فهرست مطالب
Journal of Research and Health
Volume:12 Issue: 2, Mar-Apr 2022
- تاریخ انتشار: 1401/04/12
- تعداد عناوین: 9
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Pages 65-74Background
The health system of each country are required to achieve the goals based on appropriate frameworks. Assessment of health system performance provides an opportunity to address the main mission through recognizing new needs and resolving existing gaps. This review study aims to investigate Iran’s health system performance in achieving its goals based on the World Health Organization (WHO)’s conceptual framework.
MethodsThis scoping review was conducted based on Arksey and O’Malley’s methodological framework. A search in international databases including Web of Science, Scopus, PubMed/Medline and in national databases such as SID, MagIran and IranDoc was conducted using the keywords “health system, Iran”, “disease burden”, “responsiveness” and “financial contribution”, which were used in both English and Persian separately for each variables of health promotion, responsiveness, and fair financial contribution. Retrieved articles were analyzed using qualitative synthesis method.
ResultsData extracted from articles categorized into the three groups of “Health” (with sub-categories of epidemiologic and demographic transitions), “Responsiveness” and “Fair financing and financial risk protection”. Synthesis of data revealed that the profiles of diseases has been changed over recent decades in Iran, which has resulted in epidemiologic and demographic transitions. In terms of responsiveness, services provided by the health system had not fulfilled patients’ expectations. Regarding fair financial contribution, synthesis of data showed that people had faced high health costs, with a high amount of out-of-pocket payment.
ConclusionIran’s health system has not yet achieved the goals recommended by the World Health Organization. Fundamental reforming is required in the health system of this country.
Keywords: Health care system, Responsiveness, Literature review, World health organization, Iran -
Pages 75-83Background
To assess determinants of Willingness to Pay (WTP) for Community Health Insurance (CHI) among commercial motorcyclists (Boda boda riders) in Kampala City, Uganda.
MethodsThis is a descriptive study with a cross-sectional design. A total of 381 commercial motorcyclists were selected from Nakawa Division using purposive and simple random sampling methods. Structured interviews and contingency valuation method were used for data collection and measuring WTP for CHI. Data were collected in April, May and June 2019. Data were analyzed in SPSS software, v. 21 by multivariate regression analysis and considering at significance level of P<0.05.
ResultsMost of Boda boda riders had WTP for CHI (70%); 7 out of 10 commercial motorcyclists were willing to pay a premium of at least 70,000 UGX (20 USD).Those with at least five years of experience in the commercial motorcycle business were 9 times more willing to pay for CHI. Those with hired motorcycles and a history of involvement in a riding accident were less likely to pay for CHI. The other key determinants of WTP included: Being a commercial motorcyclist for 3 years or more, being aware of CHI, self-employment (riding own motorcycle), a history of payment for any form of insurance, and being single.
ConclusionThe WTP for CHI is high among commercial motorcyclists in Kampala City. The WTP among these motorcyclists is determined more by individual factors and less by insurance scheme-related factors. The results recommend the coverage of informal sector by CHI schemes to increase universal health coverage in Uganda.
Keywords: Willingness to pay, Contingent valuation, Community Health Insurance, Boda Boda, Uganda -
Pages 85-93Background
The loss of breast is a major concern for women with breast cancer volunteer for mastectomy, because they feel that their feminine identity is at risk of damage. The present study aims to investigate the mediating role of Cognitive Emotion Regulation (CER) in the relationship between anxiety and body image in women with breast cancer volunteered for mastectomy.
MethodsThe is a correlational study. The study population consists of all women with breast cancer volunteered for mastectomy referred to Imam Khomeini and Imam Hossein hospitals in Tehran, Iran. Of these, 350 volunteers were selected by a convenience sampling method. The instruments were Beck Anxiety Inventorry, Body Image and Relationship Scale of Hormes et al., and Cognitive Emotion Regulation Questionnaire of Garnefski et al. Structural equation modeling were used to analyze the research hypotheses.
