Conclusion: Despite the importance of services related to health tourism and considering the increasing demand of this industry, travelers who travel to Mazandaran province need a variety of services, and the need to pay attention to quality service development in tourism destinations is evident. Therefore, the provision of other essentials for health tourists such as infrastructure, destination attractions, financial capacities, sociocultural conditions, human resources, situational factors are  the requirements for the development of this industry.

2Objective (s): Health system responsiveness and meeting patients' expectations are important in creating public trust in the health system. This study was conducted to determine the relationship between health system responsiveness and public trust in the health system in Gorgan, Iran. Methods: This cross-sectional study was conducted in 2020. The sample size in this study was 450 households. To collect data, a health system responsiveness questionnaire including 32 questions in 8 dimensions, and a public trust questionnaire including 25 questions in 6 dimensions were used. The validity and reliability of the instruments were confirmed. The path analysis was used in AMOS software to determine the relationship between responsiveness and public trust in the health system. Results: The mean score of responsiveness was 3.4 (±0.53) out of 5, the highest score was related to social support and the lowest was related to the right to choose a doctor. The mean score of public trust was 3.3 (± 0.52) out of 5, the highest score was related to the quality of care, and the lowest was related to macro health policies. The hypothesis test findings showed a positive and significant relationship between all dimensions of responsiveness and public trust in the health system. In general, 64% of the variance in public trust is explained by the health system responsiveness. Conclusion: The health system responsiveness and public trust in the health system were evaluated at an average level, and responsiveness plays an important role in influencing public trust in the health system. Therefore, the government should play its role in properly managing citizens' needs in order to regulate its credibility and most importantly to maintain public trust.

2Objective(s): Convulsions caused by fever in children and parents not knowing about the nature of this disease cause severe anxiety and inappropriate performance in parents. Due to the cost-effectiveness of the telenursing method, nurses can use it to provide a large amount of information in a short period with distance education. Therefore, the present study was conducted with the aim of determining the effect of telenursing training on the anxiety of mothers with children suffering from febrile convulsions.   Methods: This quasi-experimental intervention study was conducted in 2020-2021 among 60 mothers with children suffering from febrile seizures in the hospitals of Birjand, Iran. The sampling method was accessible and then people were randomly divided into two intervention and control groups. After being discharged from the hospital, the intervention group received telenursing (for 2 weeks and 3 sessions each week for 15 minutes via mobile phone and by calling the mothers and sending an educational video). The control group received routine training at discharge. The data collection questionnaire included the demographic and background information and the Spielberger anxiety questionnaire. The Spielberger questionnaire was completed at the beginning and after the end of the intervention. SPSS software version 16 and paired t, independent t and chi-square statistical tests were used for data analysis. Results: Stait and trait anxiety before the intervention was not significant between the control and intervention groups (P=0.865 and P=0.153, respectively). There was a statistically significant difference between the two intervention and control groups in Stait and trait anxiety after the intervention, and it was reduced in the intervention group (P<0.001). Conclusion: Telenursing training was an effective method in reducing the anxiety of mothers with children suffering from febrile convulsions. Therefore, it is suggested to use the telenursing method in order to reduce anxiety among mothers with children suffering from febrile convulsions.

2Objective(s): To determine the effectiveness of theory-based education on self-care behaviors among the elderly in Ilam, Iran. Methods: The study was conducted in two descriptive and semi-experimental phases among elderly. The samples were selected randomly. In the descriptive phase, 200 and in the semi-experimental phase, 140 eldrly participated in the study The educational intervention was conducted virtually during a month. The intervention data was collected in two stages using valid and reliable questionnaire and telephone interview method and analyzed using SPSS version 25 software. Results: The results of the descriptive stage showed that perceived benefits and self-efficacy are the strongest predictors of self-care behavior among the elderly. The results of the experimental stage showed that before the intervention, there was no significant difference between the test and control groups in the constructs of the health belief model and behavior. After the educational intervention, there was a significant difference in all variables in the test group compared to the control group and compared to before the intervention. Conclusion: It seems that the health belief model can predict self-care behavior among elderly. Therefore, it is recommended to design educational interventions using the health belief model to promote self-care of the elderly.

