Hakim Journal
Year:2010 | Volume:13 | Issue:3|Papers Count:10

Introduction: The aim of this study was to evaluate self reported health, illness and self care among the physicians of Tehran University of Medical Sciences’ hospitals, to prepare efficient programs for promotion of physicians’ health.Methods: This was a case study with 80 specialists working in Imam Khomeini, Sina and Farabi hospitals. The data was collected through questionnaires filled by the physicians and was analyzed with software SPSS 10.Results: Among the mentioned specialists, 60% were male and 6% were single. Their mean age was 48.5 year, their mean number of children was 2, and their mean BMI was 25.1 kg/m2. The mean number of working and sleep hours were 11: 40 and 6: 20 hours per day, respectively; the quality of sleep among interventionist was worse than non-interventionist. They spent only 1: 40 hours per week on exercise, and 25 days off –work yearly. The monthly income of most physician (56.3%) was about 15-50 million Rials.37.5% had enough fruit and vegetable in their diet and 61% eat breakfast.22.5% had regular annual checkup program and 33% had regular dentist visiting.22% used psychotherapeutic drugs and 31% were cigarette smokers. As they spent more hours working, the quality of their sleep and tooth health became worse.Conclusion: Increase in working hours and decrease of vacations, affects different aspects of health in physicians. Factors that affect health such as diet, exercise and regular check up is not satisfying among physicians. Not having enough spare time and motivation causes poor control of their diseases.

Introduction: The prevalence of catastrophic medical payments is one of the most important concerns in most of low income and developing countries. Iran is one of the countries that Out-of-pocket payment is a major method to provide health system finances which may result in catastrophic health payments. In this study we try to identify factors that influence catastrophic health payments in patients of teaching hospitals affiliated to Iran University of Medical Science in 2009.Methods: In this cross-sectional study, 400 patients were selected among patients hospitalized in hospitals affiliated to Iran University of Medical Sciences. The information was collected by a questionnaire, and the SPSS software was used to analyze the data and accomplish x2 test.Results: We found that 8 variables including gender of the household’s head, health status of the member of household, the size of household, residency in Tehran city, number of previous hospitalization, having a house, the level of income and finally complementary health insurance coverage, were influential factors on exposure to catastrophic medical payments.Conclusion: The inefficiency of current health insurance scheme to protect patients against catastrophic medical payment was the most important result in this paper; however, the complementary health insurance had a weak statistical relation with occurrence of catastrophic medical payment. It seems that health policy makers in Iran had poorly considered the economic, social, cultural, demographic and epidemiological factors while designing health insurance schemes.

Introduction: Tehran has been built over the Earth's crust. Research has shown that preparedness in dealing with disasters can minimize loss of life and property. This study was performed to measure residents of Tehran’s knowledge, attitude and practice regarding earthquake preparedness.Methods: This descriptive/ analytical study was carried out using cross-sectional design. A questionnaire was used for a door-to-door survey of the 22 municipal districts in Tehran which involved 1211 subjects aged 15 and above. Odds ratio and confidence interval of factors of variables were determined. Statistical significance was analyzed using  c2 test and Data adjustment was undertaken by logistic regression model.Results: 588 of subjects (48.6%) were male. Minimum and maximum limits of age were 15 to 100 years for men (mean± SD: 37.3±16.4) and 15 to 84 years for women (mean± SD: 34.5±14.6) .31.4% of Tehran residents had poor knowledge of disaster preparedness. For 31.4% the knowledge was at a "moderate" level, and the remaining 37.2% had a level of knowledge judged to be "acceptable". The relative frequencies of people with poor, moderate and acceptable attitude were 25.6%, 32.5% and 41.9%, respectively. Poor, moderate and acceptable practice was seen in 25.7%, 29% and 45.3%, respectively.Conclusion: The housewives, jobless and retired people, residents of western, central and southern districts, senior citizens, pensioners, single people, poorly educated people, and people living in crowded families are high risk groups and need education.

