مجله پیاورد سلامت
سال هفدهم شماره 1 (فروردین و اردیبهشت 1402)

The emergence and continuity of Corona has forced universities and higher education centers to change their educational strategy to take appropriate and consistent action to improve their educational programs. Due to the importance of e-learning and e-learning in response to these conditions, the present study investigated the experience of students of Hamadan University of Medical Sciences from e-learning in the Covid-19 crisis condition.

This was a qualitative research with an interpretive phenomenological approach. The purposeful sampling method was used. Semi-structured interviews were used to collect data. After the thirteenth interview, the theoretical saturation of the data was achieved and the interview process with the sixteenth person was completed. In order to analyze the text of the interviews, the Colaizzi method was used.

From the analysis of the obtained data, three main themes: “Communication and interaction” with five sub-themes (lack of proper interaction between student/professor and student/student, lack of motivation, security and mental health, knowledge sharing and efficiency atmosphere in time and cost), “Management of time and learning style” with six sub-themes (low quality of teaching, stress, access and provision of resources, exam health, gaining experience and skills and opportunity to learn again and innovation in education) and “Infrastructure and technical facilities” were extracted with three sub-themes (weak support, ignoring educational equality and promoting media literacy). Weak interaction between professor and student, increasing level of anxiety and individual responsibility to achieve success in learning and weak technical and management infrastructure were the main challenges obtained from these three themes. Providing a platform for research, self-regulation and self-management in learning, increasing the knowledge and skills of information and communication technology are among the opportunities that are included in these themes.

The results of the current research require attention to the approach of interaction and communication between the learner and the learner, to review the methods of teaching and skill-learning, to improve the quality of electronic learning and to prepare suitable infrastructures for optimal use of electronic learning.

 Burned patients experience a high level of anxiety during dress changing. The use of complementary medicine is one of the methods of anxiety management that many studies have conducted about it in recent years. The purpose of this study was to compare the effectiveness of progressive relaxation with abdominal respiration technique on pain anxiety of burn dressing. 

 This study was a randomized clinical trial with a control group. We selected forty-five patients referred to Zare Hospital in Sari through simple sampling and assigned into three groups. The first group received relaxation intervention, the second group received respiratory technique intervention, and no intervention was performed in the control group. Burn Specific Pain Anxiety Scale (BSPAS) was used to measure pain-related anxiety. SPSS software version 20 was used to analyze the data. Descriptive statistics, ANOVA and Tukey’s post hoc test were used for data analysis.

 Based on the results, 28% of the participants in the study were single and 72% were married. In terms of age, most of the participants were between 31 and 40 years old. The findings showed that there was no significant difference between the mean pain anxiety levels in the three groups before the intervention. There was a significant difference in the average burn dressing pain anxiety after the intervention between the relaxation group and the control group (P<0.001) and the breathing techniques group and the control group (P<0.000), so that the average burn dressing pain anxiety in the group Relaxation was reduced by 8.60 units as compared to the control group and in the breathing techniques group by 11.60 units as compared to the control group.

 The use of relaxation “techniques” and respiratory techniques, which are non-pharmacological methods, are recommended during dress changing in the burned patient. These methods are simple and inexpensive and can reduce the effects of pain anxiety during dress changing.

 Antibiotics are one of the most commonly used drugs that help to heal and treat diseases, but improper administration and excessive use of them can increase length of stay and cost of hospitalization. The purpose of this study was to analyze relationship between experimental use of antibiotics and duration of stay of premature infants admitted to Mahdiyeh hospital in Tehran.

This descriptive-analytical and cross-sectional study was carried out in 2019 on 159 premature infants admitted to intensive care ward of Mahdiyeh hospital in Tehran were investigated. The study tool was a questionnaire that validity of questionnaire was measured by content analysis method and reliability of questionnaire was measured by Cronbach’s alpha method. Data analysis was done using SPSS software, with help of descriptive statistics of frequency and percentage and statistical test of one-way analysis of variance and independent t-test.

