مجله تحقیقات نظام سلامت حکیم
سال بیست و چهارم شماره 2 (پیاپی 93، تابستان 1400)

The Ministry of Health and Medical Education for the first time drafted and communicated the National Nutrition and Food Security Document in order to implement targeted programs. This study aims to evaluate the provincial nutrition and food security document and outline strategies to improve the efficiency and effectiveness of provincial document deployment at the organizational, inter-organizational and community level.

Documents received by the universities / colleges of medical sciences were classified for evaluation purposes. The studied dimentions consisted of the provincial document cut-off, the beneficiaries of the program, the establishment and implementation of the submitted documents. In the next step, self-declaration compliance assessment and scoring were performed.

Out of 28 provincial documents (90%), 60% were documented, 21% provincial data were not used, and desirable measures were taken to attract stakeholders. No effective measures were taken to evaluate the results as the most important pillar of the document. Among 255 projects anticipated, 7 were documented and 6 were approved, and only 4 projects were submitted to the researchers, and for 5 projects had written

Despite the relatively favorable performance in most of the documented and targeted areas of the document at the national level, assessments show that this trend has not been very successful at the provincial level. This study clearly shows policy makers' lack of support for nutrition programs and poorly evaluates nutrition support.

According to the concept of Universal Health Coverage (UHC), health services include health promotion, prevention, treatment, rehabilitation and palliative services. The aim of this study was to investigate the contribution of each health service to out-of-pocket payments (OOP) and financial protection.

In this study, OOP were extracted from the 1396 (2017) national household income expenditure survey with a sample of 37866 households. Catastrophic health expenditures were defined as health expenses greater than 10 percent of a household's expenditures and impoverishing health expenditures were calculated using WHO method. Binary logistic regression test was used to examine the effect of payment for different health services on households having catastrophic and impoverishing health expenditures.

According to the survey questionnaire, health services could be classified into 4 categories of treatment, prevention, diagnosis and rehabilitation services, and questions about promotion and palliative services were not been asked specifically. Treatment services accounted for the largest out-of-pocket share with 81%. In urban households, Per capita OOP payments in all aspects of health services were higher than rural households. Treatment services alone were alone responsible 75% and 89% of households suffering from catastrophic and impoverishing health expeditures respectively. OOP payments for all types of health services had a significant effect on a household's exposure to catastrophic and impoverishing health expenditures.

Focusing and implementing interventions to reduce out-of-pocket payments for Treatment services can significantly improve financial protection indicators, paving the way to the achievement of UHC in Iran.

In Iran, the tendency to have only one child has increased. This study explored the experiences of Delijan parents in terms of only child.

This qualitative study was conducted in 2020. The starting point of sampling was among the health records of comprehensive health service centers of Delijan city that had voluntary only child and the mother’s age was over 35 years old. Parents from different age, gender, educational and occupational groups were interviewed to get maximum diversity in the data and deep insight from the experiences of individuals. Thirty semi-structured in-depth interviews were conducted. The participants (18 women and 12 men) were asked about their experiences about only child. Data analysed by conventional content analysis method. Continuous analysis of data began and continued up to data saturation. To increase the validity and reliability of the data, the suggested proposed methods by Lincoln and Cuban were used (including prolong engagement with the participants, peer check, member check, and data saturation).

The mean age of participants was 41.7 years with a standard deviation of 5.5. Predisposing factors of one child with 5 subcatrgories including family causes, physical causes, negative previous experiences, psychological causes, socio-economic-political causes and decisional balance with 2 subclasses including perceived pros of having one child and perceived cons of having one child were emerged as participants, experiences of having only one child.

Identifying the experiences of parents having only one child may be a kind of needs assessment to design interventions to increase couples’ tendency to have more children.

The spread of Covid 19 led to quarantine at home and the closure of many recreational and educational centers, which negatively affected people’s mental health and led to various psychological reactions. It also affected preventive behaviors. The aim of this study was the moderating role of personality type in the relationship between psychological response and preventive behavior of the corona.

In this descriptive-correlational study, 200 students from different universities across the country were selected by convenience sampling method. Participants responded online (WhatsApp& Telegram) to the subscales of the 60-item Neo Questionnaire, the Hong & Fada Psychological Response Questionnaire (1996), and the researcher-made preventive behavior. Data analysis was performed using SPSS version 25 and linear regression analysis.

The results showed that there is a direct and significant relationship between psychological response and preventive behavior ( p <0.001 , β = -0.443). However, personality traits of conscientiousness (p = 0.001, β = 0.952), resilience (p <0.001, β = 0.037), neuroticism (p <0.001, β = - 0.039) and openness to experience (p <0.001, β = 0.931) were able to moderate this relationship and cause Increased preventive behavior in individuals, but the characteristic of extroversion did not play a role in the relationship between psychological reaction and preventive behavior.

There is a need for educational and therapeutic interventions to reduce psychological problems and strengthen positive psychological characteristics to combat Covid 19 disease.

Today, the Hospital Information System (HIS) has become an essential part of the diagnostic and therapeutic processes of health care professionals. The Nutrition Decision Support System (NDSS) as a subsystem of HIS plays an important role in supporting clinical decision making and food policies.

