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Patient-Centered Care: Current Practice and Recommendations for Nigeria 以患者为中心的护理:尼日利亚的现行做法和建议
Pub Date : 2023-12-05 DOI: 10.18502/jebhpme.v7i3.14280
G. Akpegah, Isaac Brown Ado, Joseph Akem Agbama, Emmanuel Aniekan Essien
The Article Abstract is not available.
文章摘要不可用。
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引用次数: 0
The Relationship between Symptoms of COVID-19 Patients, Their Demographic Characteristics, Underlying Condition, and Comorbidities: A Case Study in Iran COVID-19 患者的症状、人口统计学特征、基础疾病和并发症之间的关系:伊朗病例研究
Pub Date : 2023-12-05 DOI: 10.18502/jebhpme.v7i3.14284
Tahereh Shafaghat, Mohammad Zarezadeh, Mohammad Kazem Rahimi
Background: Since the emergence of COVID-19 disease and its spread, many people have been globally infected. Also, evidence has shown that some specific conditions and underlying diseases result in more severe symptoms in the patients. Therefore, this study aimed to investigate the relationship between demographic characteristics and underlying conditions with symptoms in patients with COVID-19 in one of Iran's major hospitals. Methods: The present cross-sectional and descriptive-analytical study was conducted from February 20th, 2020 to August 20th, 2021. The sampling method was census. The data were collected from the statistics department, medical records, HIS, and they were analysed via SPSS software version 25 using descriptive statistics and statistical tests such as Spearman, Mann-Whitney, and Chi-square. Results: Among the 7,236 patients with a definite diagnosis of COVID-19, most (53.2%) of the subjects were men and the total death rate was 8%. There was a positive correlation (p-value=0.000) between age and length of stay. About 69% of the patients had symptoms related to the disease in their CT scan and 39.5% had an oxygen level of less than 93%, which roughly 2.6% of them were intubated. There was a significant relationship between patients' age, sex, and length of stay with their discharge status, first symptoms of disease, and patient’s underlying conditions. Also, there was a significant difference in patients' discharge status based on having some early symptoms, gastrointestinal symptoms, and underlying conditions. Conclusion: The findings of this study emphasize the importance of early detection and management strategies, especially for individuals with specific risk factors. These insights are crucial in guiding healthcare practices and policies to effectively combat the ongoing pandemic. Also, the study outcomes provide valuable insights for healthcare professionals and policymakers, aiding in the development of targeted interventions and patient-centered care protocols.
背景:自2019冠状病毒病出现并传播以来,全球已有许多人感染。此外,有证据表明,某些特定情况和潜在疾病会导致患者出现更严重的症状。因此,本研究旨在调查伊朗一家大医院中COVID-19患者的人口统计学特征与潜在疾病与症状之间的关系。方法:本研究于2020年2月20日至2021年8月20日进行横断面和描述性分析。抽样方法为人口普查。数据来源于统计部门、病历、HIS,采用SPSS软件25版进行描述性统计和Spearman、Mann-Whitney、Chi-square等统计检验。结果:7236例确诊新冠肺炎患者中,男性占53.2%,总死亡率为8%。年龄与住院时间呈正相关(p值=0.000)。约69%的患者在CT扫描中出现了与疾病相关的症状,39.5%的患者氧含量低于93%,其中约2.6%的患者接受了插管。患者的年龄、性别、住院时间与其出院状态、首发症状和患者的基础状况之间存在显著关系。此外,基于某些早期症状、胃肠道症状和基础疾病的患者出院情况存在显著差异。结论:本研究结果强调了早期发现和管理策略的重要性,特别是对于具有特定危险因素的个体。这些见解对于指导卫生保健实践和政策以有效防治当前的大流行至关重要。此外,研究结果为医疗保健专业人员和政策制定者提供了有价值的见解,有助于制定有针对性的干预措施和以患者为中心的护理方案。
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引用次数: 0
The Supportive Role of Companion Midwife on Maternal and Newborn Outcomes in Primiparous Women: A Retrospective Cost Analysis in Yazd 助产士对初产妇产妇和新生儿结局的支持作用:亚兹德的回顾性成本分析
Pub Date : 2023-12-05 DOI: 10.18502/jebhpme.v7i3.14285
Mohammad Zarezadeh, Fatemeh Zareian, Mehdi Raadabadi, Seyed Masood Mousavi, Moslem Taheri Soodejani, Maryam Dafei
Background: The World Health Organization recommends that women be continuously supported by a favorite companion during labor. Currently, there is no strong evidence on specific support measures by midwifery in relation to improving the delivery process. Methods: The present retrospective cost analysis study was conducted during 2021-2022. The reports of 243 deliveries were checked in the patients’ files in selected hospitals of Yazd city. Data analysis was done using SPSS26. Results: According to the study objectives, the desired delivery outcomes included type of delivery, postpartum complications, postpartum bleeding, and length of the active phase of labor, resuscitation of the newborn, hospitalization of the newborn, and Apgar score of the newborn in the first and fifth minutes. There was a statistically significant difference in delivery, postpartum complications, length of the active phase of labor and hospitalization of the newborn in the neonatal unit, resuscitation of the newborn, and the amount of nutrition of the exposed group compared to the non-exposed group. Among the desired performance indicators, patient length of stay and total cost per person between the exposure and non-exposure groups, the mean score of the cost per person had a statistically significant difference between the two groups (P<0.001). Conclusion: Generally, the presence of a companion midwife next to the mother in the delivery room improves some of the outcomes of the mother and the baby. It is recommended to carry out studies in this field along with checking mothers' satisfaction with companion midwives.
