مجله پایش
سال چهاردهم شماره 6 (پیاپی 64، آذر و دی 1394)

Objective (s): Outpatient care is one of the important parts of health system. The aim of this study was to assess time spent during outpatient visits by family physician and in the referral system plan. This was a cross–sectional study. The study population was main providers including family physician and midwives working for the referral system plan. Random sampling method was applied and time spent during outpatients visits was recorded as indicated by the study participants. In all 1814 physicians and 1803 midwives were studied. The study finding indicated that most physicians reported average of 5 to 10 minutes and midwives between 10 to 15 minutes time spent for their outpatient visits. About 45.3% of physicians and 21.8% of midwives believed that this was not enough time. The findings suggest that time spent in outpatient visits is not enough. It seems that a proper defined population for each family physician or referral center is an important step in improving visiting time.

Objective (s): With more than 12 million new cases of cancers and nearly 7.6 million deaths all around the world in 2007, cancer currently is the third leading cause of death in the world. This study was conducted to determine medical and non-medical direct costs of cancer patients’ hospitalized in Namazi Hospital in Shiraz, Iran. This was a cross-sectional study. All patients over 20 years old with cancer including breast, prostate, leukemia, lymphatic, stomach, liver, lung, bladder, uterine and intestine cancers. Initially eligible patients invited to participate in this study. The data was collected through structured interviews with patients and or their caregivers. The data, then, was analyzed using the SPSS software The mean of non-medical direct costs for one month was 2,470,000±2,860,000 Rials. The mean of medical direct costs for one month was 21,550,000±16,980,000 Rials. The mean of total costs paid by patients was 24,020,000±17,300,000 Rials for one month. Patients pay a huge cost for cancer treatment. In order to support patients, health care system should find ways to decrease out-of-pocket payments by cancer patients.

Objective (s): Medical tourism is quickly emerging as a symbol of global trade in health care. The aim of the study was to assess Qazvin’s hospitals preparedness in attracting medical tourists based on JCI patient-oriented standards. A descriptive study was conducted in seven hospitals of Qazvin in 2012. The patient-oriented checklist of JCI standards was used to collect data. The results showed that among 7 standards, maximum score was belonged to Anesthesia and Surgical Care (77.5%) and minimum score was belonged to Patient and Family Education standard (52.5%). Finally, The Rahimian hospital acquired maximum score (85.4%) and the Kosar hospital acquired minimum score (5). The hospitals in Qazvin showed a relative preparedness in medical tourists. Standards in private hospitals were more acceptable than state teaching hospitals.

Objective (s): One of the most important strategies to achieve equity is facilitating population access to health services. As such geographical accessibility modeling was suggested. This paper as part of a larger study on geographical accessibility modeling to medical laboratory services in Iran reports the findings from the city of Takab, Iran. The detail of methodology and accessibility modeling are reported elsewhere. In brief, study units included existing medical laboratories, which were active by the end of March 2013 and located within the city borders. Data were analyzed using Geographic Information System (GIS). Spatial analysis performed using the ArcGIS software. The criteria ranking scores for site selection were unacceptable, poor, somewhat poor, somewhat good, good and excellent. Takab is located in the west Azarbiyejan Province. According to the accessibility model, the sites for new medical laboratories were identified for Takab. The total area needed was estimated to be about 2000 square meters (in the horizontal expansion of city) and ranked as somewhat good, good and excellent. It is possible to establish 9 new medical laboratories (laboratories outside of hospitals and clinics) in Takab city.The model was accurate in identifying new sites. However, it seems that the accuracy of selected sites should be confirmed by field visits and opinions of local experts.

