Context: Studies have shown that various Assemblages, sub-assemblage (subtypes) and genotypes of Giardia intestinalis have multiple hosts; therefore, their distribution reservoirs as well as pattern of epidemiological distribution are different. The present study was conducted to summarize the results of genetic studies on Giardia intestinalis in Iran. Evidence Acquisition: To investigate the articles on the sub-assemblage of Giardia intestinalis in Iran, a systematic search was conducted in Persian and English databases. The search process led to the entry of 23 articles into this systematic review. Also, in this study, to estimate the ratio of the dominant sub-assemblage of Giardia parasite in Iran, meta-analysis was used and a significant level of 0.05 was considered. Results: The results of this study showed that investigations on assemblages and sub-assemblage of Giardia intestinalis had been mostly made in the western half of Iran. The overall prevalence of A, B, and the mixed assemblages of Giardia intestinalis in these areas of Iran was estimated to be 0.56, 0.27, and 0.16, respectively. Also, the prevalence of AI and AII sub-assemblage of Giardia intestinalis in the same areas of Iran was 0.34 and 0.5, respectively. The prevalence of BIII and BIV sub-assemblage of this parasite in mentioned areas was further found to be 0.2 and 0.06, respectively. In addition, the total prevalence of all sub-assemblage (AI, AII, BIII, & BIV) was calculated to be 0.18 (P < 0.001). Conclusions: Given that assemblage A of Giardia Intestinalis has the highest prevalence in the human society of western half of Iran, in this area of the country, the main epidemiological pattern of Giardia transmission is zoonotic. However, to identify the source of this parasite spread, more studies are needed.
{"title":"An Overview on the Main Assemblages and Sub-assemblages of Giardia Intestinalis in the Western Half of Iran","authors":"Z. Eslamirad, R. Hajihossein, A. Moslemi","doi":"10.5812/semj-116536","DOIUrl":"https://doi.org/10.5812/semj-116536","url":null,"abstract":"Context: Studies have shown that various Assemblages, sub-assemblage (subtypes) and genotypes of Giardia intestinalis have multiple hosts; therefore, their distribution reservoirs as well as pattern of epidemiological distribution are different. The present study was conducted to summarize the results of genetic studies on Giardia intestinalis in Iran. Evidence Acquisition: To investigate the articles on the sub-assemblage of Giardia intestinalis in Iran, a systematic search was conducted in Persian and English databases. The search process led to the entry of 23 articles into this systematic review. Also, in this study, to estimate the ratio of the dominant sub-assemblage of Giardia parasite in Iran, meta-analysis was used and a significant level of 0.05 was considered. Results: The results of this study showed that investigations on assemblages and sub-assemblage of Giardia intestinalis had been mostly made in the western half of Iran. The overall prevalence of A, B, and the mixed assemblages of Giardia intestinalis in these areas of Iran was estimated to be 0.56, 0.27, and 0.16, respectively. Also, the prevalence of AI and AII sub-assemblage of Giardia intestinalis in the same areas of Iran was 0.34 and 0.5, respectively. The prevalence of BIII and BIV sub-assemblage of this parasite in mentioned areas was further found to be 0.2 and 0.06, respectively. In addition, the total prevalence of all sub-assemblage (AI, AII, BIII, & BIV) was calculated to be 0.18 (P < 0.001). Conclusions: Given that assemblage A of Giardia Intestinalis has the highest prevalence in the human society of western half of Iran, in this area of the country, the main epidemiological pattern of Giardia transmission is zoonotic. However, to identify the source of this parasite spread, more studies are needed.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79266172","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}
Amir Karimkhany, Ehsan Zarei, S. Arabi, E. Navvabi, Somayeh Anisi
Background: While the ultimate goal of health care is to maintain or improve the health status, features of care, including the quality of hotel services, are important to enhance the quality of health care services. Due to the limited resources of the health system, it is important to recognize the strengths and weaknesses of health service providers for policy-making and allocating resources in line with customers’ expectations. Objectives: The current study aimed at ranking the dimensions of hospital hoteling services from patients’ perspectives using the importance-performance analysis (IPA) method in Tehran, Iran. Methods: In this cross-sectional study, 440 patients were enrolled through multi-stage random sampling. The data collection tool was a questionnaire consisting of 44 items in six dimensions. Its internal reliability was determined based on Cronbach’s alpha coefficient (α = 0.97). The IPA method was used to prioritize the dimensions. Data were analyzed using descriptive statistics and the paired t-test at a significance level of < 0.05. Results: In all aspects of hoteling, there was a significant difference between the performance of hospitals and the expectations of patients. The highest and lowest gaps between