Introduction: According to classification of the Emergency Department (ED) as a high-risk area in a hospital, failures of six problematic emergency processes in Rasoule Akram Emergency Department were identified, assessed, prioritized, and analyzed in order to improve patients' safety. The Failure Mode and Effects Analysis (FMEA), as one of the risk management techniques, was used for the analysis.Methods: This was a descriptive research that quantitatively and qualitatively analyzed some failure modes and effects. FMEA is a team-based, systematic, proactive technique that is used to prevent process and product problems before they occur. For identification of root causes of the analyzed failures, Eindhoven Classification Model (ECM) was used.Results: By FMEA, 51 failure modes in the 6 selected emergency processes were identified and assessed.With the 75% reliability, 16 failure modes (with RPN³250) were identified and entitled as "failures with non-acceptable risk", and then root causes of them were classified by ECM.Conclusion: According to these result, Proactive FMEA was an efficient and effective method for identifying and prioritizing the improvable points of a running process in a crowded and complex hospital ward, such as an ED.

Introduction: Influenza A (H1N1) has occurred as pandemic form in 2009. The disease spread very quickly and caused a lot of mortality and morbidity. The aim of this study was to determine the pandemic situation in Iran and lessens learned from this matter.Methods: In this cross-sectional study, data related to mortality and morbidity of this disease during pandemic duration in Iran (23.06.2009 to 18.11.2009) was collected and analyzed by excel 2007. In addition the climate data for the same duration was assessed.Results: The result of this study indicated 3672 cases of the disease with 140 reported death in Iran during the study period. It has to be said that the disease started with 3 patients who were travelers from abroad.During the same period the mean temperature in Tehran was 15.6 degrees centigrade (lowest and highest were -5 and 41, respectively) and the mean humidity was 43% (lowest and highest were 15% and 91%, respectively) .Conclusion: The disease was controlled by Iran’s ministry of health and other organizations which were involved during the pandemic. Some of the lessons learnt from this pandemic are discussed in this article.

Introduction: Use of information system is an index of development in healthcare. An information system captures healthcare data and processes it to create useful information. Nursing leaders are interested in developing computerized records. In Iran, there are some computerized systems for documentation of nursing data; some functions of these systems are: bed management, Lab, X-ray and drug requests, vital signs, nursing report, Caredex and ward management. This research was done with the objective of assessing nursing information systems (NIS) in Iran.Methods: Current computer companies in Iran which have nursing modules (9 companies) were assessed in this cross sectional study in 2010. First, literature was reviewed and a valid and reliable questionnaire was developed. Then experts prioritized NIS needs. Finally, Iran’s NISs were assessed using the identified priorities.Results: Result showed that our NISs comply only 35.7% (95% CI: 29.99-41.41) of the identified priorities. None of the NISs comply nursing classification systems’ needs.85.2% of financial reports’ needs (95% CI: 73.73-96.67) were complied in our NISs.Conclusion: The result showed that NISs in Iran are not very good. Using nursing data coding systems, paying attention to bedside data capturing and active participation of nurses are recommended.

Introduction: The purpose of this research was to study mental health status of Isfahan Oil Refining Company staff.Methods: The Study population consisted of all 1191 official Personnel in the Isfahan Oil Refining Company in 2008-9. Using stratified random sampling, 212 people were selected. The instrument was the General Health Questionnaire (GHQ-28) with cut off point of 21.Results: This study showed that 20% of employees are suspected to have psychological disorders. There was significant correlation between job status and social dysfunction. Also, Age of employees was related to depression. But there was no significant relationship between mental health status of employees and management position, education status, job experience and job type.Conclusion: Job status is a good predictor of psychological disorders among personnel, so paying attention to work status of personnel is very important.

Introduction: Poor Nutrition is a risk factor of chronic diseases which result in increasing the cost of treatments, increasing employee’s leave of absence and finally an ineffective labor. This research was designed to understand the effective factors on nutritional behavior of female workers as a base for further trainings.Methods: This research is a part of a sequential mixed method designed research.70 women aged 20-45 years who work in industrial factories were chosen by purposeful sampling with maximum diversity and participated in focus group discussions. Data was analyzed using content analysis method.Results: Results show that female workers had relatively good knowledge and attitude about healthy nutrition. Paying attention to taste of spouse and children was the most important subjective norm of women.Imitation of mother’s habit and the effect of mother in taste making in family is another subjective norm in female workers. Women also mentioned the impact of socio-cultural factors such as body image and community norms as a subjective norm that affects nutrition behaviors. Limited time and place were the most important barriers of healthy nutrition. Results showed insufficient self-efficacy and limited power of planning in female workers; in addition few women intended to have a healthy nutrition behavior.Conclusion: Nutritional habits of female workers are affected by nutritional information, access to food, preference and socio-cultural believes prevailing in the community. Educating female workers about nutritional facts can upgrade nutritional behavior of the whole family.