Objective (s): Despite the negative attitude of the society toward reverse marital age heterogamy, in which women are older than men, spreading of reverse age discrepant marriages and their impacts on changes in community structure illustrate the necessity of identifying the reasons for choosing this type of marriages. This research was conducted to identify and assess factors affecting the marital satisfaction, in couples with reverse age differences. Due to the limitations of using questionnaire surveys in the field of marital satisfaction, the data was gathered using a qualitative method (Phenomenology) by conducting interviews with 30 couples with reverse age difference as well as using observational techniques and assessing the recorded audios and transcribed texts of interviews. We used axial, selective and open coding methods to analyze the data. In all, 130 concepts were selected and categorized into five main factors that affected marital satisfaction in these couples. These factors were: individual-, family-, attitude, motivation, and background-related factors. The accurate ways to decrease possible breakdown of such marriages is recommended.

Objective (s): Sexual function has interaction with health and may significantly interfere with health. This study aimed to determine the status of sexual function and help seeking behaviors in newly married women in Sari, Iran

This cross-sectional study was conducted on 363 newly married women in year 2013-2014. A selected randomly selected attending health center of Sari entered into the study. The data were collected by Sexual Function (ASEX), help seeking behaviors and socio-demographic questionnaires. One way analysis of variance, general liner model and logistic regression were used for data analysis.

The mean score of sexual function was 14.5 (SD: 4.9) of the attainable range score of 5-30. Prevalence of sexual dysfunction was 21.2%. The highest disorder (16%) was for orgasm and lowest (3.6%) for desire dimension. There was statistical significant relationship between exercise, income and living with family with sexual function in women (p<0.05). Only 41% of women had sought help and 82% of them had refereed to gynecologist. The most cause of not seeking help was “I am ashamed to speak about it”. 61% of women desired for therapy.

The findings of this study show that the sexual dysfunction is almost prevalent in women and most do not request help. Indeed determining causes of not seeking help seems necessary.

Objective (s): Newborn screening program is an essential public health program to identify genetic diseases and congenital disorders. Abnormal screening test results should be followed immediately through health centers; otherwise there would be a delay in the process of diagnosis and treatment. As the number of studies related to the use of newborn screening information systems in Iran is few, in this study, general issues related to newborn screening system and the necessity of using information technologies in newborn screening process are reviewed. In this study, the relevant literature from 2000 to 2013 was reviewed. The electronic databases including Web of Science, Science Direct, PubMed, Medline, Ovid and MagIran were used to find relevant literature. Data related to the newborn screening information system in the selected countries (America, England and Australia) was gathered using electronic databases and the official websites of the organizations involved in newborn screening programs. The results showed that not only newborn screening information system integrates screening processes among blood sampling centers, hospitals and referral centers, but also reduces the amount of manual processes. While in some countries national or regional newborn screening information systems are used, in Iran, newborn screening data are collected in several forms to be sent to the higher authorities. It seems that the use of a newborn screening information system that is able to gather screening information along with other personal health data will increase productivity and help managers to make effective decisions.

Objective (s): Painful procedures such as venipuncture that are performed repeatedly on preterm infants in NICU has been proposed as one of the factors that may contribute to altered development of cognition, motor function and behavior in infants born preterm. Therefore it has been suggested that pain management in infants is necessary. This study assessed the effect of sucrose on pain reduction at different stages of venipuncture. In this clinical trial and double blind study 64 premature infants aged 35-32 weeks hospitalized in intensive care randomly assigned into two groups (sucrose group) and control group. In both groups ten minutes before starting the intervention until ten minutes after the ending of venipuncture simultaneously was filmed from infants` face and monitored by using two video cameras. In the experimental group, 2 minutes before blood sampling, 0.5 ml oral sucrose solution 24% with syringe was administered on the anterior portion of tongue and for the infant in control group, 0.5 ml strill water was given to infants. The Premature Infant Pain Profile was used for pain evaluation. Average pain scores before venipuncture, during blood sampling, immediately after removing needle and ten minutes after blood sampling was calculated. The mean pain scores in both groups during blood sampling and immediately after removing needle in comparison with before blood sampling decreased significantly (P<0.001). The mean pain score during blood sample in the sucrose group was significantly lower than the mean pain score of the control group (p<0.001). In both groups mean pain score ten minutes after venipuncture returned to the baseline. Oral sucrose was effective on pain reduction at different stages of venipuncture in preterm infants. This non-pharmacological method is recommended for pain relieve in minor painful interventions in infants hospitalized in neonatal intensive care units.