performance and expectation were related to the economic-financial and performance-process factors, respectively (P < 0.05). Based on the IPA matrix, the "physical-structural" and "economic-financial" factors were the major weaknesses, and the "need to allocate more resources" and "human-behavioral" factors were recognized as the most strong points. Considering that the dimensions of "cultural-religious” and "safety-security" were located in the third quadrant of the IPA matrix, these dimensions did not require additional resources. Conclusions: The existence of a gap between hospital performance and patient expectation in all the hoteling dimensions indicated that the performance of hospitals in providing hoteling services was not proportional to the importance of these factors from the viewpoints of patients. The "physical-structural" and "economic-financial" factors were the major weaknesses of the hospitals studied. Therefore, it is necessary to pay more attention and allocate resources to these dimensions. Efforts should be continued to maintain and upgrade the status quo regarding the human-behavioral factors to boost patient satisfaction and improve the quality of hoteling services.
{"title":"Ranking Hospital Hoteling Services from Patients’ Perspective Using Importance-Performance Analysis","authors":"Amir Karimkhany, Ehsan Zarei, S. Arabi, E. Navvabi, Somayeh Anisi","doi":"10.5812/semj-119702","DOIUrl":"https://doi.org/10.5812/semj-119702","url":null,"abstract":"Background: While the ultimate goal of health care is to maintain or improve the health status, features of care, including the quality of hotel services, are important to enhance the quality of health care services. Due to the limited resources of the health system, it is important to recognize the strengths and weaknesses of health service providers for policy-making and allocating resources in line with customers’ expectations. Objectives: The current study aimed at ranking the dimensions of hospital hoteling services from patients’ perspectives using the importance-performance analysis (IPA) method in Tehran, Iran. Methods: In this cross-sectional study, 440 patients were enrolled through multi-stage random sampling. The data collection tool was a questionnaire consisting of 44 items in six dimensions. Its internal reliability was determined based on Cronbach’s alpha coefficient (α = 0.97). The IPA method was used to prioritize the dimensions. Data were analyzed using descriptive statistics and the paired t-test at a significance level of < 0.05. Results: In all aspects of hoteling, there was a significant difference between the performance of hospitals and the expectations of patients. The highest and lowest gaps between performance and expectation were related to the economic-financial and performance-process factors, respectively (P < 0.05). Based on the IPA matrix, the \"physical-structural\" and \"economic-financial\" factors were the major weaknesses, and the \"need to allocate more resources\" and \"human-behavioral\" factors were recognized as the most strong points. Considering that the dimensions of \"cultural-religious” and \"safety-security\" were located in the third quadrant of the IPA matrix, these dimensions did not require additional resources. Conclusions: The existence of a gap between hospital performance and patient expectation in all the hoteling dimensions indicated that the performance of hospitals in providing hoteling services was not proportional to the importance of these factors from the viewpoints of patients. The \"physical-structural\" and \"economic-financial\" factors were the major weaknesses of the hospitals studied. Therefore, it is necessary to pay more attention and allocate resources to these dimensions. Efforts should be continued to maintain and upgrade the status quo regarding the human-behavioral factors to boost patient satisfaction and improve the quality of hoteling services.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84701168","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}
H. Joulaei, F. Roosta, Z. Foroozanfar, Fariba Ghiasi, Aygin Sehat Nezhad
Background: This study aimed to evaluate the quality of services provided in Voluntary Counseling and Testing (VCT) centers from the perspective of clients. Methods: This cross-sectional study was conducted on people living with human immunodeficiency virus (PLWH) in Shiraz, Iran, in 2019. The data were collected using a SERVQUAL questionnaire. Results: The mean scores of expected and perceived service qualities were 4.81 (95% CI: 4.741 - 4.864) and 3.96 (95% CI: 3.901 - 4.019) in male subjects and 4.85 (95% CI: 4.80 - 4.89) and 4.09 (95% CI: 4.01 - 4.135) in female subjects, respectively. There was a significant difference between the expectations and perceptions of clients in all dimensions of service quality in VCT centers. The gaps in the dimensions of responsiveness and empathy were greater than all other dimensions. Conclusions: Due to the high dissatisfaction of PLWH with the quality of services in the responsiveness, accessibility, and empathy dimensions, priority should be given to these dimensions in any improvement effort. The low education level of this group should be taken into account for any educational programs to be successful.