ResultsAnxiety had a positive effect on maladaptive CER strategies (β=0.654) and a negative effect on body image (β=-0.574) (P<0.001). The direct effect of maladaptive CER strategies on body image was positive and significant (β=0.271, P<0.05). The direct effects of anxiety on adaptive CER strategies (β=-0.836) and body image (β=-0.849) were negative and significant (P<0.001). The direct effect of adaptive CER strategies on body image was negative and significant (β=-0.266, P<0.001).
ConclusionWomen undergoing mastectomy will experience more anxiety and negative body image if they use maladaptive CER strategies, while those who use adaptive CER strategies will experience less anxiety and negative body image.
Keywords: Breast cancer, Anxiety, Body image, Cognitive emotion regulation -
Pages 95-102Background
Marital infidelity damages marriage and increases the tensions between couples. The present study aims to evaluate the effect of group narrative therapy on feeling of inferiority and attachment styles in married women experienced marital infidelity.
MethodsThis is a quasi-experimental study with a pretest/posttest design using a control group. The study population consists of all women experienced marital infidelity referred to Peidayesh Counseling Center in Mashhad, Iran. Of these, 40 eligible women were selected using a convenience sampling method and assigned into intervention (n=20) and control (n=20) groups. Data collection tools were Hazan and Shaver (1986)’s Adult Attachment Questionnaire and Eysenck (1988)’s Inferiority Questionnaire. Group narrative therapy was performed in the intervention group at 7 sessions while the control group did not receive any intervention. Data analysis was performed by univariate and multivariate analysis of covariance in SPSS software, v. 22.
ResultsGroup narrative therapy had significant effects on feeling of inferiority and all three secure, avoidant and ambivalent attachment styles (P=0.001).
ConclusionGroup narrative therapy can reduce feelings of inferiority and avoidant and ambivalent attachments and increase secure attachment in women experienced marital infidelity. This method can be used to improve psychological problems of these women.
Keywords: Narrative therapy, Feeling of inferiority, Attachment, Marital -
Pages 103-112Background
The prerequisite of effective nutrition intervention is an appropriate education. This study aimed to evaluate the effectiveness of nutrition education based on discussion and multimedia in the learning of pregnant women.
MethodsThis randomized educational trial was conducted on 174 pregnant women in Gonabad City, northeast Iran. The study participants were randomly assigned into three groups (58, 57, and 59 women in the multimedia group, discussion group, and control group, respectively). The demographic information form and assessment of learning questionnaire were completed before the study for all three groups. In the intervention group, training was based on the discussion and multimedia packages. Multimedia packages were given to mothers in the intervention group for 2 weeks. In the discussion group, mothers were divided into subgroups of 8 to 12 members, and educational subjects were presented over three 90 min sessions. One month after the intervention, a post-test was administered to all groups.
ResultsThe mean gestational ages in the multimedia group, discussion group, and control group were 9.66, 9.54, and 9.40 weeks, respectively. The results showed that the difference between the multimedia and discussion groups (P<0.001) regarding the cognitive scores was significant before and after the intervention. There were significant differences between groups regarding affective domain scores before and after the intervention (P=0.03).
ConclusionThe effectiveness of multimedia learning in the cognitive domain and discussion in the affective domain was confirmed. Therefore, it is recommended to use innovative and effective methods such as multimedia packages for educating pregnant women.
Keywords: Pregnancy nutrition, Educational program, Learning, Group discussion, Multimedia -
Pages 113-120Background
This study aims to examine the effectiveness of flourishing training based on positive psychology on the anxiety and depression of female gifted students.
MethodsThis is a quasi-experimental study using a pre-test/post-test design a control group. Participants were 50 female gifted students in Torbat-e Heydariyeh, Iran. They were randomly divided into two groups of training (n=25) and control (n=25). For the training group, flourishing training was presented at 14 sessions of 60 minutes, while the control group did not receive any education. The 21-item Depression, Anxiety, and Stress Scale was used for collecting data. Data were analyzed in SPSS v 26 software using ANCOVA.