背景:世界卫生组织建议妇女在分娩过程中有一个最喜欢的伴侣持续支持。目前,没有强有力的证据表明助产人员采取了具体的支持措施来改善分娩过程。方法:在2021-2022年期间进行回顾性成本分析研究。对亚兹德市选定医院的243例分娩报告进行了检查。数据分析采用SPSS26软件。结果:根据研究目的,期望的分娩结局包括分娩类型、产后并发症、产后出血、产程活跃期长短、新生儿复苏情况、新生儿住院情况、新生儿第1分钟和第5分钟Apgar评分。暴露组与未暴露组在分娩、产后并发症、产程活跃期、新生儿在新生儿病房住院时间、新生儿复苏情况、营养摄入量等方面差异均有统计学意义。在暴露组与非暴露组的期望绩效指标、患者住院时间和人均总费用中,两组人均费用平均得分差异有统计学意义(P<0.001)。结论:一般来说,在产房中母亲旁边有一名陪产员会改善母亲和婴儿的一些结局。建议开展这一领域的研究,同时检查母亲对陪伴助产士的满意度。
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引用次数: 0
Exploring HIV Testing Models for Differentiated Service Delivery in Southern Africa: A Systematic Review 探索南部非洲提供差异化服务的 HIV 检测模式:系统回顾
Pub Date : 2023-12-05 DOI: 10.18502/jebhpme.v7i3.14287
H. Mugauri, Mujinga Karakadzai, O. Mugurungi, Joconiah Chirenda, K. Takarinda, Mufuta Tshimanga
Background: Targeting HIV testing services, as the World Health Organization (WHO) recommended in 2015, fast-tracks the identification of individuals with HIV and addresses the persisting HIV testing gap which might delay epidemic control. Following this recommendation, different models of targeted testing have been implemented, exposing varied interpretations by different countries. This study identifies, aggregates, and synthesizes targeted HIV testing models to develop a concise targeted testing package which can increase the identification of people with HIV. Methods: A systematic literature search in PubMed, Scopus and Web of Science databases identified cross-sectional studies of people (18 years and above) from Southern Africa published between 2016 and 2021. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied, and the quality of studies was evaluated using the Joanna Brigs Institute tool (JBI). Data were extracted using a guided matrix to identify the target population, testing models, description, and positivity ratio. Conclusions and methodological suggestions were narratively synthesized. Results: The authors identified 574 studies; 42 full-text articles were screened which yielded 29 studies of moderate quality (71%) meeting the eligibility criteria. Of these, 25 studies (86.2%) were quantitative. From the included studies, similar models were synthesized, and 12 targeted testing models emerged. Prioritized models were Index testing, described in 3 (10.3%) of the studies, scoring the highest positivity ratio of >30%. Six studies (20.7%) described male-targeted models with yields influenced by age, economic status, and educational level, with a positivity ratio of 10% among first-time testers. In contrast, four (13.8%) described Key and Vulnerable Populations (KVP) focused models (positivity ratio of 37.5%) and recency-informed targeted testing (13.1% positivity ratio). Conclusion: This review provides a critical overview and insights into the targeted testing models implemented in Southern Africa. Synthesizing comparable models can meet the various needs of unique populations comprehensively and increase positivity ratio. The recommended models can improve the efficiency of programs in targeting HIV testing services.
