Payesh
Year:2024 | Volume:23 | Issue:6|Papers Count:11

Objective(s): Informatics in nursing and midwifery is developing and evolving worldwide. The present study aimed to systematically review the existing literature to identify the components of informatics competencies in the provision of electronic health services in nursing and midwifery. Methods: Web of Science, PubMed, and Scopus databases were searched using the keywords telemedicine, e-health informatics, competence, and their equivalents, without time limits. The quality of the articles was checked independently by two researchers using ten criteria selected from the Strobe checklist. Analysis was conducted in accordance with PRISMA guidelines. Results: In all 668 articles retrieved. After removing duplicates, 187 articles remained, and after reviewing the full text of the articles, 13 studies were included in the final review and analysis. Articles were on providing nursing services and no studies were found for midwifery care. In total, "e-health literacy", "nurses' attitude towards the provision of e-health services" and "individual-social-occupational factors related to informatics competence" were among the components found in studies related to nursing. Conclusion: The review indicated the need for basic knowledge, work on nurses' attitudes and research in nurses' informatics competence. Informatics competence and its related components in midwives and midwifery students were lacking in the literature, so it is recommended to investigate this among midwifery groups.

Objective(s): The COVID-19 pandemic, with its sudden widespread shocked the whole world, especially the health care systems. Considering the vital role that nurses in the intensive care units played for COVID-19 patients, a deep understanding of nurses' lived experiences can help to improve their skills in dealing with stressful situations and the quality of patient care. Therefore, the present study was conducted to explore nurses' experiences in the intensive care units caring for patients with COVID-19. Methods: This was a qualitative study. Fifteen intensive care unit nurses were purposively selected. In-depth and semi-structured interviews and field notes were used to collect data. The text of the interviews was recorded and analyzed using the hermeneutic approach and the Diekelmann method. Results: Ten participants were women and five were men. The mean age of the participants was 32 years and the mean work experience in the critical department was six years. The three main themes that emerged from the data analysis in this study included conflicting emotions, the emergence of a new image of nursing, and the crystallization of professional nursing. Conclusion: Working in difficult and unknown conditions with countless challenges has resulted in mental and physical health decline in intensive care unit nurses. However, nurses who demonstrated a spirit of sacrifice did not abandon their diligent efforts to combat this unknown enemy and fulfilled their professional responsibilities to provide paramount care to patients. In doing so, the nurses showed society a new image of nursing. The results can be applied to management policies when planning for the future.

Objective(s): Maldistribution of physicians in different areas has detrimental impacts on people's access to health services. The distribution of physicians in different regions are influenced by various factors. Therefore, this study was carried out with the aim of identifying factors and components affecting the geographical distribution of physicians in different countries. Methods: A scoping review based on the framework of Arkesy and O'Malley was conducted using keywords related to distribution and physicians in five English and Persian databases (Web of Sciences, PubMed, Scopus, Google scholar, SID) between 2000 and 2023. The original and review articles in English and Persian were included in the study. First, the studies were screened based on the title and abstract, and in the next step, the full text of the articles was reviewed. Finally, data were extracted using a self-designed checklist. The identified factors were analyzed using thematic analysis. Results: After removing duplicates, 122 were identified. Of these 50 articles were reviewed. Finally, based on the inclusion and exclusion criteria, 17 studies were included in the final analysis. The included studies were conducted in different countries. In the analysis of the components and factors affecting the dispersion and distribution of physicians, five main themes emerged including demographic and geographic factors, personal and professional characteristics of the physicians, social, economic and political factors, factors related to the health system and social and cultural factors. Conclusion: The findings showed that the unequal distribution of physicians is a global problem and most countries were struggling such a problem. The findings showed that the distribution of physicians is influenced by many factors that must be taken into consideration by policy makers and managers. They should develop and design policies and interventions for equitable distribution of physicians.

Objective(s): The increasing growth of treatment costs indicates the necessity of insurance coverage of the population. The continuance of this coverage requires sufficient financial resources. One of these financial sources is the insurance premium. Failure to pay it timely causes problems for the insurer and the insured. This study seeks to identify the causes of non-payment of insurance premiums by the health insurance organization and provide solutions to solve them. Methods: This qualitative study was conducted through semi-structured interviews and focused discussion sessions. The snowball method was used to identify the interviewees. The interviews continued until data saturation was reached. To analyze the data, the conventional content analysis approach was used based on the method suggested by Granheim and Lundman. Results: Based on the findings of the study, the causes of non-payment of insurance premiums include non-payment/late payment of insurance premiums by the government, non-payment/late payment of insurance premiums by the executive body, unscientific budgeting, budget deficit, non-compliance with the law, and allocation It is a quarterly budget. By using a set of legal and non-legal solutions, it is possible to facilitate the timely collection of insurance premiums. Conclusion: Although the government is the main provider of the organization's insurance premium, the organization as a key institution should seek to find solutions to solve its financial problems. Active management of the organization's expenses, taking advantage of new methods of income generation, and attracting the support of charity organizations are suitable solutions to solve the relative financial problems of the organization.