Objective (s): Physiological edema of pregnancy is a common finding in pregnancy and there are several interventions to control it. As such the feet elevation is one of the most common approaches. However, this approach may cause some limitations. Thus, the use of massage as a new therapy is increasing. The present study was performed to compare the effectiveness of massage and feet elevation on physiological edema of pregnancy. In this study, 180 healthy pregnant women non-randomly assigned to 3 groups: massage group, feet elevation group and control group. Massage group received 20 minutes feet massage and the feet elevation group received feet elevation for 20 minutes. The study was performed during 5 days. Edema was measured before and after interventions and was compared among three groups. There were significant differences among three groups in terms of the mean rate of change of the circumferences. However, this change was greater for the massage group. The results indicated that compared with feet elevation, massage has greater impact on pregnancy edema.

Objective (s): The purpose of this study was to evaluate the effectiveness of a theory-based educational intervention for increasing exercise to prevent osteoporosis in pre-menopausal women. This study used a randomized controlled design to evaluate an 8-week exercise education intervention program based on the Health Belief Model and Self Regulation construct to prevent osteoporosis in 140 pre-menopausal women. The results of post intervention and 3 months follow up revealed that individuals in the experimental group had a positive and significant progress, whereas no progression occurred in the control group. After the intervention, the experimental group demonstrated significant improvements in physical activity, muscle strength and feasibility, with no significant changes in the control group. These results support the applicability of the integrated model for a physical activity intervention in order to prevent osteoporosis in women.

Objective (s): Thermal comfort consists of three parameters: temperature, humidity and airflow. It is one of the important factors on maintaining health and optimizing the performance of students in the classrooms. According to the climatic conditions of Qom province and the importance of thermal comfort in schools, this study aimed to assess classroom thermal conditions in primary schools. This cross-sectional study was conducted in primary schools in Qom province in 2013. Relative humidity was measured using a CASELLA hygrometer and temperature was measured using a mercury thermometer at five points in each classroom at one meter height from ground level. The measurements were performed between 9 AM to 15 PM in the spring. Thermal discomfort was measured using the thermal discomfort index (DI). All statistical analysis performed using SPSS software version 16. Overall 115 classrooms were assessed. In this study, mean temperature was equals to 27.42±2.84°C. The mean of relative humidity was 30.4±7/43% and mean of the DI was 22.46±1.72°C. In 17.4% of classrooms the DI was less than 21°C, in 60% of classrooms was 21-24°C and in 22.6% of classrooms was 24-27 °C. As a result only in 17.4% of classrooms thermal comfort conditions was favorable for students. In order to increase thermal comfort level in primary schools and educational environments, especially in tropical areas such as Qom province, appropriate actions are recommended.

Objective (s): Health information seeking behavior describes how the individual search for and obtain health and medical information about health risks, diseases and illnesses, and health promotion activities. Understanding the patient's information seeking behavior can provide the medical and information specialists useful evidence in improving the patient's health. A sample of 362 diabetic patients in Isfahan, Iran was studied. The SPSS version 20, descriptive and analytic statistics are applied in analysis of this work. The Lngo’s health information seeking behavior questionnaire was used to collect data. Descriptive analysis was performed to explore the data. The findings indicatedthat most usable information sources by diabetic patients were physicians (3.12%), television (2.43%), family members (2.32%), news (2.01%), other health care providers (1.38%) and radio (1.19%). Help lines was not indicated as a source of information at all. Differences between passive information seeking (41.68) and active information seeking (39.20) considered statistically significant (p < 0.001). Passive transition of health information on diabetes through most usable information sources seems to be the best way of making these patients alert.