outcomes assessment

Decision making and the quality of care provided for chronic diseases have been shown to improve through patient participation. The HeartQoL questionnaire is a core healthrelated quality of life (HRQOL) tool specifically designed for individuals with ischemic heart disease (IHD) who have undergone interventions such as cardiac rehabilitation (CR).

In this cross-sectional and multicenter study, 150 patients were recruited. The participants completed the HeartQoL, MacNew Heart Disease Questionnaire, and Short Form Health Survey (SF-36) on entering CR for validity assessment. The HeartQoL along with a Global Rating of Change (GRoC) scale (for responsiveness measurement) were completed by 100 participants 3 months later.

The mean age of all participants in validity assessment was 61.87 ± 8.13 years. Cronbach’s alphas of the total scales ranged from 0.70 to 0.81 and of the subscales from 0.70 to 0.82. The Pearson correlation coefficient was used to determine construct validity; similar constructs were confirmed with correlation coefficients ranging from 0.50 to 0.69 and dissimilar constructs with correlation coefficients ranging from 0.28 to 0.29 (P < 0.010). The assessment of the responsiveness of the questionnaire indicated that the area under curve (AUC) was greater than 0.70 (range: 0.74 to 0.91) and the optimal cut-off point was 0.65.

The Persian version of the HeartQoL questionnaire demonstrated satisfactory psychometric properties in the sample of participants admitted to CR after coronary artery bypass grafting (CABG). The present study results showed that the HRQOL can be used by clinicians and researchers in conjunction with other outcome measures to gain additional information about symptoms relevant to HRQOL in patients referred to CR and to evaluate change over time.

Evidence-based clinical care guidelines effectively assists medical teams to increase the quality of clinical practice, and improve outcomes in patients. This study aimed to design and implement evidence-based care guidelines for removing arterial sheath in patients undergoing angioplasty of coronary artery. This clinical trial study was performed on 200 patients (two groups of 100 patients) with mean age of 62.5 ± 10.8 years, from July 2014 to February 2014 in Baqiyatallah University of Medical Sciences (BUMS), Tehran, Iran. First, we designed a five-step guideline for removing arterial sheath. Then, the designed guideline (based on five-step Stetler model, i.e. preparation, validation, comparative study, implementation, and execution) in the current study, and the routine guideline were used for removing arterial sheath in patients in the intervention and the control groups, respectively. In both groups, the relevant outcomes including bleeding, vasovagal reactions, urinary retention, and pain were evaluated. There were significant differences between the two groups in terms of bleeding, hematoma, vasovagal reactions (n = 11 versus n = 24), urinary retention (n = 8 versus n = 31), and back pain after removing arterial sheath (P < 0.050 for all). Based on the results of this study, the use of evidence-based care guidelines after removal of atrial sheath in patients undergoing angioplasty is recommended.

One of the significant goals of healthcare delivery organizations is to promote people’s health and provide high quality care. In this regard, health reform plan was designed in Iran. Therefore, the present study aimed to evaluate the performance of teaching hospitals after running of health system reform plan in Iran. This retrospective-descriptive study was carried out in 4 hospitals (Avicenna, Velayat, Rajaee, and Qhods) affiliated with Qazvin University of Medical Sciences, Qazvin, Iran, in 2014. Data collection tool was the checklist of standard indicators of Iranian Ministry of Health, because the checklist is standard to measure hospitals’ performance. In this study, 19 indicators (performance indicators, personnel indicators, and financial indicators) were investigated. To fill out the indicators checklist, the statistics unit of Ministry of Health was used according to the reports of two consecutive years of 2013 and 2014. The collected data were analyzed using Excel software. In general, out of the 7 performance indicators that were investigated in the hospitals, increase was observed in four, and decrease was seen in three items. Out of the six personnel indicators, all of the hospitals experienced a rise; and out of the six financial indicators, four items increased and two decreased. The results of this study indicated that after one year of implementing health reform plan, the mentioned health care system experienced a remarkable progress in the hospitals. Providing the necessary infrastructures can help better conduction of the plan and promotion of the mentioned indicators by removing or decreasing the effect of some barriers.

Background and Objects: The patient’s age at the first hypospadias repair may be an important factor for determining postoperative outcomes. Age at the first procedure differs between Western countries and medical centers in China. This review examines the differences between the incidence of surgical complications and surgical age in boys receiving hypospadias repairs in North America, Europe and China.. Literature reports were reviewed in PubMed and WanFang databases using the key terms and phrases; ‘hypospadias outcomes’, ‘complications of hypospadias repair’ and ‘timing of hypospadias repair’. All peer-reviewed articles published over the past decade (2001-2011) were considered if; a full text was available, the article included age at the first hypospadias procedure and surgical complications.. In total, 16 131 patients were reported in 113 papers from North America, Europe and China according to our inclusion criteria. There was a significant difference in age at the first hypospadias surgery (P < 0.0005) and in the incidence of complications (P <0.001) between the different global regions investigated, with the earliest surgeries occurring in North American patients. Urethral fistulas were the most common complication reported in all of the regions included in this study.. Fellowship training in pediatric urology could improve surgical outcomes,particularly in young children. Younger children experience fewer complications following hypospadias surgeries, independent of training and access to resources.