ResultsThe results showed that the effect of flourishing training on anxiety (F=206.1, P<0.001) and depression (F=42.96, P<0.001) was significant. Flourishing training reduced anxiety and depression in the training group compared to the control group.
ConclusionFlourishing training based on positive psychology can be effective in reducing anxiety and depression in female gifted students.
Keywords: Positive psychology, Depression, Anxiety -
Pages 121-130Background
Social distance, linked with negative emotional impacts, is one strategy to avoid COVID-19 disease, particularly for single parents and their children. This research aimed to see how Filial therapy and cognitive-behavioral art-play therapy can help single mothers’ emotional perspectives.
MethodsA quasi-experimental study was conducted with three groups in two stages: pre-test and post-test. The study’s statistical population included mothers of children aged 6 to 12 years living in Isfahan City, Iran, in 1400. A total of 54 mothers with single parent children were chosen via purposive sampling method based on the inclusion criteria. Then, they were randomly assigned to three experimental and control groups during public call in. The dependent variable was measured online using Evelynekehe (2011) meta-emotion perspective questionnaire. In ten consecutive sessions, mothers with children in the two groups received the intervention, whereas the control group received no intervention. Multivariate analysis of covariance was used to analyze the obtained data in SPSS software, v. 27.
ResultsThere was a significant difference in guidance beliefs between the art-play therapy group and the Filial therapy group, as well as between the two modalities of treatment (P<0.01). The findings also revealed a significant difference in views about sufficiency and competence between the art-play and the Filial control group (P<0.01), as well as between the Filial therapy and the control group (P<0.01). This finding suggests that art-play and Filial therapy boosted meta-emotion and its components in Evelynekehe.
ConclusionConsidering the effect of two interventions of art - play therapy and filial therapy on improving the mother 's meta-emotion perspective and the effect of art - play therapy on moderating ideas related to guidance and competence of mothers, it is necessary to pay attention to medical and educational planning. Consider the plight of single mothers in the COVID-19 epidemic and quarantine.
Keywords: Art-play therapy, Filial therapy, Meta-emotion, Mothers of single-parent children, COVID-19 -
Pages 131-136Background
It is challenging to implement evidence-based care and update and improve health care policy. Adhering to evidence-based Clinical Practice Guidelines (CPGs) serves as a guide for making decisions based on the best evidence and making an attempt to improve the quality of patient care and outcomes. Despite the need for implementing CPGs in Iranian hospitals, the concept and implementation method of CPGs are not clear yet. This action research aims to propose the soft systems methodology (SSM) to facilitate the implementation of CPGs in a general hospital in Iran.
MethodsWe employed the SSM to conceptualize the situation for the implementation of CPGs. Semi-structured in-depth interviews and group discussions with different stakeholders were used to define the purposeful activity model. The SSM tools and techniques were used to identify the main areas of change and select necessary measures to facilitate the implementation of CPGs. Flexible qualitative methods for data collection and analysis were utilized throughout the study.
ResultsApplying SSM for implementing CPGs could generate knowledge by recognizing hyper-complexity in healthcare setting, adopting an attitude of inquiry, and fostering dynamic changes in diverse and numerous worldviews of professionals in the accommodation process. This knowledge can provide a model for the successful implementation of CPGs at a macro-system level and facilitate the persuasion process for its implementation at the mesosystem level. More importantly, adopting SSM can create iterative learning loops over time and, thus, help the clinical microsystems face future healthcare complexities.
ConclusionThe application of systems thinking approaches, especially SSM is recommended for implementing CPGs and addressing complex issues in healthcare settings and other system levels.
Keywords: Clinical Practice Guideline, Systems Thinking, Soft Systems Methodology