背景:正如世界卫生组织(世卫组织)在2015年建议的那样,针对艾滋病毒检测服务,可以快速识别艾滋病毒感染者,并解决可能延迟流行病控制的持续存在的艾滋病毒检测差距。根据这一建议,实施了不同的目标检测模式,暴露了不同国家的不同解释。本研究对HIV靶向检测模型进行识别、汇总和综合,以开发一种简明的靶向检测包,从而提高对HIV感染者的识别。方法:在PubMed、Scopus和Web of Science数据库中进行系统的文献检索,确定了2016年至2021年间发表的来自南部非洲的人群(18岁及以上)的横断面研究。应用系统评价和荟萃分析(PRISMA)指南的首选报告项目,并使用乔安娜布里格斯研究所工具(JBI)评估研究质量。使用引导矩阵提取数据,以确定目标人群、测试模型、描述和阳性率。结论和方法建议叙述综合。结果:作者确定了574项研究;筛选了42篇全文文章,其中29篇中等质量的研究(71%)符合入选标准。其中定量研究25项(86.2%)。从纳入的研究中,综合了相似的模型,形成了12个针对性的测试模型。优先考虑的模型是Index检验,有3篇(10.3%)的研究描述了Index检验,阳性率最高,>30%。6项研究(20.7%)描述了以男性为目标的模型,其收益率受年龄、经济状况和教育水平的影响,首次测试者的阳性率为10%。相比之下,4个(13.8%)描述了重点和弱势群体(KVP)聚焦模型(阳性率为37.5%)和近期知情的定向检测(阳性率为13.1%)。结论:这篇综述提供了一个关键的概述和见解到有针对性的测试模式实施在南部非洲。综合可比模型可以全面满足独特种群的各种需求,提高正性比。所推荐的模式可以提高艾滋病毒检测服务项目的效率。
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引用次数: 0
Risk Factors Affecting the Death of Hospitalized Patients with COVID-19 in the South of Iran 影响伊朗南部 COVID-19 住院病人死亡的风险因素
Pub Date : 2023-12-05 DOI: 10.18502/jebhpme.v7i3.14282
Ehsan Goroei Sardu, Fatemeh Rezabeigi Davarani, Bahareh Kermani, R. Faryabi, Shiva Kargar, Shamim Tashakori, S. Daneshi
Background: Identifying effective factors in death caused by the infection of COVID-19 is one of the most worrisome issues in the globe. This study aims to investigate the frequency of risk factors leading to death in patients with COVID-19. Methods: This was a retrospective descriptive study done on 150 confirmed cases of  COVID-19 in Imam Khomeini Hospital in Jiroft in 2019. Patients were included in the study by census method. The required information was extracted and recorded in the researcher's checklist; which included demographic and social characteristics of patients (age, gender, smoking, and opium consumption), underlying disease,test results (leukopenia, leukocytosis, neutropenia, decrease in albumin, increase in creatinine, ALT, AST, LDH and CRP), and the RT-PCR test.,. The researchers analyzed data using independent sample t-test, and chi-square by SPSS-V22.  Results: The mean age of the patients was 72.19 ± 15.97. Most of those who died with COVID-19 were men. There was a statistically significant relationship between the use of drugs and the death of patients with COVID-19(P-value<0.05). The average body mass index (BMI) of the confirmed patients was 31.14 ± 7.08 kg/m2 in the overweight group (P-value<0.001). Moreover, there was a significant relationship between the risk factors CRP, ALB, AST, ALT, Cr, lym, Neut, WBC and inevitable death in patients with COVID-19(P-Value<0.001). Regarding underlying diseases, diabetes, lung, and kidney diseases have been observed in most terminal patients (P-value<0.001). Conclusion: Old age, male gender, high BMI, blood pressure, increased factors of CRP, AST, ALT, Cr, lym, Neut, WBC, and decreased ALB are among the risk factors leading to death in COVID-19 patients.  
