مجله پایش
سال بیست و یکم شماره 2 (پیاپی 102، فروردین و اردیبهشت 1401)

Objective (s):

An accreditation program aims to evaluate the quality and safety of services provided in health care organizations. Governance, standards, surveying methods and surveyors are the four main pillars of an accreditation program. Validity of an accreditation program depends largely on the performance and behavior of the surveyors. Therefore, this study seeks to identify the typology of styles and methods used by the hospitals accreditation surveyors.

This qualitative research was conducted using 35 purposeful semi-structured interviews with surveyors of the accreditation program and hospital managers. We employed thematic analysis method for data analysis. The insights from a panel of experts were then sought to verify the accuracy and precision of the styles.

Overall six styles including mainly Disciplined, Personalized, Participatory, Interrogative, Systematic and Explorative were emerged to be practiced by the accreditation surveyors while evaluating the hospitals.

Cognizance of surveyors’ style might play a role in organizing effective assessment teams and their optimal distribution in a way to enhance the learning and improve surveyors' capabilities and skills. Moreover, it is possible to arrange the evaluation teams in a way to suit the surveyors’ encounter with various organizational environments. It is expected that paying attention to the results of this study by managers and policy makers in the field of accreditation help to create positive results in the accreditation process of hospitals.

Objective (s):

despite the efforts made by biomedical investigators in the past three decades to develop an appropriate model and measurement for cultural competence for health care professionals, a comprehensive cultural competencies of medical graduates and its components does not exist in Iran. Therefore, the main aim of the present study was to develop a model for identifying the necessary cultural competencies among graduates of medical sciences.

This was a qualitative study. First we reviewed the literature. Then, semi-structured interviews were conducted with 15 key informants on the field of cultural competence of medical graduates. Finally, a focus group discussion was conducted with the presence of five experts and the findings were obtained.

The initial model with the central component of transcendent motivation and three main components of awareness, knowledge, and cultural skills was achieved. Finally, a matrix in three levels of individual (human), university (graduate) and medical professions and three horizontal levels of emotional domain (transcendental motivation), cognitive domains (cultural knowledge and knowledge in general), and behavioral domain (cultural skills).

The current model can be used to assess the cultural competencies of graduates of various medical sciences in Iranian universities (while modifying the educational curriculum in universities).

Objective (s):

The concept of respectful maternity care is to organize and provide care accompanied with respect and dignity for all women. RMC is an approach based on human rights which improve quality of care and birth experience. Implementation of RMC is unsatisfactory in some hospitals in Tehran. This study aimed to determine the challenges and barriers of respectful maternity care, based on the experiences of midwives.

This was a qualitative-phenomenological study which conducted in selective hospitals affiliated to Tehran University of Medical Science in 2020. Participants were 40 midwives who administer antenatal care. The data were collected by 4 sessions of   focus group discussion and 6 semi-structured interviews and analyzed using thematic analysis method by MAXQDA 10 software.

Midwives faced with a number of challenges and barriers in providing respectful maternity care. In all six main themes emerged from the analysis: governance, human resource education, structural, processing and provider- related and receiver- related challenges and barriers.

Barriers for providing respectful maternity care are nested in all levels of health system. Developing interventions for each level, coordinated with each other, is essential in provision of a respectful care for mother in labor and during childbirth.

Objective (s):

Hospitalization of premature infants in the neonatal intensive care unit (NICU) is associated with stress and anxiety. The aim of this study was to investigate the effect of stress management training on stress and anxiety level of the mothers of premature infants admitted to NICU.

The present study was a quasi-experimental with a pretest-posttest design with a control group. The statistical population of the study consisted of all mothers of infants admitted to NICU in Shahid Sadoughi Hospital. Using convenient sampling method, 60 mothers were selected and randomly assigned in two groups the experimental and the control groups. Both groups completed the Depression, Anxiety and Stress Scale Questionnaire (DASS-21) in the pre-test and post-test stages. Experimental group received stress management for eight weeks including a 90-minutes training session twice per week. The control group receive the routine care. The pre- and post-test data was analyzed to achieve the study objective.

