مجله پایش
سال نوزدهم شماره 5 (پیاپی 93، مهر و آبان 1399)

Objective (s): 

The purpose of this study was to review the content of the national health information systems in Iran. The practical purpose was to provide the necessary information to increase the efficiency of national health information systems in order to improve health services.

This was a mixed method study (review and qualitative). First, documents related to the health information system (especially on the website of the Ministry of Health and its affiliated organizations) were reviewed. Search strategy included the following keywords: Health system, Health system in transition, Health information system, Health information system in transition, Health information. At this stage the study was seeking to collect data for following questions: Who is running the site? What are the variables that each system registers and maintains? What are the information recording processes? What outputs and reports are extracted? Who are the users of this information? Then, a qualitative study was conducted and seven experts were interviewed. All systems were checked for the following information such as mission, aims, client, moderator, variables, registration process, output, beneficiaries and target groups.

In all there were 10 national health information systems, and more than 150 specific registries for disease conditions. In addition, we found 11 different names for Electronic Health Record (EHR).

In general, health-related databases (healthcare and insurance databases) have not yet been fully integrated, and it is not possible to detect drug disorders or violations in addition to duplicate or more recording of information. Also, there was no codified program found to analyze the data in the databases studied.

Objective (s):

 Health surveillance systems provide regular and continuous monitoring and analysis of health issues, coordination of information production collections and ensuring the use of information. Strategic guidance to the (2025) prospect requires precise, comprehensive and timely information. According to the rules of the fifth and sixth five-year development plans of the I.R. of Iran and the original features of the health policy system, it is necessary to design a health monitoring system. This study aimed to design a health observatory system in Iran.

This was a system design study. Initially, the principles for designing this system were formulated by reviewing the experiences of other countries, the history of the subject in the country, documents, analyzing the status of production and managing health information, and studying the platforms for deploying the observatory system. Then, prepared draft was reviewed and finalized in three stages by experts, and representatives of data and information producers using a written letter and a focused group discussion.

In this proposed model, principles of observatory system, observation functions, types of reporting methods, added outputs and value, observatory system products, main dimensions of observatory system, processes, procedures and standards, financial resources, information security and executive guarantee was considered that can be implemented and deployed in one of the organizational units.

The system designed with the approval of the High Council of Health and Food Security can lead to obtaining the budget line of national surveys in the parliament or the program organization and facilitate its establishment in one of the universities or the headquarters of the Ministry of Health.

Objective (s): 

The basic health services package is the minimum set of essential health services that all people should have access to it, but there is no consensus on the services included in a package or the services to be included. The aim of this study was to identify the dimensions and components for designing a basic package in Iran.

This was a mixed method study. In qualitative phase 25 in-depth individual interviews were conducted with experts from the Ministry of Health, incurrence organization and the Planning and Budget Organization, and the data were analyzed using content analysis method. In the quantitative phase 285 managers and faculty members were selected from the Ministry of Health, insurance organizations, and 12 universities of medical sciences. Data were collected using a two-part questionnaire, including demographic characteristics and evaluation of 58 criteria, and analyzed using SPSS.23 and Smart-pls.3.2.8 software for exploratory and confirmatory factor analyses.

8 Dimensions of community health priority, structure and potential capacity of service delivery system, peoplechr('39')s demands, cost effectiveness, benefits, funding, social acceptance of service, and governance obligations and requirements for designing a basic health services package were identified, of which 57 components were classified under these eight factors. According to the goodness of fit index in factor analysis, the overall performance of the model was strong (GOF = 0.8).

It is important to design a basic health service package. The basic health services package needs to be comprehensive and accessible so that all individuals are willing and satisfied to use the services.

Hospital accreditation is “an external evaluation of a hospital’s structures, processes, outputs and outcomes by an independent professional accreditation body using pre-established optimum standards”. Accreditation is a strategy for ensuring the quality, safety, effectiveness and efficiency of hospital services. The efficacy of an accreditation program depends on the validity of the accreditation governance, methods, standards, and the surveyors. Iranchr('39')s hospital accreditation system faces some challenges. Benchmarking leading international accreditation bodies’ methods benefit the Iranian hospital accreditation system. Hence, this study aimed to compare the Iranian hospital accreditation methods with the world leading international hospital accreditation bodies’ methods.