背景:确定COVID-19感染导致死亡的有效因素是全球最令人担忧的问题之一。本研究旨在调查导致COVID-19患者死亡的危险因素频率。方法:对2019年伊玛目霍梅尼医院收治的150例新冠肺炎确诊病例进行回顾性描述性研究。采用普查方法纳入患者。提取所需信息并记录在研究人员的检查表中;其中包括患者的人口统计学和社会特征(年龄、性别、吸烟和吸食鸦片)、潜在疾病、检测结果(白细胞减少、白细胞增多、中性粒细胞减少、白蛋白降低、肌酐升高、ALT、AST、LDH和CRP)以及RT-PCR检测。研究人员使用独立样本t检验和SPSS-V22卡方分析数据。结果:患者平均年龄72.19±15.97岁。死于COVID-19的大多数是男性。药物使用与COVID-19患者死亡有统计学意义(p值<0.05)。超重组确诊患者的平均体重指数(BMI)为31.14±7.08 kg/m2 (p值<0.001)。此外,危险因素CRP、ALB、AST、ALT、Cr、lym、Neut、WBC与COVID-19患者不可避免死亡之间存在显著相关性(p值<0.001)。在基础疾病方面,大多数终末期患者有糖尿病、肺部和肾脏疾病(p值<0.001)。结论:老年、男性、高BMI、血压、CRP、AST、ALT、Cr、lym、Neut、WBC升高、ALB降低是导致COVID-19患者死亡的危险因素。
{"title":"Risk Factors Affecting the Death of Hospitalized Patients with COVID-19 in the South of Iran","authors":"Ehsan Goroei Sardu, Fatemeh Rezabeigi Davarani, Bahareh Kermani, R. Faryabi, Shiva Kargar, Shamim Tashakori, S. Daneshi","doi":"10.18502/jebhpme.v7i3.14282","DOIUrl":"https://doi.org/10.18502/jebhpme.v7i3.14282","url":null,"abstract":"Background: Identifying effective factors in death caused by the infection of COVID-19 is one of the most worrisome issues in the globe. This study aims to investigate the frequency of risk factors leading to death in patients with COVID-19. \u0000Methods: This was a retrospective descriptive study done on 150 confirmed cases of  COVID-19 in Imam Khomeini Hospital in Jiroft in 2019. Patients were included in the study by census method. The required information was extracted and recorded in the researcher's checklist; which included demographic and social characteristics of patients (age, gender, smoking, and opium consumption), underlying disease,test results (leukopenia, leukocytosis, neutropenia, decrease in albumin, increase in creatinine, ALT, AST, LDH and CRP), and the RT-PCR test.,. The researchers analyzed data using independent sample t-test, and chi-square by SPSS-V22. \u0000 Results: The mean age of the patients was 72.19 ± 15.97. Most of those who died with COVID-19 were men. There was a statistically significant relationship between the use of drugs and the death of patients with COVID-19(P-value<0.05). The average body mass index (BMI) of the confirmed patients was 31.14 ± 7.08 kg/m2 in the overweight group (P-value<0.001). Moreover, there was a significant relationship between the risk factors CRP, ALB, AST, ALT, Cr, lym, Neut, WBC and inevitable death in patients with COVID-19(P-Value<0.001). Regarding underlying diseases, diabetes, lung, and kidney diseases have been observed in most terminal patients (P-value<0.001). \u0000Conclusion: Old age, male gender, high BMI, blood pressure, increased factors of CRP, AST, ALT, Cr, lym, Neut, WBC, and decreased ALB are among the risk factors leading to death in COVID-19 patients. \u0000 ","PeriodicalId":198049,"journal":{"name":"Evidence Based Health Policy, Management and Economics","volume":"122 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138599432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenge of Managing Hospitals during the COVID-19 Pandemic: A Qualita-tive Study COVID-19 大流行期间医院管理面临的挑战:质量研究
Pub Date : 2023-12-05 DOI: 10.18502/jebhpme.v7i3.14286
Marziyeh Najafi, Mohammad Arab, B. Pouragha, Morteza Nazari, Roya Rajaee, Masoumeh Vaziri-Seta, Mohsen Seyed Mahmoudi
Background: The COVID-19 pandemic has posed many challenges on the health system and hospitals to provide services. This study investigated the difference between factors affecting hospital management which considered in preparing a disaster management plan for hospital in the face of a pandemic based on the experiences of hospital managers. Methods: This qualitative research was conducted on selected hospitals affiliated in Alborz University of Medical Sciences in 2021. Data were gathered with purposive sampling and semi-structured interviews with 16 hospital managers. MAXQDA 10 and framework analysis were used to analyze the data. Results: The results were categorized in four categories: 1) Mitigation including staffing, bed capacity, enough space for quarantines, protective equipment, diagnosis and treatment equipment, funding, medicines, patient follow-up, management and leadership; 2) Preparedness such as crisis committee, preparedness and response plan, measures, action plan; 3) Response including motivating health workers, cooperation and coordination; 4) Recovery and lessons learned including providing facilities, expediting patient processes, control, economic conditions, and planning better, passive defense, regular crisis committee meetings, human resources, documentation and use of information systems in planning. Conclusion: In addition to providing the necessary infrastructure, it is important to plan for fair distribution of resources and effective supply chain management. A mechanism should also be developed at the national level to anticipate future health crises and to prevent and control diseases in the most effective way.  
