فهرست مطالب

Shiraz Emedical Journal - Volume:18 Issue: 11, 2017
  • Volume:18 Issue: 11, 2017
  • تاریخ انتشار: 1396/08/17
  • تعداد عناوین: 6
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  • Kamran Bagheri Lankaran, Hamid Reza Khankeh, Nooshin Zarei, Mohammad Fararouei, Zahra Saboori, Hassan Joulaei * Page 2
    Background
    To improve health equity, many countries have undergone consistent health sector reforms during the two past decades although most of them still have some challenges ahead.
    Objectives
    This systematic review aimed to determine the impact of health system reforms on inequities and social determinants of health (SDOH) since the year 2000.
    Methods
    PubMed, Scopus, and Google Scholar databases were utilized to conduct a literature search of related records from January 2000 to August 2014. Out of 1,559 published articles, 29 were selected according to specified inclusion and exclusion criteria.
    Results
    Almost all investigated countries have considered financial interventions to address increases in governmental health expenditures and implement universal health coverage. While most countries stressed in-patient or outpatient care, primary care is often disregarded in many health system reforms. Although the aforementioned reforms have been somewhat successful, several socioeconomic groups continue to experience health inequities.
    Conclusions
    These results illustrate the vital role that socioeconomic and political determinants play in the success of studied reforms. Furthermore, emphasizing primary health care, implementing reforms in a stepwise and well-monitored manner, and utilizing quality control mechanisms can mitigate health inequity.
    Keywords: Health Sector Reform, Socio, Economic Status, Equity, Utilization
  • Mohammadkarim Bahadori, Khalil Alimohammadzadeh, Kolsoum Abdolkarimi, Ramin Ravangard Page 3
    Background
    The most important barriers to the implementation of electronic health records (EHRs) are people’s attitudinal-behavioral limitations and organizational changes. Given its complexity, applicability of EHRs is very important, especially for physicians.
    Objectives
    This study aimed to investigate the physicians’ attitudes towards the implementation of EHRs in a university-affiliated teaching hospital in Tehran, Iran.
    Methods
    This cross sectional study was conducted in a university-affiliated teaching hospital in Tehran, Iran in the second half of 2016. The attitudes of all physicians working in this hospital (n, 169) towards the implementation of EHRs were investigated, using census sampling method. The required data were collected using the translated and localized Morton’s standard questionnaire (2008). The collected data were analyzed using SPSS version 21.0 and AMOS version 18.0. P value less than 0.05 was considered statistically significant.
    Results
    The results showed that the studied conceptual model had a good fit and was structurally confirmed. Moreover, the results showed that independent variables could predict 51% of variations in the dependent variable of “physicians’ attitudes”. The results of structural equation modeling (SEM) also showed that variables of “perceived usefulness” (r, 0.52) and “perceived ease of use” (r, 0.26) had major effects on the physicians’ positive attitudes (P
    Conclusions
    The results showed that physicians working in the studied hospital agreed with the implementation of EHRs, and they had the required abilities and readiness to implement EHRs. According to these results, development of standards related to information security and privacy, as well as standards for conveying messages, especially for physicians and users who work directly with the system, is recommended.
    Keywords: Electronic Health Records, Health, Health, Iran
  • Mahmood Rahmati, Behnam Khaledi, Nader Salari, Mohammad-Rafi Bazrafshan, Anahita Haydarian* Page 4
    Background
    Spiritual support, belief in God, and praying are of the elements and tools used by a family to deal with stressful events.
    Objectives
    The present study is aimed at examining the effects of spiritual and religious interventions on the resilience of family members of ICU patients.
    Methods
    A quasi-experimental study was carried out with participation of 34 family members and blood relatives who kept the patients in the ICU ward of Kermanshah Imam Reza hospital company. The participants were selected through convenient sampling and then randomly allocated to the experiment (n = 17) and control (n = 17) groups. The experiment group received interventions in the form of spiritual-religious intervention sessions (8 group sessions, 3 sessions a week, each 45 - 60 minutes). Resilience was measured using Connor Davidson resilience scale (CD RIS) before and after the interventions and the data was analyzed in SPSS (20).
