مجله پایش
سال بیستم شماره 2 (پیاپی 96، فروردین و اردیبهشت 1400)

Medical tourism is the process of traveling to another country for the purpose of promoting, restoring, and maintaining health along with recreation and pleasure. Iran has a high potential to attract medical tourists due to its special geographical location, abundant natural resources and quality and cheap medical services. The aim of this study was to identify reasons for choosing Iran by medical tourists to receive medical services.

This qualitative study was conducted in 2020 using semi-structured interviews with 18 medical tourists and 23 physicians, nurses and medical tourism experts (Pluralistic evaluations) in Tehran city, Iran. Thematic analysis method was used to analyse data.

In this study, overall 22 reasons for choosing Iran to receive medical services were identified, which were divided into seven groups: type of service (type and severity of illness and availability and comprehensiveness of service), quality of service (specialized and committed physicians and staff, advanced equipment, amenities, fast and easy service delivery process and effective result), service cost (medical service tariff and health insurance coverage), patient previous experience, advertising (hospital and tourism company advertising, word of mouth, and the internet), contextual factors (cultural affinity, tourist attractions, and political climate) and patient socio-economic factors. Finally, a conceptual model of medical tourists’ reasons for choosing Iran to receive medical services was designed. Health tourists who evaluate the value of a countrychr('39')s medical services well, choose that country, and if they are satisfied with the services, they come again or recommend it to others.

Advanced, high quality and cheap medical services are the three main reasons for choosing Iran by medical tourists. However, Iran faces some challenges in utilizing its health tourism capacities. Politicians and health system policymakers should strengthen the countrychr('39')s health tourism industry by analysing its strengths, weaknesses, opportunities and threats and formulating and implementing a strategic plan.

Cognitive emotion regulation represents an essential role in managing stressful events in peoplechr('39')s lives. Some strategies are adaptive, while others are maladaptive and associated with various forms of psychopathology. This study aimed to investigate the factor structure and psychometric properties of the Persian version of the short form of the Cognitive Emotion Regulation Questionnaire (CERQ-18) among Staff of a Military University.

This was a psychometric research. The statistical population of this study was one of the military units in Tehran. Based on the inclusion and exclusion criteria, 310 people were selected by convenience sampling method. The instruments used included the Cognitive Emotion Regulation Questionnaire (CERQ-18), the Depression, Anxiety and Stress Scale (DASS-42) and the General Job Satisfaction Scale (GJSS). Structural validity was examined by performing confirmatory factor analysis. Cronbachchr('39')s alpha coefficients and test-retest were used to evaluate the reliability. The data were analyzed using SPSS-25 and AMOS-22.

Confirmatory factor analysis results indicated a two-factor model of this questionnaire (RMSEA=0.03; SRMR=0.02; CFI=0.98; GFI=0.94).  The correlation scores of adaptive coping strategies with depression (-0.48), anxiety (-0.44), stress (-0.46) and job satisfaction (0.36) were significant (p <0.01) Also, the correlation of the scores of maladaptive coping strategies with depression (0.55), anxiety (0.42), stress (0.40) and job satisfaction (-0.30) was significant (p <0.01). The reliability coefficients of Cronbachchr('39')s alpha and test-retest at 4-weeks intervals for adaptive coping strategies were 0.95, 0.88 and for maladaptive coping strategies was 0.88 and 0.77, respectively, indicating satisfactory results.

According to the findings of the present study, the short form of the Iranian version of Cognitive Emotion Regulation Questionnaire (CERQ-18) is a suitable tool with good psychometric properties to measure cognitive coping strategies.

Objective (s): 

Aging is one of the most important anthropological phenomena of the 21st century. Thus due to various benefits of physical activity for health and fitness, it considers being one of the most important factors in healthy aging. This study aimed to investigate physical activity and its determinants in older adults.

This cross-sectional study was performed on 393 older adults in Mazandaran, Iran, using a multi-stage sampling method. Inclusion criteria included elderly men and women over 60 years of age and their tendency to participate in the study. The data were collected using a demographic questionnaire, the physical activity questionnaire for older adults (CHAMPS), incentive factors, and barriers to physical activity. Descriptive statistics, t-test, and regression were used to analyze the data.

The age of participants ranged from 60-94 years. The results showed that 25.96% of the older adults were sedentary and 34.86% had low-intensity, 38.42% had a moderate intensity and 0.76% had high-intensity physical activity. The main factors for physical activity were: The right companion, feeling relaxed, friends’ encouragement, meeting friends, the doctor prescribing, and maintaining fitness. Barriers included illness and medical factors, long distances, lack of sports venues, fear of falling and injury, lack of access to equipment and facilities. The results also indicated a relationship between physical activity and variables such as age, living conditions, elderly male occupation, cardiovascular disease, and osteoporosis.

Overall, physical activity in older adults seems to be multifactorial in nature, and a wide range of socio-demographic factors are involved in determining the level of individual activity. The level of physical activity in the present study was low and most participants had low-intensity physical activity. Based on the findings, identifying effective factors and barriers has an important role in promoting physical activity in older adults.

Objective (s):

 The association between self-esteem and the process of mental development of individuals and mental health is well established. In adolescence, the role of parents and their skills in communicating is very sensitive and vital. The purpose of this study was to assess the effect of parentschr('39') communication skills training on the self-esteem of adolescent female students.