背景:2019冠状病毒病大流行给卫生系统和医院提供服务带来了许多挑战。本研究调查了影响医院管理的因素之间的差异,这些因素是根据医院管理人员的经验在面对大流行时为医院制定灾害管理计划所考虑的。方法:选取阿尔博尔斯医科大学附属医院于2021年进行定性研究。通过有目的的抽样和对16家医院管理人员的半结构化访谈收集数据。采用MAXQDA 10和框架分析对数据进行分析。结果:结果分为四类:1)缓解措施包括人员配备、床位容量、足够的隔离空间、防护装备、诊疗设备、资金、药品、患者随访、管理和领导;2)准备工作,如危机委员会、准备和应对计划、措施、行动计划;3)应对措施,包括激励卫生工作者、合作和协调;4)恢复和经验教训,包括提供设施,加快病人流程,控制,经济条件和更好的计划,被动防御,定期危机委员会会议,人力资源,文件和计划中信息系统的使用。结论:除了提供必要的基础设施外,规划资源的公平分配和有效的供应链管理也很重要。还应在国家一级建立一种机制,以预测未来的健康危机,并以最有效的方式预防和控制疾病。
{"title":"Challenge of Managing Hospitals during the COVID-19 Pandemic: A Qualita-tive Study","authors":"Marziyeh Najafi, Mohammad Arab, B. Pouragha, Morteza Nazari, Roya Rajaee, Masoumeh Vaziri-Seta, Mohsen Seyed Mahmoudi","doi":"10.18502/jebhpme.v7i3.14286","DOIUrl":"https://doi.org/10.18502/jebhpme.v7i3.14286","url":null,"abstract":"Background: The COVID-19 pandemic has posed many challenges on the health system and hospitals to provide services. This study investigated the difference between factors affecting hospital management which considered in preparing a disaster management plan for hospital in the face of a pandemic based on the experiences of hospital managers. \u0000Methods: This qualitative research was conducted on selected hospitals affiliated in Alborz University of Medical Sciences in 2021. Data were gathered with purposive sampling and semi-structured interviews with 16 hospital managers. MAXQDA 10 and framework analysis were used to analyze the data. \u0000Results: The results were categorized in four categories: 1) Mitigation including staffing, bed capacity, enough space for quarantines, protective equipment, diagnosis and treatment equipment, funding, medicines, patient follow-up, management and leadership; 2) Preparedness such as crisis committee, preparedness and response plan, measures, action plan; 3) Response including motivating health workers, cooperation and coordination; 4) Recovery and lessons learned including providing facilities, expediting patient processes, control, economic conditions, and planning better, passive defense, regular crisis committee meetings, human resources, documentation and use of information systems in planning. \u0000Conclusion: In addition to providing the necessary infrastructure, it is important to plan for fair distribution of resources and effective supply chain management. A mechanism should also be developed at the national level to anticipate future health crises and to prevent and control diseases in the most effective way. \u0000 ","PeriodicalId":198049,"journal":{"name":"Evidence Based Health Policy, Management and Economics","volume":"114 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138599413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the Hospitals’ Preparedness Against COVID-19: A Hybrid Multi-Criteria Decision-Making Approach 评估医院应对COVID-19的准备:一种混合多标准决策方法
Pub Date : 2023-07-05 DOI: 10.18502/jebhpme.v7i2.13140
S. M. Hosseini Sarkhosh, M. Zahedi
Background: COVID-19 pandemic, the different mutations of the virus, and the emergence of different variants requires that hospitals upgrade their levels of preparedness in managing the crisis. This study aims to provide a method for assessing the level of hospitals’ preparedness in dealing with such situations. Methods: In the initial stage, effective criteria for assessing hospital preparedness were identified through literature review. Following that, the Delphi method was used to obtain the perspectives of 40 experts from the healthcare system in order to validate the criteria. Then, the SWARA (Stepwise Weight Assessment Ratio Analysis) technique was applied to determine the weights of the criteria. Through MABAC (Multi-Attributive Border Approximation Area Comparison) technique, the preparedness of 10 selected hospitals in Tehran was assessed. Finally, using sensitivity