The results showed that the mean and standard deviation of the stress and anxiety scores of the experimental group were 16.33 ± 1.88 and 15.30 ± 2.18 in the pre-test and 12.13 ± 1.91 and 10.41 ± 1.99 in the post-test. also the mean and standard deviation of the stress and anxiety scores of the control group were 15.97 ± 1.81 and 15.07  ±1.96 in the pre-test and 15.63 ± 2.15 and 14.90 ± 1.82 in the post-test. Therefore, stress management training has significantly reduced the stress scores and anxiety of mothers of premature infants admitted to the intensive care unit in the experimental group (P<0.001).

Stress management training can be used as an effective intervention to reduce stress and anxiety in preterm infants admitted to the neonatal intensive care units.

Objective (s):

Pregnancy at a young age is high risk for both mother and child. The aim of this study was to evaluate the demographic and socioeconomic correlators of pregnancy status of girls under 19 years old in Iran.

This was a secondary analysis of the data based on the 2016 census. The study population included 10- to 19-years-old girls in Iran who participated in the sampling of 2% of the 2016 (n =107346). Using the number of live births, the girls were divided into three groups: never married, married without children and married with children.

Most girls were unmarried before the age of 14, at the age of 15, 7% of girls were married and 1% had children. About 40% of girls were married at the age of 19 and 14% of them had children. Most girls who had children were not studying, they were illiterate, living in rural areas, and mostly were in low-income provinces.

The relationship between development-related variables and childbearing at an early age indicates that the fertility of girls at an early age is a socioeconomic phenomenon. Girls who were illiterate and have dropped out of school seems are less aware of healthy reproductive conditions and this need to be considered in health policies in order to have a healthy delivery.

Objective (s):

Due to the rapid growth of the country's elderly population, the need to pay attention to social participation as one of the determinants of health and modifiable in the process of active aging is very important. Thus, the aim of study was to determine the level of social participation, barriers, and related factors in the elderly people of Mazandaran province, Iran.

In this descriptive-study, 421 elderly people over 60 years old in Mazandaran province were selected by stratified and cluster random sampling. The data collection tools were a demographic characteristics questionnaire, a researcher-made questionnaire of social participation, and the Social Participation Barriers. Data were analyzed by SPSS v24 using independent t-test, one-way ANOVA, Pearson correlation coefficient, and linear regression at a significant level of P<0.05.

The mean age of the samples was 72.55 (8.81) years, and the mean score of social participation was 22.87)11.81(. The highest level of participation was related to the cultural-religious dimension 8.43)4.46) and the lowest level was related to the political activity dimension 3.76(2.44).  Being out of reach (86.7%), lack of physical accessibility of activity and facilities (83.6%), impatience (83.1%), costs and financial problems (82.7%), and diseases and health problems (80%) were respectively the most important barriers to social participation. The male elderly with low age, employed, and college-educated had significantly better scores of social participation (P<0.05). According to the regression analysis, 59% of the variance of social participation was explained by age, education, and gender.

The social participation level of the elderly in Mazandaran was low. Therefore, the need for policy-making and the design of comprehensive programs, and developing a proper environment to reduce barriers, seems important to improve social participation in elderly.

Objective (s):

 Internet addiction as a new phenomenon in the young generation, especially in students, has led to a lack of attention to physical and mental health, reduced quality of life, sleep and educational problems. Also, self-efficacy as a personality trait that can play a role in Internet addiction. The purpose of this study was to compare self-efficacy, quality of life and sleep quality of medical students with and without internet addiction.           

The present study was a cross-sectional study. The study population was all students of Tehran University of Medical Sciences in academic year 2019-2020. Using the stratified random sampling method, 300 students (115 men and 185 women) were selected as the samples.  The Young internet addiction questionnaire, the short form health survey (SF-36), the Sherer self-efficacy beliefs questionnaire, and the Pittsburgh Sleep Quality questionnaire were used to collect data Multivariate analysis of variance used to analyze the data.

In all 300 medical and dental students aged 18 to 39 years participated in the study. Multivariate analysis of variance, showed that there was a significant difference between quality of life (P< 0/001), self-efficacy (P< 0/001) and sleep quality (P< 0/001) of among students with and without internet addiction.

The findings confirmed that the internet addicted users had lower quality of life, lower sleep quality and lower self-efficacy, than regular users.