A comparative research was used in this study in 2019. The Iranian hospital accreditation methods was compared with those of the Joint commission international, the Accreditation Canada international and the Australian Council on Healthcare Standards International. Framework analysis was used for the qualitative data analysis in this study.

While the Iranian hospital accreditation program is governmental and compulsory, the three leading international accreditation programs are private, not for profit, and voluntary. While Iran’s hospital accreditation method includes the self-assessment and the on-site survey, the other countries use self-assessment, on-site survey, un-noticed survey, periodic review, examining key performance indicators and measuring patient satisfaction. The international accreditation award levels include “Fully accredited”, Provisionally accredited” and “Not accredited” and the accreditation certification is valid for 3-4 years. The Iran’s accreditation certificate is valid for 2 years and consisted of 7 levels from “Excellent” to “Not accredited”.

Complementary evaluation methods should be used to strengthen the validity and reliability of Iran’s hospital accreditation program. Furthermore, the time period of the accreditation certificate validity should be increased and the awards levels should be decreased.

Objective (s): 

Childlessness in low fertility rate situation can be considered as a demographic problem. This study was attempted to investigate the permanent or lifetime childlessness among married women aged 40-49 living in Gilan, Mazandaran and Tehran provinces as provinces with very low fertility rates.

The data were derived from the 2016 census micro-data. Data analysis was performed in SPSS 20 using frequency tables, Chi-square test and logistic regression analysis.

The results showed that 4.4% of the women were permanent childless. Logistic regression analysis indicated that educational level as an individual characteristic as well as the type of home ownership and living area as the residential and household characteristics had a statistically significant effect on the odds of being childless.

The prevalence of lifetime childlessness was relatively low in population studied. Planning to improve the housing situation of households, especially among young households, might prevent the increase of the proportion of childlessness in the future.

Objective (s): 

Body mass index (BMI) is one of the major contributors to the spread of non-communicable diseases that it is affected by various factors such as demographic variables and living environment. The aim of this study was to investigate body mass index and its predictors in Rash, Iran.

This was a cross sectional study that performed on 1,000 residents of 5 neighborhoods in Rasht, 2017. Data were collected using a questionnaire including residents’ characteristics and living environment indicators derived from the Foxton and Jones Social Capital questionnaire. Every participants’ height and weight were measured. Simple and multivariate linear regression using SPSS v.20 was used for data analysis.

The prevalence of overweight and obesity in the study population was %55.5 and the results showed that age (B = -0.031, P <0.023), not having children (B = -2.466, P <0.001), not having non-communicable diseases (B = -1.016, P<0.003) and duration of residence in residential environment (B = 0.172, P<0.040) were independent predictors of BMI increasing.

Due to the high prevalence of obesity and overweight in different age groups, identifying predictive factors in populations with different culture is very important. Indeed, preventive steps should be taken in healthchr('39')s macro policymaking.

Objective (s): 

The current study aimed to investigate the association between health-related quality of life (HRQoL) of parents and their offspring.

This study conducted in the framework of the Tehran Lipid and Glucose study (TLGS) on  564 families including children (297 boys and 267 girls), mothers and fathers. Data on HRQoL of children and parents was collected by interviews using Persian version of the Pediatric Quality of Life Inventory (PedsQL™4.0) and the Short-Form Health Survey version 2 (SF-12v2) respectively. Asssociations between HRQoL of parents and offspring were assessed using regression models by SPSS software (Version 23).

Mean(sd) age of participants was 13.8(3.1) years and 52.7% were boys. Comparision of HRQol scores in boys and girls indicated that boys had higher HRQoL scores in physicql functioning [91.2(10.3) vs. 89.1(11.1), p=0.019] and emotional functioning [77.2(16.9) vs. 72.8(18.9), p=0.003]. Parental physical and mental HRQoL scores did not significantly differ between male and female offspring; however, physical functioning, role emotional and mental health scores were significantly higher in mothers of female compared to male offspring. Both maternal and paternal physical HRQoL scores were not significantly assocaited with offspring’s HRQoL. Maternal mental HRQoL score was significantly associated with physical functioning (β= 0.16, p=0.02) and social functioning (β=0.26, p=0.006) in girls, school functioning in boys (β= 0.19, p=0.007) and emotional functioning in both boys (β= 0.23, p=0.008) and girls (β= 0.24, p=0.04) and paternal mental HRQoL score was significantly associated with only school functioning in boys (β= 0.23, p=0.004). 