{"title":"Assessment of HIV/AIDS Service Quality Using SERVQUAL Model in Iran: A Cross-Sectional Study","authors":"H. Joulaei, F. Roosta, Z. Foroozanfar, Fariba Ghiasi, Aygin Sehat Nezhad","doi":"10.5812/semj-121816","DOIUrl":"https://doi.org/10.5812/semj-121816","url":null,"abstract":"Background: This study aimed to evaluate the quality of services provided in Voluntary Counseling and Testing (VCT) centers from the perspective of clients. Methods: This cross-sectional study was conducted on people living with human immunodeficiency virus (PLWH) in Shiraz, Iran, in 2019. The data were collected using a SERVQUAL questionnaire. Results: The mean scores of expected and perceived service qualities were 4.81 (95% CI: 4.741 - 4.864) and 3.96 (95% CI: 3.901 - 4.019) in male subjects and 4.85 (95% CI: 4.80 - 4.89) and 4.09 (95% CI: 4.01 - 4.135) in female subjects, respectively. There was a significant difference between the expectations and perceptions of clients in all dimensions of service quality in VCT centers. The gaps in the dimensions of responsiveness and empathy were greater than all other dimensions. Conclusions: Due to the high dissatisfaction of PLWH with the quality of services in the responsiveness, accessibility, and empathy dimensions, priority should be given to these dimensions in any improvement effort. The low education level of this group should be taken into account for any educational programs to be successful.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75262765","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}
M. Khammarnia, Zeynab Soroodi Golestani, Arezoo Alinejad Ranjbar, M. Peyvand, Alireza Khorram, F. Setoodehzadeh
Background: Information literacy is a capability that enables individuals to create, sustain, and deepen communication with others, which can be effective in many organizational dimensions such as organizational ethics and career development. Objectives: This study aimed to determine the relationship of information literacy and professional ethics with career development among Zahedan University of Medical Sciences (ZAUMS) staff. Methods: Using systematic sampling, this cross-sectional study was conducted on 238 ZAUMS staff in southeast Iran in 2018. Data were collected through individual interviews using standard questionnaires Information Literacy, Professional Ethics, and Career Development. The data were analyzed using SPSS-v21 software and descriptive statistics, one-way ANOVA, and t-test. Results: Of 237 individuals, 116 (48.7%) were males with a mean age of 38 years. The information literacy and career development scores were in the moderate range (means of 170 and 56, respectively), while the professional ethics score of the majority was poor, with a mean of 32. There was a significant direct relationship between information literacy (coefficient = 0.189) and professional ethics (coefficient = 0.391) with career development (P < 0.05). Multivariate linear regression showed that an increased level of employees' access to information had significant positive effects on career development (β = 0.878, P < 0.01). Also, an increase in the level of career development (performance evaluation, workplace environment, supervision status, and educational factors) and professional ethics (loyalty and respect to others) was associated with increased levels of information literacy (P < 0.05). Conclusions: Information literacy and professional ethics could increase career development. Therefore, it could improve organizational productivity. It is suggested that professional ethics workshops and courses be held to improve staff's information literacy.