Objective(s): Health insurance literacy (HIL) is the knowledge, ability, and confidence of people to find and evaluate information about insurance plans, choose the best plan and how to use it. This study was conducted to examine the level of HIL among the insured person of the Iran Health Insurance Organization in Tehran. Methods: This cross-sectional study was conducted in 2023 with the participation of 309 insured person. The data were collected using a 27-item questionnaire that included three dimensions of access, insurance terms, and performance skills. The validity and reliability of the questionnaire were confirmed. Data analysis was performed in SPSS.24 using T-test and One-way ANOVA. Results: The mean score for access was 8.5±1.91, insurance terms 10.21±2.46 and performance skill was 22.94±3.23. The overall mean HIL score was 41.64±6.22. The HIL status of 60% of the insured person was intermediate and 40% was low. The mean score of HIL was higher among people living in the northern region, those covered by the special diseases fund, those with a monthly less income, and those without supplementary insurance. The HIL level was also higher among people whose source of insurance information was friends and acquaintances (P<0.05). Conclusion: The majority of people had relatively low levels of HIL. Knowing the level of HIL and the factors that influence it can guide policy makers in developing educational interventions to remove barriers and improve HIL. Educational interventions through public media such as television, short videos on the websites and applications of insurance organizations and social media, and the provision of insurance information on waiting room monitors in medical centers are suggested to improve HIL.

Objective(s): The level of health literacy is not the same in all people, and the level of health literacy is lower in the group of the elderly, immigrants and people with low economic status. Considering the importance of health literacy and obtaining useful information and performing screening behaviors in the elderly, the present study aimed to assess the relationship between health literacy and performing colorectal cancer early diagnosis in the elderly of Shahrekord, Iran. Methods: This cross-sectional study examined the level of health literacy and performing cancer-screening behaviors in the 351elderly of Shahrekord whose information was fully recorded in electronic case records and selected randomly. After collecting information using standard health literacy questionnaire and checklist about colorectal cancer early diagnosis, the data was analyzed using SPSS version 25 software. Results: The mean age of the elderly participants in the study was 67.08 ± 5.75 years. The mean health literacy score of the elderly was 60.65±12. About 52% of elderly had performed colorectal cancer screening. The mean score of health literacy was higher in men (p<0.001). Married people, self-employed, university educated, the elderly with a history of illness in the family, had higher health literacy (p<0.001). There was a significant relationship between the health literacy score and colorectal cancer early diagnosis (p<0.001). Conclusion: Improving health literacy may be an effective strategy in improving and promoting colorectal cancer early diagnosis in the elderly. Therefore, developing comprehensive programs, creating simple and understandable media and educational materials, as well as effective educational interventions for people with insufficient health literacy can be an effective step to improve health literacy among this population.

Objective(s): Maternal health indicators, especially for pregnant mothers, are among the most important health indicators for any country. Given the implementation of the health transformation plan in the service delivery system in Iran, it was expected that there would be a significant improvement in the quality and quantity of services provided to mothers in recent years. Therefore, the aim of this research was to investigate the effect of implementing healthcare reform on maternal health indicators in East Azerbaijan province, Iran. Methods: This was a quasi-experimental study. The research population consisted of people living in villages in East Azerbaijan province - Tabriz district, Iran; with active health centers from 2007 to 2016, including a sample size of 200 mothers per year. Villages were randomly selected as clusters. Data collection tool was a questionnaire and all data were analyzed by SPSS version 22 statistical software. Results: The findings showed that the mean age of mothers during the study period ranged from 25 to 27 years. The number of pregnancies before the reform was 1.39 and after the reform, it was 1.20 which was statistically significant. Examination of the insurance status of pregnant mothers showed that before the reform, 6.4% of rural residents were uninsured, while after the reform, all of them were covered. In terms of laboratory services, 97.7% of mothers underwent routine tests in the first trimester, and 90.5% underwent routine tests in the second trimester. Additionally, over 99% of mothers had undergone at least one ultrasound, with an average of 2.56 ultrasound appointments. Conclusion: The implementation of the healthcare reform increased the insurance coverage of pregnant mothers and the utilization of services such as ultrasound. This initiative led to a reduction in maternal and neonatal mortality rates and a decrease in the rate of natural childbirth.