The current study was cross-sectional and descriptive. The research population includes the nutrition information system of the HIS pertaining to Shahid Beheshti University of Medical Sciences in 2021. The systems had been designed by Tirajeh Rayaneh Company, Rayavaran and Tarasheh Hushmand Novin. The data was collected using a checklist including 21 criteria that distributed among 20 nutritionists through visiting 19 affiliated hospitals of Shahid Beheshti University of Medical Sciences. We used content validity and test-retest method for specifying validity and reliability of the checklist. Also, data analysis performed through using SPSS 19 software.

Findings indicated that the designed nutrition information systems did not have 80% of the main criteria including the ability to connect to the electronic medical record; the ability to provide warnings when drug-food interactions occur; and to provide food menus based on the patient’s treatment conditions.

Considering the importance of nutrition information system, it is necessary to equip our hospitals with this software system as a subsystem of HIS. The nutrition information system is a main solution to reduce and prevent patients’ exposure to nutritional problems and drug-food interactions. It causes to reduce medical errors and improve the quality of medical care.

Health is determined by a wide range of factors including environmental, economic and social factors, which are becoming a key focus for policy-makers in terms of reducing health inequity and improving overall health outcomes. The aim of this study is to estimate the effects of some socio - economic factors on health in Iran.

The present study is an analytical cross - sectional study. In the first step, the dependent and explanatory variables were identified to answer the research questions. Then in the second step, the required data for the analysis were extracted from available resources. Next in the third step, using statistical and regression models, the correlation between dependent and explanatory variables were tested. Data were extracted from multiple sources including annual reports of the national statistical center (census), STEPwise approach to NCD risk factors surveillance survey -STEPS 2016 (n=30541) and the study of the children’s health profile 2017: anthropometry, development, nutrition (n=19270).

The study variables included a range of socio - economic and health factors including, household income, unemployment rate, family size, health price, mortality rate of children under age 1, malnutrition rates of children under age 5 and years of lost life due to the mortality of children under 1 year. The estimation of the elasticity coefficients indicated that the elasticity of life expectancy in relation to income, health price, unemployment rate and family size was (0.023), (0.060), (-0.010), (-0.171), respectively and all variables except unemployment rate were statistically significant with a p-value <0.04. the coefficient of elasticity of malnutrition among children under 5 years of age in relation to the income, health price, economic participation rate and family size was (0.601), (1.430), (-1.733), (2.268) respectively and all variables, except economic participation rate, were statistically significant with a p-value <0.08.

In this study, the effect of a number of socio-economic factors on health were evaluated through the estimation of the health functions. The results showed that most of these factors could affect health and hence, policy makers should consider them to address health inequity and improving overall health outcomes.

Family practice is an integrated service delivery approach at the first level of health care delivery, in which the family physician and his team members are responsible for providing comprehensive, continuous, coordinated and individual and family-based health services. However, the concept of family practice in the primary health care system has always been challenging. The aim of this study was to explain the principles and concepts of family practice.

This research was conducted using conceptual review method. Four electronic databases (Pubmed, Science Direct, Scopus, and Web Of Science) and Google Scholar and Google search engines were searched. Finally, 73 articles and documents were selected for final review.

Family practice is a community-based program for health services delivery in which a trained family medical team provides comprehensive, coordinated, continuous, and patient-centered primary health care services to all people of all ages and genders to promote, restore, and maintain their health. Comprehensiveness, continuity, coordination, and patient-centeredness are main principles of the family practice program. Prerequisites for a family practice program include governance and leadership, financing, manpower, equipment and supplies, service delivery, information, and political, social, economic, and technological factors. A family practice program affects the accessibility, quality, efficiency, equity, resilience and sustainability of health services and, ultimately, people health and the responsiveness and financial protection of the primary health care system.

The family practice program has had many achievements. Successful implementation of this program requires understanding its principles and prerequisites. The availability of prerequisites and ongoing evaluation of the family practice program facilitates the achievement of its goals.

Considering that the corona virus has spread all over the world so far and has many psychological consequences for the people, the government emphasizes on observing preventive behaviors. In the meantime, some people are more observant of preventive behaviors, which can be for various reasons. The aim of this study was to investigate the mediating role of empathy in the relationship between personality types and preventive behavior of Covid 19.

In this descriptive-correlational study, 200 students from different universities across the country were selected by convenience sampling method. Participants responded online (WhatsApp& Telegram) to the subscales of the 60-item Neo Questionnaire, the Jolif-Farrington Empathy Questionnaire (2000), and the researcher-made preventive behavior. Data analysis was performed using SPSS version 25 and linear regression analysis.

The results showed that the personality types of agreement (p <0.001 β = 0.438), conscientiousness (p <0.001 β = 0.511) and openness (p <0.001 β = 0.531) were directly related to preventive behavior and indirectly using The variables of empathy also strengthened this relationship and in relation to the components of neuroticism (p <0.001 β = -0.394) and extraversion (p <0.001 β = -0.503) with preventive behavior that had a negative relationship, empathy could not weaken this relationship. And increase preventive behavior.

The results showed that people with the characteristics of agreement, conscience and openness to experience more Preventive behaviors related to Covid 19 and empathy also strengthens this relationship. These results will have practical implications for formulating interventions for current and future crises.