2Objective (s): Considering the role of self-care in reducing the burden of non-communicable diseases and in order to properly increase the importance of health to society, paying attention to the self-care is a priority. This study was conducted with the aim of investigating the effect of an educational intervention in the context of social messengers on the awareness of the health workers regarding the self-care program. Methods: This semi-experimental study was conducted on 705 employees (doctors, nurses, midwives, health care workers) of health centers in Ilam province, Iran during 2020 and 2021. To collect data, a self-designed questionnaire containing 330 questions related to the 22 educational packages of the national self-care program provided by the Ministry of Health was used. The questionnaire was completed before an educational intervention and 9-months follow-up. The data was analyzed with SPSS version 24 software and through paired t-test and chi-square test. Results: The results indicated a significant increase in the awareness of health workers in the field of self-care program during a period of nine months after the educational intervention using the virtual educational method. A statistically significant relationship was observed between increasing the level of awareness of health workers with variables such as age (0.01), education level (0.05), gender (0.01) and organizational position (0.01). Conclusion: Considering the important and fundamental role of health workers in improving the level of health literacy of the society and on the other hand the growing trend of access to social messengers, it is suggested with a cascade approach and based on social accountability, suitable educational programs to improve the awareness of health workers and subsequently health ambassadors at the household level should be prioritized.

2Objective(s): Anthropometric indicators are considered to be the most important health indicators for evaluating the condition of newborns. In the epidemic of infectious diseases, including the Covid-19 pandemic, pregnant women and their fetuses are among the high-risk population. The present study was conducted with the aim of investigating the changes in the anthropometric indices of newborns at birth and the factors affecting it in 6 months before and 6 months after the beginning of the covid-19 pandemic.                                                  Methods: This analytical-comparative study before and after was conducted on the number of 30540 newborns in 6 months before the covid-19 pandemic and 5009 newborns in 6 months after the covid-19 pandemic. The information was obtained from the integrated system of the Ministry of Health. The data was analyzed in SPSS 22 software. Results: The average birth weight of newborns in two periods 6 months before and after the beginning of the covid-19 pandemic was 3140.94 (469.93) and 3198.04 (446.22) grams respectively, which means that the average weight of newborns increased and statistically, there was a significant difference (P<0.001). The average height of newborns increased from 49.72 (2.31) cm in 6 months before the beginning of covid-19 to 49.78 (2.19) in 6 months after it, which increased and did not show a significant difference (P=0.125). The difference in the head circumference of newborns in 6 months before the beginning of covid-19 was 34.36(1.40) cm compared to 6 months after was 34.49(1.38), showed an increase and it was significant (P<0.001). Multivariate analysis with linear test model showed that by controlling the effect of possible confounders, being in the period before or after the covid-19 pandemic has no effect on birth weight, height and head circumference.             Conclusion: The findings of this study showed that the covid-19 pandemic and its possible complications on the health of the mother and the Newborn in a short period of 6 months compared to the previous period had no effect on the average anthropometric indices of newborns.

2Objentive (s): Physicians are in the frontline of the distribution channel in the pharmaceutical value chain. The prescribing behavior of doctors influences the use of herbal medicines. This study investigated the effect of knowledge, attitude, and social marketing mix on doctors' prescribing behavior of herbal medicines. Methods: The current cross-sectional study was conducted in 2022 in Ahvaz, Iran. Its statistical population included 878 doctors working in medical centers and public and private offices in Ahvaz, and the data were collected using the census method. Data was collected using a self-designed questionnaire to measure the level of knowledge and attitude of doctors and the role of social marketing mix on doctors' prescribing behavior. Descriptive and analytical statistics, including Pearson's correlation, linear regression, t-test, and one-way analysis of variance were used to analyze the data. Results: The results showed a significant relationship between all research variables and doctors' prescribing behavior (p= 0.001), where the attitude showed the strongest positive relationship (r= 0.692). Regression analysis showed that the two factors of attitude and knowledge had a positive effect, and promotion strategy has a negative and inverse effect on doctors' prescribing behavior. Also, a significant relationship observed between doctors' prescribing behavior and gender (p= 0.001) and education level (p= 0.004). Conclusion: Knowledge, attitude, and promotion strategy are predictors of herbal medicine prescribing behavior by physicians.

