HAYAT
Year:2018 | Volume:24 | Issue:3|Papers Count:8

Economic evaluation is an invaluable and important tool in healthcare decisionand policy-making. The volume-based paradigm has been a prominent tool to evaluate healthcare economy for consecutive decades. In this approach, the main focus is on volume of treated patients alongside to reduce healthcare costs. Despite this view and during recent years, there was a dramatic rising in healthcare costs without attaining excellence in quality and health outcomes. This status is escalating to the point at which governmental budgets, service providers, and patients are unwilling or unable to afford its related costs (1). There is a similar situation in highincome countries that spend several times more money on health than middle-income and low-income countries (2)...

Background & Aim: Female genital cancers are the third most common type of malignancy among women. Considering the importance of these cancers, the present study was conducted to determine the age-standardized rate (ASR) of female genital cancers in Iran. Methods & Materials: In this systematic review, six international databases (Medline/PubMed, ProQuest, Scopus, Embase, ScienceDirect, and Google Scholar), and four national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) were searched in 2017. Thereafter, Persian and English papers referring to the ASR of female genital cancers in Iran were included. The Joanna Briggs checklist was used to evaluate the quality of studies. Data were independently extracted by two reviewers. Results: A total of 264 papers were found in the initial search of the databases, and 27 papers were included for final analysis. Based on the random-effect model, the ASR was 2. 07 (95% CI, 1. 83-2. 31) for cervical cancer, 3. 15 (95% CI, 2. 75-3. 54) for ovarian cancer, and 1. 52 (95% CI, 1. 32-1. 73) per 100, 000 for uterine cancer. Conclusion: The ASR of female genital cancers in Iran was lower than other countries of the world. It should be noted that the results of this review must be judged with caution because of the high heterogeneity of the studies.

Background & Aim: Falling is a serious problem in the elderly population, with many physical, psychological, social and economic consequences. The fear of falling has been considered an activity limiting condition, which can lead to a reduction in the quality of life of the elderly people. The study aimed to determine effect of fall care behaviors training on fear of falling among the elderly people referred to health centers. Methods & Materials: This double-blind randomized clinical trial was carried out on 110 elderly people referred to health centers in Ardabil in 2017. Participants were selected by the multi-stage random sampling and divided into intervention and control groups by random allocation. The data collection tools were consisted of demographic questionnaire, Mini-Mental State Examination: MMSE, Abbreviated Mental Test Score: AMTS and Fall efficacy scale international: FES-I. Data were analyzed using statistical tests on the SPSS software version 22. Results: The mean and standard deviation of fear of falling in the intervention and control groups before the intervention were 33. 91± 12. 03 and 31. 22± 14. 76, respectively (P=0. 29). Three months after the intervention, the mean and standard deviation of fear of falling were 22. 32± 4. 45 and 30. 85± 15. 03 (P<0. 001). Also, ANCOVA was used for controlling pre-test scores and level of education compared to the post-test scores in the two groups (P<0. 001). Conclusion: The results showed that education on fall care behaviors reduces the fear of falling in the elderly people. Therefore, this education is suggested to be considered in the self-care program for elderly people.

Background & Aim: A desirable level of happiness among nurses is related to the quality of nursing care services. This study aimed to evaluate the level of happiness among nurses and its’ relation to some demographic factors in Zanjan province-2017. Methods & Materials: In this cross sectional study, 371 nurses employed in the hospitals affiliated to Zanjan University of medical sciences were participated. The Oxford happiness inventory was used to collect data. The data were analyzed using descriptive statistics and Chi-square test through the SPSS software version 16. A P<0. 05 was considered statistically significant. Results: The mean and standard deviation of age of samples were 32. 2± 7. 08. Most nurses were female (86. 79%) and married (68. 46%). Most nurses had a bachelor’ s degree (94. 88%) and the rest of them had a master’ s degree. The mean score of happiness in nurses was 43. 1± 13. 3 (the range 0-87). Concerning the demographic and occupational variables, a statistically significant relationship was found between job satisfaction and happiness level (P=0. 049). Conclusion: According to the findings of the study, the level of happiness in the nurses was at an acceptable level. Considering the relationship between happiness and job satisfaction, and given the importance of job satisfaction in the motivation and retention of nurses in the profession, it is necessary to pay attention to this matter.