The relationship between the HRQoL in parents and children follows a pattern related to the gender of the parent and the child. Maternal mental HRQoL in offspring of both sexes and paternal mental HRQoL only in boys were associated with different subscales of offspring’s HRQoL.

Objective (s): 

Colorectal cancer is one of the most common chronic diseases and the second most common cause of cancer deaths in the world, which is associated with many physical and psychological complications. The aim of the present study was to evaluate the effectiveness of acceptance and commitment therapy on the acceptance and post-traumatic Growth in Colorectal Cancer Patients Comorbid with Stress.

This was a quasi-experimental study with pretest, posttest and two-months follow-up design and a control group. Using stratified sampling method, 30 patients with colorectal cancer were randomly selected and randomly assigned to experimental group and control group. The data were collected by three questionnaires of stress-anxiety-depression, acceptance and practice and post-traumatic growth and were analyzed by repeated measures ANOVA and Bonferroni post hoc test.

According to the results, there was a significant difference between the two groups in the pre-test, post-test and follow-up stages (P<0.01). Also, the results of the post hoc test showed that there was a significant difference between the pre-test with post-test and follow-up scores (P<0.01) and between the post-test with follow-up scores the non-significant difference (P>0.05).

The results support the effectiveness of acceptance and commitment therapy as an effective psychological intervention to increase the degree of acceptance and post-traumatic growth in colorectal cancer patients.

Objective (s):

 Low back pain is a common disorder of spine. One of the most important concerns is the increasing rate of low back pain in schoolchildren that might predict adult disability. The purpose of this study was to explain the structural relationship between low back pain and spine-related behavior among pupils via structural equation modeling based on social cognitive theory (SCT). The hypothesized model included skills, knowledge of spine care principals, self-efficacy, and expectation beliefs as independent variables, and spine-related behavior as a dependent variable.

We collected data from 204 students attending public elementary schools using a structured questionnaire in Tehran, Iran from October 2018 to March 2019. The hypothesized model was examined via a structural equation modeling (SEM) analysis using SPSS, version 24.0, and LISREL, version 8.80.

The effect of skills, knowledge, self-efficacy and beliefs on spine-related behavior was 0.73 (t-value=13.09), 0.42 (t-value=6.71), 0.87 (t-value=16.67), and 0.55 (t-value=4.95) respectively. In addition, various indicators, such as Comparative Fit Index (CFI), Normed Fit Index (NFI), χ2/df, and Root Mean Squared Error of Approximation (RMSEA) showed the good fitness of the models.

The results revealed that the pupils who had more confident, skills, expectation beliefs, and knowledge were more likely to perform proper spine-related behavior. In this regard, school-based low back pain prevention interventions should be addressed using key cognitive factors that consider the potential change strategies.

Objective (s): 

Considering the consequences of body image of pregnant women on their quality of life and regarding the fact that valid and reliable assessment of body image in Iranian pregnant women are required, the present study aimed to examine the psychometric properties of the Persian version of the Body Image in Pregnancy Scale (BIPS) in Iranian pregnant women.

This was a cross-sectional study. A sample of 151 pregnant women who were in their third trimester of pregnancy and referred to three hospitals in Tehran, Iran for pregnancy care, were selected using convenience sampling. To collect data, the Body Image in Pregnancy Scale (BIPS), the Body Image Concern Inventory (BICI) and the Edinburgh Postnatal Depression Scale (EPDS) were used. In this study, the construct validity of the scale was assessed using exploratory factor analysis. The internal consistency was assessed via Cronbachchr('39')s alpha coefficient. Convergent validity assessment was examined by using the correlation between the Body Image in Pregnancy, the Body Image Concern Inventory and the Edinburg Postnatal Depression Scale.

Cronbachchr('39')s alpha coefficient for the subscales ranged from 0.60 to 0.86. Exploratory factor analysis indicated good fit for scale with seven factors. The BIPS subscale scores demonstrated good convergent validity with measures of body image and depressive symptoms.

The Body Image in Pregnancy Scale has acceptable psychometric properties in Iranian women and could assess the body image during pregnancy.