2Objective (s): In a situation where the vaccine was not completely accurate and up-to-date against different strains of the virus in all people of the world, compliance with health guidelines was the main key to prevent transmission. But what is clear is that compliance with health protocols is not the same among all communities and depends on factors. This article examines the effects and attitudes of health protocols. Methods: This research was a descriptive-quantitative cross-sectional study, which was conducted among 385 students of Shahid Beheshti University of Medical Sciences, Iran in the last week of May 2022. Factors affecting the adherence to water hygiene behaviors due to covid-19 were investigated using a questionnaire and the results were analyzed and reported in ordinal regression with SPSS 25 software. Results: The ratio of the average score of compliance (19.08) from the total of eight health behaviors to the maximum score (25) was reported as 76%. It was reported that the score of awareness was very high, 94%, and the average score of attitude was about 75%. In the ordinal regression, it was found that having knowledge was not effective in following all health protocols and only two behaviors of avoiding attending gatherings and avoiding losing when meeting acquaintances showed a statistically significant relationship. In other words, with the increase of each score of awareness, the chance of having higher compliance scores in these two behaviors increased by about 1.5 times. On the other hand, the attitude score had a statistically significant relationship with most of the behaviors, except the compliance of coughing and sneezing into a handkerchief or the corner of the arm, and it had a positive simultaneous effect on the compliance of the behaviors. Conclusion: The high level of awareness among the studied community can partially indicate the effectiveness of interventions in increasing awareness, but the gap between awareness, attitude and behavior indicates the need to pay attention to other factors affecting attitude and behavior.

2Objective(s): One of the most common problems of nursing students in the clinical environment and Objective Structured Clinical Examination (OSCE), is anxiety and lack of accuracy, which can lead to negative effects on their learning and performance. Considering the simplicity and cost-effectiveness of aromatherapy, the present study aims to the effect of lavender aromatherapy on the accuracy, exam anxiety, and performance of nursing students in OSCE. Methods: This clinical trial study was conducted on 60 undergraduate nursing students under the OSCE in 2022. Eligible students who met inclusion criteria were recruited by convenience sampling and then were allocated randomly with the random sequence generation software, to intervention (n=30) and control groups (n=30). The intervention included aromatherapy with lavender essential oil with 100% purity for 10 minutes. Toulouse- Pieron Attention questionnaire, Sarason's test anxiety, and performance checklist were used in this study. Data were analyzed using descriptive and inferential statistical methods by SPSS version 26 statistical software. Results: The results indicated a significant decrease in the average exam anxiety score with P = 0.03 and a significant improvement in accuracy with P < 0.001 after aromatherapy in the intervention group. Also, the results of the independent t-test showed that after the intervention, there was a significant difference in the average exam anxiety score with P = 0.02 and accuracy with P < 0.001 between the intervention and control groups. Meanwhile, the average performance score of the students' grades was not significant between the two groups. Conclusion: Considering the positive effects of inhaling the scent of lavender in improving the accuracy and reducing the anxiety of the nursing students' exam, the use of this low-cost program, with easy access and without complications, is recommended along with other methods.

2Objective(s): The purpose of this study was to develop and validate health insurance literacy assessment tool in Iran. Methods: A cross-sectional descriptive study was conducted with the aim of standardizing the Iranian tool for measuring health insurance literacy. The items of the tool were extracted from a qualitative study based on Paez et al. model. A total of 219 patients of a general medical center in southwest of Iran were randomly selected to participate in the study. Content validity was assessed estimating CVR and CVI and face validity was performed by a panel of experts. Structural validity was evaluated using the exploratory factor analysis. To measure reliability, we used Cronbach's alpha. Results: The findings of the study showed a 7-factor solution accounting for 66% of variance observed. Also a high internal consistency between the items was estimated (Cronbach's alpha=0.85) . All study constructs showed a positive and significant correlation with the main variable. Conclusion: The Iranian tool for measuring health insurance literacy as a valid and reliable tool can be used in Iran. This tool can be used in assessing the needs of interventions to empower the insured regarding how to apply insurance coverage in the health market.

2Dear Editor, At present is the era of tremendous changes in human knowledge. The importance of knowledge transfers and the use of research results for decision makers, as a supplement to knowledge production, is increasing in developed and developing countries. In Iran, knowledge-based development is one of the pillars of the country's 20-year vision. Nevertheless, despite three decades of efforts in knowledge translation produced in medical sciences, the status of knowledge transfers and exchange is not satisfactory. On the other hand, due to the large amount of time, money and energy that is spent on conducting research, greater effectiveness and optimal use of its results are always the concern of managers and executives at all levels. In such a situation, it is necessary to move from the current situation to the ideal situation through review the current process, formulate intervention and solutions based on the existing context and platform, modify and improve the current trends.

2Dear Editor, The education systems became virtual during Covid-19. This problem increased students’ access to mobile phones, media and caused Internet addiction. Media also caused many health problems in teenagers. Media literacy is defined as the ability to access, analyze, evaluate and create messages in different contexts. Media literacy can deal with the potential negative effects of media. Thus, considering the importance of media literacy, it is necessary to teach children the knowledge and skills of the media literacy from childhood. .