Background & Aim: The physiologic childbirth program in Iran is an emerging program that needs to be evaluated like any other program to improve its quality and process. Evidence suggests that the implementation of the physiologic childbirth program faces some challenges. The present research aimed to explore the challenges of the physiologic childbirth program from the perspective of service providers. Methods & Materials: This qualitative research was carried out through a content analysis method in two mother-friendly hospitals of Ahwaz and Mashhad in 2016-2017. Data were collected through semistructured interviews with 17 physiologic childbirth service providers. The content analysis method of Elo and Kyngas was used for qualitative data analysis. Results: Data analysis led to five main categories: low motivation of midwives in performing physiologic childbirth; barriers related to manpower; medical interventions in physiologic childbirth; challenges from the environment and facilities; and educational barriers. Conclusion: Different challenges in interaction with each other create a complex environment in which the implementation of physiologic childbirth program becomes more difficult. Therefore, policymakers, authorities, doctors, midwives and mothers need to work in a coordinated way to resolve the mentioned challenge.

The pre-post test study with control group is one of the most widely used methods to evaluate clinical research and educational designs. The data analysis of this design is done in a variety of ways. However, considering that the interaction between the pre-test score and intervention score is considered a threat for external validity in these types of study designs, the ANCOVA test is recommended for its control. Also, due to the importance of accurately estimating the effect size of intervention, it is necessary to assess the differences in the accuracy of its estimate among conventional methods. In this regard, the ANCOVA test, a common linear model that combines the analysis of variance and regression, estimates the effect size better than other common analyzes. In this article, the data of a hypothetical study were analyzed using these two tests to clarify the different results between the independent t-test and the ANCOVA test. The result showed that the obtained effect size from ANCOVA was greater than that from the independent t-test. Therefore, it is suggested that the ANCOVA test be used to analyze the data and estimate the effect size in the pre-post test designs with control group.

Background & Aim: Women with cancer face many stresses. Social support can facilitate coping skills and improve active coping strategies. The purpose of this study was to assess perceived stress and its relationship with perceived social support in women undergoing chemotherapy for genital cancers. Methods & Materials: This descriptive, correlational study was conducted from March to May 2016 on 151 patients undergoing chemotherapy for gynecologic cancers in oncology wards of Alzahra and Shahid Ghazi hospitals in Tabriz. The perceived stress scale (PSS) and perceived social support scale (PRQ-85-part2) were completed through interviews with patients. Data analysis was performed using the Pearson correlation test, one-way ANOVA and independent t-test. Results: Mean (and standard deviation) total score of perceived stress for women was 42. 26 (3. 97) in the score range of 0-56. Mean (and standard deviation) total score of perceived social support for women was 127. 55 (16. 64) in the score range of 25-175. Based on the Pearson correlation test, no statistically significant correlation was observed between perceived stress and perceived social support (P=0. 324, r=0. 08). Conclusion: The findings indicated that the perceived stress score for women with genital cancers was high. Nevertheless, no relationship was observed between perceived stress and perceived social support. Therefore, further studies are needed in this area.

Background & Aim: Nursing prescription is an expanding category with many supporters and critics. The present research attempts to answer three questions: What are the fields of activity of nurse prescribers? What are the challenges of nursing prescription? and what are the positive outcomes of nursing prescription? Methods & Materials: In the present systematic review, all relevant papers published until March 2017, were examined. Search was done in databases: SID, Iran Medex, Iran Doc, Magiran, Science Direct, Medline/PubMed, Web of Science, Scopus, ProQuest, Google Scholar, Cochrane Library and with keywords: nursing prescription, nurse prescribing, nurse prescriber, independent prescribing, supplementary prescribing and their equivalent terms in persian. Inclusion criteria were articles in English or persian, quasi experimental, questionnaire based study, qualitative study and relevant to the objectives of the study. Exclusion criteria were review articles, posters, presentation, and letter to the editor. Results: A total of 72 articles that were included in the systematic review, showed extensive nurse prescribing activity in the fields of diabetes, mental health, rheumatology, dermatology, primary care, elderly care, epilepsy, pain, asthma, hypertension, constipation, emergency, hemodialysis, glaucoma and elderly. Challenges included: the critical look of the care team and lack of support, lack of attention to professional competence assessment, legal constraints, and lack of community awareness of the role of nurse purscribers. The positive outcomes of nursing prescription were classified in three areas related to the patient, the nurse and the organization. Conclusion: Nurse prescribing activity is changing, and identifying its challenges and outcomes will help it progress.