The results showed that 52.2% of infants were girls and 79.9% of deliveries were performed by cesarean section. The average length of stay of infants was 31.47 days and average birth of infants was 30 weeks. According to results of study, there was a significant relationship between length of hospitalization of infants with duration of antibiotic treatment and number of periods of receiving antibiotics (P<0.05). The duration of hospitalization of infants with a period of receiving less than 14 days of antibiotics was almost half of duration of hospitalization of infants with more than 14 days of receiving antibiotics. Also, there was a significant relationship between number of antibiotic courses and length of hospitalization of patients (P<0.05). With increase in number of antibiotic sessions, duration of hospitalization of infants increased significantly. The results of study showed that there was a significant relationship between birth weight of babies, cost of bed, and total cost of experimental administration of antibiotics (P<0.05).

Considering that rational use of antibiotics reduce length of stay of hospitalized infants, Ministry of Health should develop an updated and transparent antibiotic adminstration protocol for premature infants and awareness physicians to inform particularly prescription of antibiotics and implementation of stewardship antibiotic programs in neonatal intensive care unit. Also the publication of standard treatment guidelines, instructions including importance of prescribing antibiotics with correct dose and clinical education of physicians are necessary.

Home care is an alternative method of hospitalization, especially for chronic patients and is an innovative approach to improve care and reduce the costs of hospital readmissions. The present study was conducted with the aim of investigating the benefits and challenges of implementing the home care plan after being discharged from the hospital considering the perspective of health service recipients and providers at Tehran University of Medical Sciences in 2021.

The present study is an applied research that was conducted qualitatively using structured and semi-structured interviews. The research sample was those responsible for the implementation of this project at the ministry and university level, the implementers of this project in 4 hospitals, 5 institutions providing home care services, and family of patients. Twenty-eight people from the research community were included in the study using the purposeful and snowball sampling method. Content analysis method was used to analyze the interview data. MAXQDA2020 software was used for data classification.

The results were classified into two categories: benefits and challenges of the home care plan after discharge. A total of 61 open codes were extracted from the analysis of research interviews, so that 27 codes led to the identification of 5 themes (Including improving service delivery, reducing costs, achieving health goals, cultural and social benefits, providing the necessary infrastructure) in the benefits and 34 codes led to the identification of 7 themes (including policy-making, legal and ethical, economic, manpower, cultural-social-communication, service provision limitations and time and place limitations) in the challenges.

The result of this research showed that home care services after being discharged from the hospital play an important role in completing the provision of healthcare services. Home care services after being discharged from the hospital improves service delivery, reduces costs, and helps in achieving health goals. It also benefits patients, society and the government in various cultural and social fields. On the other hand, it seems that there are challenges in the political, legal, economic and cultural fields in the way of the optimal implementation of this plan. Therefore, planning to evaluate and solve the problems facing these services is essential.

There is a correlation between disease and quality of life in patients with chronic disease and physical disorders have a direct effect on all aspects of quality of life. Therefore, this study was conducted to determine the effect of family-centered empowerment model based on multimedia education on the quality of life of children with thalassemia.

In this experimental study, 120 patients along with their parents, who had medical records at the thalassemia center of Khatam al-Anbiya Hospital in Shoushtar, were selected according to the inclusion criteria and were divided into two groups of intervention and control (n=60) by random allocation. Subjects were matched in terms of age and gender. The data collection tools included Pediatric Quality of Life Inventory (Ped-SQL) and researcher-made questionnaires of awareness and self-efficacy in the area of thalassemia. The collected data were analyzed using SPSS and Mann-Whitney and Wilcoxon statistical tests and Pearson’s correlation coefficient.

Out of 120 children who were included in the study, 87 were girls (72.5%), the mean age of these children was 9.74±2.25 years and disease duration was 5.35±4.47 years. In this study, in terms of children’s quality of life and its dimensions, after the implementation of the educational model, a significant increase was observed compared to pre-test phase only in the intervention group (P<0.001). After implementing this model, the level of knowledge (P<0.001) and self-efficacy of parents (P=0.003) was faced with a significant increase, and this significance was also observed compared to the control group (P<0.001). The variables of age, gender, disease duration and parents’ education level had no effect on parents’ self-efficacy and knowledge as well as children’s quality of life (P>0.05).