This was a quasi-experimental study that conducted in one of the state high schools in Damavand, Iran in 2019. The sample consisted of 77 adolescent girls and their parents who were assigned to two groups: intervention and control. Parents in the intervention group received 16 training sessions in a group pf 10 participants. The control group received nothing. In both groups students completed a self-esteem questionnaire (Cooper-Smith questionnaire) at two points in time: before intervention and three months after the intervention. The data were analyzed by Wilcoxon, Mann-Whitney and analysis of covariance using SPSS22 software.

Both groups were similar in most characteristics and at baseline self-esteem score did not differ significantly between two groups (p=0.49). However, after the intervention, there was a significant difference between the experimental and control groups according to analysis of covariance (p=0.001).

Conclusion :

The findings suggest parentschr('39') communication skills training could be effective in improving adolescents’ self-esteem.

Patients with breast cancer have symptoms of anxiety, depression and anxiety. This study was aimed to investigate the effectiveness of cognitive-behavioral stress management on the clinical symptoms among patients with breast cancer.

The was a quasi-experimental study with pre-test, post-test and follow up assessments. Twenty patients were randomly allocated into two groups: experimental group (10 patients) and control group (10 patients). Cognitive-behavioral stress management was administrated in 8 sessions for experimental group. The research instrument was SCL-90-R questionnaire. Data was analyzed by SPSS-25 software using repeated measure ANOVA.

The results showed that cognitive-behavioral intervention led to reduction in clinical symptoms in some dimensions as measured by the SCL-90-R among patients in experimental group (P < 0.05).

The findings indicated that the cognitive-behavioral stress management could reduce clinical symptoms of patients with breast cancer. Indeed, using cognitive-behavioral stress management in cancer treatment centers can be regarded as a complementary therapy alongside medical treatments.

Objective (s):

 Limited health literacy is a common problem in many countries worldwide. In Iran, about half of Iranian has limited health literacy. They have problems in understanding health information and making healthy decisions in critical situations such as Covid-19 pandemic. Thus it is necessary to make health information understandable to intended audiences. This quantitative study aimed to evaluate the quality of Covid-19 related information appeared on the website of Iran Ministry of Health and Medical Education.

We searched the term covid-19 on the website of Iran Ministry of Health and Medical Education. Once inter-coder reliability was established between two researchers, we evaluated the quality of each COvid-19 related information using the Clear Communication Index (CCI).

The mean CCI score for the evaluated information was 38.87 (SD = 9.72) none achieved a score higher than 90. The findings showed that the quality of included information were not desirable according to the criteria for designing instructional material for people with limited health literacy.  In the subsections, the main message, the call to action for action and language were lower than expected. Adherence to information design, tips and behavioral recommendations was significantly higher than expected.

To move toward a health literate public that is capable of combating epidemics such as Covid-19 pandemic there is a need to enhance the quality of information by using evaluation tools such as CCI.

Conditional valuation method is one of the methods of estimating the willingness to pay and is a cost-benefit analysis. The aim of the present study was to estimate the average willingness of individuals to pay for the Covid-19 vaccine with a one-year and long-term protection period and to assess its contributing factors.

The present study was a descriptive research. The required data were collected from 370 two-dimensional online questionnaires at the end of November 2020 from Iranians. Conditional valuation method and logit model were used to estimate peoples’ willingness to pay.

The results showed that 65.67 percent of people are willing to pay for the vaccine. The household income, age, history of having chronic disease, history of Covid-19, attitude, recommended amount and having an elderly person in the family had a positive and significant effect on long-term vaccination and age, household income, history of having chronic disease, attitude and the amount offered had a positive and significant effect on annual vaccination. Also, the average willingness to pay was 3,750,000 Rials per person for long-term vaccination, and 1,130,000 Rials per year.

In conditional valuation studies, individuals typically offer a lower bid for the policy under study. However, this study indicated that people are willing to pay more for vaccinations. The findings might have some implications for policy and planning.

Objective (s): 

Traditional health surveillance systems usually publish reports of infectious disease outbreaks 1 to 2 weeks after onset. The Google Trends shows people search information with a one-day delay. These data can be used to identify and manage epidemics of infectious diseases. The aim of this study was to predict the Covid-19 epidemic using the Google Trends.

This descriptive cross-sectional study was conducted in February 2021. Google Trends data was used to determine how much attention was paid to COVID-19. Data on COVID-19 deaths were obtained from the Iran Ministry of Health. Data were collected and reviewed in the period from February 22, 2020 to January 20, 2021. Data were analyzed using Excel and SPSS soft wares.

Simultaneously with the announcement of incidence of COVID-19 in Iran on February 20, the society’s sensitivity to COVID-19 has increased and the search rate for COVID-19 in Google has reached its maximum. Three waves of COVID-19 outbreak have been observed in Iran by the end of December 2020. These three waves were similarly observed in Google trends. In all three COVID-19 waves, the peak of Google search occurred 10 to 20 days before the peak of the number of deaths.

The Google Trends can detect the COVID-19 outbreak quicker. Google search data can be used as a complement to the infectious disease surveillance system.