Caspian Journal of Health Research
Volume:4 Issue: 1, Mar 2019

Service quality is one of the main challenges in health systems. In quality management, service recipients play an important role in identifying their needs and preferences. The present study was carried out to evaluate the quality of health services provided in health centers of Ahvaz city based on the SERVQUAL model in 2016. This cross-sectional descriptive study was conducted on 384 person referred to the health centers in the west of Ahvaz city in 2016. The sample were selected through quota sampling method. The SERVQUAL questionnaire which measures the five dimensions of Tangibles, Reliability, Responsiveness, Assurance and Empathy in service delivery was applied to collect the required data. The data were analyzed using paired t-test. In general, there were differences between perception and expectation of the five service dimensions and the differences were negative (expectations were beyond perceptions). The mean total difference of service quality was -0.68 (P-value < 0.05). The lowest and the highest mean scores of quality difference were obtained for reliability (-0.53) and empathy (-1.04) dimensions, (P-value < 0.001). This study revealed negative differences in all five service dimensions. So, promotion and evaluation of service quality should be continuously considered in planning. Since the highest difference in service quality was observed in empathy dimension, it seems essential to hold customer service training courses for increasing communication skills for employees

Although vaginal delivery is the safest type of childbirth, cesarean section (CS) without any medical indication is currently increasing in the world, especially in Iran. The purpose of this study was to determine the type of delivery and its related factors in women working in the departments of Guilan University of Medical Sciences. This cross-sectional study recruited 100 women employed in the departments of Guilan University of Medical Sciences in 2017. Data were collected using a questionnaire including demographic and reproductive details of all participants and the reason for choosing CS among women with previous CS. Fisher's exact test and Chi-square test were used to determine the factors related to delivery type. The prevalence of cesarean section in this study was 80%. Older age at pregnancy and higher education of the respondent and her husband was significantly associated with higher rate of CS. Spouse and relative suggestion for normal delivery was associated with lower rate of CS. The main reasons for CS were women’s fear of childbirth, labor pain, and physician’s recommendation. The rate of CS delivery is very high in working women. Since concern about pain and possible damage to the body was the most important reasons of choosing CS, providing training classes, better facilitation for normal delivery and adding a special course for girls in high school education is recommended to develop a positive attitude toward normal delivery in women.

Epidemiological knowledge of traumatic spinal fractures and spinal cord injuries (SCIs) is essential for preventive planning and health policy-making. The present study was conducted to investigate the epidemiological features of traumatic spinal fractures and SCIs in Guilan province, Iran. The present cross-sectional study was performed on all 15-80 years old patients with trauma admitted to Poursina Hospital from January 2015 to December 2017. The individual characteristics, time, place and mechanism of trauma and diagnostic characteristics of spinal trauma were gathered using trauma registry system. The incidence and epidemiological distribution of spinal fractures among traumatic patients were then estimated. The incidence of traumatic spinal fractures was found to be 0.6% in 2015, 0.3% in 2016 and 0.2% in 2017. The men to women ratio was 2.33:1. Motor Vehicle Accident (MVA) and falls were respectively the most common mechanisms of trauma and their incidence were higher in rural communities than in urban communities. There was significant relationships between mechanism of trauma and the site of vertebral fracture (P-value = 0.02). Lumbar vertebrae mostly caused by falls while cervical vertebrae caused by MVA. The incidence of SCI in all the patients with spinal fractures was 18.23% in 2015-17. SCIs were found to be more prevalent in 15-45 year olds compared to other age groups. Quadriplegia (54.83%) and paraplegia (38.7%) were the most prevalent SCI-induced types of paralysis. The incidence of SCI was significantly associated with the site of spinal fractures, although it was not associated with mechanism of trauma. This study revealed that the incidence of spinal fractures were decreased in recent years and MVA is the major cause of spinal fractures. Preventive programs are recommended to focus on traffic engineering and the training of drivers and pedestrians, especially in high-risk populations.

Patients infected with human immunodeficiency virus (HIV) are unable to find meaning in their lives, and drown in crisis. Logotherapy attempts to place a barrier against psychosis and depression by focusing on tangible and meaningful goals. The present study was conducted to investigate the efficacy of group logotherapy on the hope of life in patients with AIDS. In the present interventional study, 50 people with eligibility criteria of minimum junior high school education and receiving no treatment for depression were selected as the sample out of 180 HIV-infected patients attending a counseling center for behavioral diseases and positive club in the city of Rasht. Then, 24 participants with lower hope-of-life scores were randomly assigned to intervention and control groups. The intervention group received 10 sessions of group logotherapy, but the control group received no education. The hope of life defined as positive motivational state was determined using Schneider's Hope Scale with Cronbach’s alpha of 0.81. The scale has two components of agency defined as goal-directed energy, and pathways defined as planning to meet goals. The results from intervention and control groups were then compared using analysis of covariance. In the intervention group, mean score for hope of life increased from 33.58 (SD=7.92) at beginning of the study to 47.67 (SD=7.47) after intervention, but reduced in the control group from 36.67 (SD=3.98) at beginning to 34.33(SD=4.71) after intervention. The analysis of covariance showed that adjusted mean scores of hope of life, and its components including agency and pathway in the intervention group were significantly higher compared to the control group. According to the results, logotherapy in HIV patients had a positive effect on increasing hope of life.

Eating disorders are one of the most common psychological/psychosomatic disorders that cause many problems for physical health, mental functioning and quality of life. Eating disorder is identified by severe chaotic eating behaviors and includes anorexia nervosa and bulimia nervosa. The use of complementary medicine, such as yoga, has always been of interest to researchers in clinical sciences and has been proposed as a new approach to the treatment of eating disorders. Yoga essentially means connectivity and continuity. Through mind- and body-based techniques, yoga can be effective in the achievement of therapy goals in feeding and eating patients. The data for the present review study was collected through a search in electronic resources and databases as well as manual search of library resources. The search for relevant articles and studies was performed on the internet in relevant websites and scientific/research journals using a number of keywords. This study will address yoga therapy and its relationship with and effects on eating disorders after a review of the definition, classification, epidemiology and pathophysiology of different types of eating disorders. The results showed that eating disorders are caused by emotional disorders and stress and, essentially, by subjective factors. Many people achieve relaxation and body, soul and mind balance with yoga. This practice makes it more possible to fight eating disorders. Yoga creates self-confidence and a positive feeling about one’s body and appearance. Yoga has a holistic attitude toward human-beings and provides different, continuous and simple techniques for humans’ health, development, preparation and balance and is thus effective in improving nutrition and eating disorders.