Based on the results of the present study, the implementation of family-centered empowerment programs based on multimedia education among parents of children with thalassemia improved the quality of life of these children by increasing the knowledge and self-efficacy of their parents. It is suggested that this program be implemented on a wider scale with better facilities for parents and the family members.

Parallel to the progress of services, organizational complexity levels in health care centers (HCCs) have increased. The influential factors in this regard include the variety of services, the non-uniformity of the centers’ management conditions, and the rising expectations from the health system. Therefore, considering many factors influenced and effective, improvement of health services requires development of a systematic approach to evaluate their efficiency and management system. The aim of this study was to develop a balanced scorecard (BSC) model suitable for HCCs using a hybrid approach that combines the Fuzzy Delphi and DNAP techniques. 

This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives. 

According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.

The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.

Colorectal cancer is one of the most common cancers that its incidence and prevalence and so deaths due to this cancer have increased worldwide recently. This study examines the economic burden of colorectal cancer from different perspectives by conducting a scoping review.

In this scoping review, by searching Scopus, PubMed, Embase, Cochrane, and Web of Science, the articles reporting the costs of CRC were reviewed. The search was limited to those published in the past years leading up to 2020. In addition to categorizing different aspects of the reviewed paper, per capita costs were adjusted with the purchasing power parity in order to make some comparisons possible. In this study, the calculated costs of retrieved studies were categorized based on the perspective of each study.

Out of 29 studies, only two have reported indirect costs of CRC, and 4 studies have reported both direct and indirect costs. In other studies, only direct costs of CRC have been reported. Nearly 40% of studies calculated CRC costs from the provider’s perspective. The highest reported annual per-patient cost was $175020(PPP-adjusted) which is related to the average annual costs of patients with CRC at the fourth stage in the United States from a provider perspective. The lowest reported amount was $ 954(PPP-adjusted) which was related to average annual inpatient costs in Brazil from a provider perspective.

Due to variations in study characteristics in terms of perspective, type of costs, type of patient included, etc. any comparison between the economic burden of CRC should be made with caution. However, reviewing various aspects of the economic burden of CRC reported in included studies, will provide researchers and policymakers with a better insight into the CRC burden while designing intervention programs will reduce the budget impact of the those programs.

The field of pre-hospital rapid response teams is facing major challenges in the field of chemical, biological, radiation and nuclear accidents. Considering that the country of Iran is exposed to the occurrence of these incidents, the possibility of the danger of these incidents and threats cannot be ignored. This study was conducted with the aim of determining effective factors in the formation of pre-hospital rapid response teams in the field of health in response to CBRN accidents.

the current study is qualitative research with a content analysis approach; which was conducted using semi-structured in-depth interviews with 18 specialists and experts through purposive and snowball sampling. Sampling was done until data saturation. Thematic analysis method was used to analyze the data. The study aimed to extract effective factors in the formation of pre-hospital rapid response teams in the field of health in response to chemical, biological, radiation and nuclear accidents in Iran in 2022.

The factors affecting the formation of the team were divided into 5 main classes and 5 subgroups including capacity building (Education, training), operational requirements (information and communication, command and control, emergency response operational plan, internal and external coordination), required resources (equipment, financing), team formation requirements (decontamination requirements, structural requirements) and team formation structure (general team composition, specialized team composition). The highest number of codes with 39% was related to the emergency response operational plan subcategory and the lowest number of codes with 8% was related to the equipment subcategory.

This study presented the design of the local pre-hospital rapid response team in the field of health in chemical, biological, radiation and nuclear accidents in Iran. This plan is for quick pre-hospital response to attend and intervene in the acute phase of these incidents. In order to increase the response capacity and capability of these teams, in addition to the general composition of the team, in order to improve the specialized preparation to deal with the health effects of these incidents, a specialized composition has also been provided. It is suggested; A separate team should be formed for each CBRN area based on the risk assessment of the offending areas of the country.