analysis, the robustness and reliability of the proposed method were examined. Results: Results indicated that personnel, their education and work experience, medical equipment, and the emergency networks were critical factors in determining the level of hospital preparedness against COVID-19. Out of the 10 selected hospitals, the Imam Khomeini Hospital was found to have the highest level of preparedness. Conclusion: This is the first study which recommends a simple and effective tool for assessing the level of preparedness through the hybrid MCDM (Multi-Criteria Decision Making) approach. This tool facilitates the proper allocation of budgets and other resources in strengthening the preparedness of hospitals in handling the situation
背景:COVID-19大流行、病毒的不同突变以及不同变体的出现要求医院提高危机管理的准备水平。本研究旨在提供一种评估医院应对此类情况的准备水平的方法。方法:在初始阶段,通过文献综述,确定有效的医院准备评估标准。随后,采用德尔菲法获得来自医疗保健系统的40位专家的观点,以验证标准。然后,应用逐步权重评估比率分析(SWARA)技术确定各指标的权重。通过MABAC(多属性边界近似面积比较)技术,评估了德黑兰10家选定医院的准备情况。最后,通过灵敏度分析,验证了该方法的鲁棒性和可靠性。结果:人员及其学历和工作经验、医疗设备和应急网络是决定医院COVID-19防范水平的关键因素。在10所选定的医院中,伊玛目霍梅尼医院的准备工作被认为是最高的。结论:该研究首次推荐了一种简单有效的工具,通过混合MCDM(多标准决策)方法来评估准备水平。这一工具有助于适当分配预算和其他资源,以加强医院应对这种情况的准备
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引用次数: 0
Investigating the Challenges of Medical tourism Development in Affiliated Centers of Iran University of Medical Sciences (IUMS) 伊朗医科大学附属中心医疗旅游发展面临的挑战
Pub Date : 2023-07-05 DOI: 10.18502/jebhpme.v7i2.13142
Fatemeh Najafipour Moghadam, N. Tavakoli, H. Farzaneh
Background: This study was conducted with the aim of investigating the challenges of health tourism development in affiliated centers of Iran University of Medical Sciences (IUMS). Methods: This was a qualitative, descriptive, and applied study. The statistical population included all the stakeholders of health tourism at IUMS. The information was obtained through purposeful sampling until data saturation was reached. 20 experts in health tourism at the IUMS were interviewed. Experts confirmed the validity of form and content and coding was done (1),  and the final result was presented. Results: 4 general categories were identified as the challenges of health tourism development in IUMS. They included political, social and economic conditions (communication at the global level and economic development), structural and internal organizational conditions (bureaucratic and administrative, supervisory and communication processes), participation (bureaucratic processes, effective communication between government departments and drafting of strategies and operational plans), and promotion (developing a strategic and coherent plan in the development of marketing and services at the global level and advertising). Conclusion: While identifying the driving factors and obstacles, It is necessary to develop medical tourism, pay attention to the political, social and economic, structural and intra-organizational conditions, attract participation and improve the existing situation and design services, which are among the challenges of medical tourism development at the Iran University of Medical Sciences.
背景:本研究旨在调查伊朗医科大学附属中心健康旅游发展面临的挑战。方法:采用定性、描述性和应用研究。统计人口包括国际医学研究所保健旅游的所有利益相关者。通过有目的的采样获取信息,直到达到数据饱和。我们采访了20位国际医学联合会的健康旅游专家。专家确认了形式和内容的有效性,并进行了编码(1),并给出了最终结果。结果:确定了综合医院健康旅游发展面临的挑战。它们包括政治、社会和经济条件(全球一级的沟通和经济发展)、结构和内部组织条件(官僚和行政、监督和沟通程序)、参与(官僚程序、政府部门之间的有效沟通和起草战略和业务计划)、推广(制定战略和连贯的计划,在全球范围内发展营销和服务以及广告)。结论:在确定驱动因素和障碍的同时,有必要发展医疗旅游,注意政治、社会和经济、结构和组织内部条件,吸引参与,改善现有状况和设计服务,这是伊朗医学大学医疗旅游发展面临的挑战之一。
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引用次数: 0
Do Celebrities Want to be Treated Differently in Health System? Using Fame In A Controversial Way 名人想在医疗系统中被区别对待吗?以有争议的方式利用名声
Pub Date : 2023-07-05 DOI: 10.18502/jebhpme.v7i2.13137
Vahid Yazdi-Feyzabadi, Fatemeh Shaygani, Sajad Delavari
The Article Abstract is not available.