    Results
    Paired t-test results indicated that there was a significant difference in terms of the mean score of resilience before and after the religious and spiritual interventions in the experiment group (P value = 0.001). The test also showed that there was no significant difference in terms of the mean resilience score before and after the interventions in the control group (P value = 0.525). The results of independent t-test indicated that there was no statistically significant difference (P value = 0.663) between the control and experimental groups before the interventions, whereas there was a statistically significant difference between the control and experimental groups after the intervention (P value = 0.025).
    Conclusions
    The findings showed significant effectiveness of spiritual- religious interventions on increasing the resilience of family members of patients.
    Keywords: Family, ICU, Resilience, Spirituality
  • Shayesteh Parashi, Arash Bordbar, Yaqoub Mahmoodi, Mahasa Rezaei Jafari * Page 5
    Background
    Intraventricular hemorrhage (IVH) is a common complication seen in premature infants. Since the brain intraventricular hemorrhage in any degree of risk is an important factor in long-term neuropathology, the role of magnesium sulfate on cerebral hemorrhage requires further investigation. Therefore, this study aimed to investigate the effect of magnesium sulfate on intraventricular hemorrhage in infants of mothers with premature rupture of membranes.
    Methods
    This study is a double blind clinical trial (IRCT: IRCT2016080729223N1) on 120 pregnant women with premature rupture of membranes at 34 weeks admitted to the hospital of Shahid Akbar Abadi that were selected based on the inclusion criteria and assigned to two groups (magnesium sulfate recipients and non-recipients). The significance level was set at p
    Results
    The mean age was 28.17 ± 6.21 in the intervention group and 28.33 ± 5.97 in the control group that showed no statistically significant difference between the groups. The average weight of infants in the intervention group and in the control group was 2336.1 ± 526.8 and 1975.3 ± 233.4, respectively, which showed no significant difference. No intraventricular brain hemorrhage occurred in the infants of the two groups.
    Conclusions
    Magnesium sulfate needs more evaluation in prevention of intraventricular hemorrhage in infants of mothers with premature rupture of membranes at 34 weeks.
    Keywords: Intraventricular Hemorrhage, Magnesium Sulfate, PROM
  • Soheila Pirdadeh Beiranvand, Zahra Behboodi Moghadam*, Mahvash Salsali, Hamid Alavi Majd, Mehdi Birjandi, Zahra Bostani Khalesi Page 6
    Background And Objectives
    Fear of childbirth is a common concern among pregnant women, which is why many women request Cesarean section. Therefore, this study aimed at determining the prevalence of fear of childbirth and its associated factors in primigravid women in Khorramabad, Lorestan province, Iran.
    Methods
    This cross-sectional study was conducted on 400 primigravid women (gestational age: 18 - 32 weeks), who referred to the health centers and stations of Khorramabad in 2014 for routine prenatal care. The participants were selected through multistage cluster sampling method. Childbirth attitude questionnaire (CAQ), demographic characteristics and pregnancy characteristics questionnaires, and Northouse social support questionnaire were used to collect data. The data were analyzed using chi-square test, t test, Mann-Whitney test, and multivariate logistic regression.
    Results
    The mean score for the fear of childbirth was 37.86 (± 9.44), and the prevalence of fear of childbirth was 80.8% (CAQ ≥ 28). According to the results of multivariate logistic regression analysis, lack of sufficient income for living expenses (P = 0.020), not participating in childbirth preparation classes (P = 0.040), and preference for mode of delivery (vaginal delivery) (P
    Conclusions
    According to the results of this study, most primigravid women had experienced the fear of childbirth. Therefore, it is required the health care providers pay special attention to the fear of childbirth during pregnancy and the factors associated with it.
    Keywords: Prevalence, Fear of Childbirth, Primigravid, Cross, Sectional Study