Objective(s): Sexual health is one of the main aspects of health that strengthens the foundation of the family. Therefore, a study was conducted aiming to explore the factors affecting the sexual health of newly married couples from the point of view of experts. Methods: This qualitative study was conducted by purposeful sampling in 2018 (May-Nov) with the participation of 20 experts using in-depth individual semi-structured interviews. All interviews were recorded and typed. The data was analyzed using conventional content analysis method and MAXQDA.10 software. Results: Factors affecting sexual health were explained in three categories and seven sub- categories. The three main categories included family factors (sexual education and economic-social status), individual factors (physical-mental health, interpersonal relationships) and marital factors (sexual schemas, sexual problems and sexual conversation). Conclusion: Based on the results obtained from the present study, couples need to receive sufficient information and special skills in psychological, individual and family, marital and socio-religious topics for improved sexual health.

Objective (s): The pandemic of the COVID-19 caused a wave of mental health problems in people. Resilience and social support can act as psychological factors to protect individuals from the devastating effects of the COVID-19 crisis and enable individuals to make positive changes in times of crisis. Based on this, the present study was designed and implemented with the aim of investigating the effect of protective factors such as social support on mental health and its mediating role on resilience in health workers of Tabriz before and during the Covid-19 pandemic Methods: This cross-sectional descriptive study is conducted on 350 health workers working in health centers in Tabriz, Iran. Health workers were selected by random cluster sampling. The data were collected using the Mental Health Continuum Short Form (MHC-SF), the Multidimensional Perceived Social Support (MPSS) and Connor-Davidson resilience questionnaire. Data were analyzed by Amos 22 software. Results: The results of the structural model showed that in coronavirus conditions, the direct effect of social support on resilience and the direct effect of social support on mental health were greater than in the situation before the outbreak of COVID-19. Also, the direct effect of mental health on resilience in the corona situation was higher than before the corona. The indirect effect of social support through mental health on resilience was also higher in the corona situation. Conclusion: The findings of the present study showed that in difficult conditions, such as the prevailing Corona pandemic, impressive social support, can improve mental health and resilience.

Dear Editor, Dengue fever with four related dengue viruses (DEN-1, DEN-2, DEN-3, DEN-4) is transmitted to humans by some species of invasive female Aedes mosquitoes, such as Aedes aegypti and Aedes albopictus, and it is rapidly spreading in the world. It seems that the causes of increasing cases and explosive spread of dengue fever are somehow related to the vectors of this disease. These factors include: 1-Global warming due to human activities and creating favorable living conditions and reproduction of Aedes mosquitoes. 2- Numerous seasonal rains that create temporary and suitable larval habitats and breeding places for Aedes mosquitoes. 3- The presence of numerous larval habitats for Aedes mosquitoes; They lay eggs anywhere there is stagnant water: in discarded used tires, in broken containers that hold water and septic tank valve pipes, and even in abandoned cans. 4-Unlike other mosquitoes that only bite once and feed once before laying eggs; Invasive Aedes mosquitoes, especially Ae. aegypti, have repeated bites daily, and multiple and repeated bites cause more transmission of dengue fever virus and its explosive spread. 5- Aedes mosquitoes infected with one of the dengue fever virus serotypes vertically transmit the virus to their next generation; That is, Aedes infected with the virus also lay infected eggs, and from the infected eggs, the infected adult mosquitoes eventually come out, which are infected with the virus from the beginning without having a blood meal from the infected human reservoir, and with their first blood meal, they get fever. They transmit dengue to a susceptible host (human).

Dear Editor, The university is the driving force of science, research and technology and plays a key role in the political, economic, social, cultural and technological development of a country. Universities underwent changes throughout history due to political, economic, social and environmental changes. The course of transformation of universities shows five different generations, including the first generation (education-oriented university), the second generation (research-oriented university), the third generation (Innovation-oriented university), the fourth generation (Society-oriented university) and the fifth generation (Value-oriented University). Most of Iran's medical universities are second generation universities. The transformation of Iran's medical universities into fourth and fifth generation universities requires the commitment and efforts of all their members and the creation of fundamental changes in the structure, culture, tasks and processes of the university. The mission and vision of universities should be redefined according to the emerging challenges of society and the needs of its various stakeholders.