文章摘要不可用。
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引用次数: 0
Management of Medication Error Reporting in HIV/AIDS Patients HIV/AIDS患者用药错误报告的管理
Pub Date : 2023-07-05 DOI: 10.18502/jebhpme.v7i2.13138
Narges Keshtkar, Iravan Masoudi Asl, S. Hessam, S. Mahfoozpour
Background: One of the most frequent medical mistakes that lower patient safety and mortality is medication errors in HIV/AIDS patients. A structured reporting system is necessary for the efficient avoidance of these kinds of mistakes. In order to discover parameters influencing the management of medication mistake reporting in HIV-infected patients, the current research was carried out. Methods: The current research is an example of an applied study that was carried out between 2010 and 2019 utilizing a hybrid (quantitative-qualitative) methodology. First, the primary factors impacting the management of medication mistake reporting in HIV positive patients were collected from a study of the research literature and 35 interviews with experts in the area of treating HIV patients, and a research questionnaire was created utilizing them. Using the Lawshe approach, the questionnaire was sent to and collected from 31 experts in order to assess its content validity. SPSS23 was then used to determine the questionnaire's reliability, which resulted in a Cronbach's alpha value of 0.920. 400 workers who treated HIV/AIDS patients provided information for the data collection. Exploratory factor analysis was used to analyze the data, together with SPSS23 and Lisrel software. Results: Four factors were found to be important in managing medication mistake reporting in HIV patients, including organizational factors (18 variables), person factors (9 variables), educational factors (10 variables), and communication factors (6 variables). The management of medication mistake reporting in HIV patients was impacted most and least by personal and educational variables, with factor loadings of 0.784 and 0.754, respectively. Conclusion: It is preferable to concentrate on individual variables (employee-related hurdles, fear of the repercussions of reporting, and others' reactions) rather than addressing all four aspects at once in order to manage medication mistake reporting in HIV positive patients (managers, colleagues, patients).  Managers, policymakers, specialists from behavioral disease counseling centers, and attending physicians should pay greater attention to both the individual (application and development of the integrated HIV management system).
背景:HIV/AIDS患者的用药错误是降低患者安全和死亡率的最常见的医疗错误之一。一个结构化的报告系统对于有效避免这类错误是必要的。为了发现影响hiv感染者用药差错报告管理的因素,开展了本研究。方法:本研究是2010年至2019年利用混合(定量-定性)方法进行的应用研究的一个例子。首先,通过查阅研究文献和对35位HIV患者治疗领域专家的访谈,收集影响HIV阳性患者用药错误报告管理的主要因素,并利用这些因素制作研究问卷。采用Lawshe方法,将问卷发送给31位专家,并从他们那里收集问卷,以评估其内容效度。采用SPSS23对问卷进行信度测定,其Cronbach’s alpha值为0.920。400名治疗艾滋病毒/艾滋病患者的工作人员为数据收集提供了资料。采用探索性因子分析,结合SPSS23和Lisrel软件对数据进行分析。结果:发现组织因素(18个变量)、个人因素(9个变量)、教育因素(10个变量)和沟通因素(6个变量)是影响HIV患者用药差错报告管理的重要因素。HIV患者用药差错报告管理受个人因素和教育因素影响最大,受教育因素影响最小,因子负荷分别为0.784和0.754。结论:在管理HIV阳性患者(管理人员、同事、患者)的用药错误报告中,最好关注个体变量(员工相关障碍、对报告后果的恐惧以及他人的反应),而不是同时解决四个方面的问题。管理者、政策制定者、行为疾病咨询中心的专家和主治医生都应该更加重视艾滋病综合管理系统的个人应用和发展。
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引用次数: 0
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Evidence Based Health Policy, Management and Economics
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