{"title":"Relationship of Information Literacy and Professional Ethics with Career Development","authors":"M. Khammarnia, Zeynab Soroodi Golestani, Arezoo Alinejad Ranjbar, M. Peyvand, Alireza Khorram, F. Setoodehzadeh","doi":"10.5812/semj-111166","DOIUrl":"https://doi.org/10.5812/semj-111166","url":null,"abstract":"Background: Information literacy is a capability that enables individuals to create, sustain, and deepen communication with others, which can be effective in many organizational dimensions such as organizational ethics and career development. Objectives: This study aimed to determine the relationship of information literacy and professional ethics with career development among Zahedan University of Medical Sciences (ZAUMS) staff. Methods: Using systematic sampling, this cross-sectional study was conducted on 238 ZAUMS staff in southeast Iran in 2018. Data were collected through individual interviews using standard questionnaires Information Literacy, Professional Ethics, and Career Development. The data were analyzed using SPSS-v21 software and descriptive statistics, one-way ANOVA, and t-test. Results: Of 237 individuals, 116 (48.7%) were males with a mean age of 38 years. The information literacy and career development scores were in the moderate range (means of 170 and 56, respectively), while the professional ethics score of the majority was poor, with a mean of 32. There was a significant direct relationship between information literacy (coefficient = 0.189) and professional ethics (coefficient = 0.391) with career development (P < 0.05). Multivariate linear regression showed that an increased level of employees' access to information had significant positive effects on career development (β = 0.878, P < 0.01). Also, an increase in the level of career development (performance evaluation, workplace environment, supervision status, and educational factors) and professional ethics (loyalty and respect to others) was associated with increased levels of information literacy (P < 0.05). Conclusions: Information literacy and professional ethics could increase career development. Therefore, it could improve organizational productivity. It is suggested that professional ethics workshops and courses be held to improve staff's information literacy.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85697649","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}
S. Niroumand, Haniye Mastour, AmirAli Moodi Ghalibaf, A. Shamshirian, M. Moghadasin
Background: The coronavirus disease 2019 (COVID-19) crisis has greatly impressed medical education by shifting traditional educational methods to e-learning. Objectives: This study evaluated the undergraduate medical students' attitudes toward e-learning during the COVID-19 pandemic Methods: This cross-sectional study included undergraduate medical students of Mashhad University of Medical Sciences, Mashhad, Iran, in the academic year 2020 - 21 by census sampling method, whose attitude toward e-learning was evaluated based on the Ghanizadeh et al. scale. Categorical variables were demonstrated with frequency and percentage, and quantitative variables were described using the mean and standard deviation. An independent-sample t test was run to study the hypothesis. Analysis of covariance (ANCOVA) was performed to compare pre-clinical and clinical groups' attitudes toward e-learning after gender control. Statistical analyses were performed by SPSS 23. Results: The study enrolled 528 undergraduate medical students. The findings indicated that 85.4% of the students agreed with the necessity of more effective e-learning in medical education, and 95.5% believed that e-learning should play a complementary role in medical education. It was found that clinical students had a marginally statistically significantly better attitude toward e-learning than pre-clinical students (t = -2.04, df = 526, P = 0.041). Nevertheless, no significant difference was observed between the two groups after gender control (t = 2.87, P = 0.091). It was shown that males had more positive attitudes toward e-learning than females (t = 2.28, df = 526, P = 0.023). Conclusions: The results revealed acceptable attitudes toward e-learning. Although many students declared e-learning's usefulness and confirmed its complementary role in medical education, some announced that it could not replace in-person training.
背景:2019冠状病毒病(COVID-19)危机使传统教育方法转向电子学习，给医学教育留下了深刻的印象。目的:本研究评估2019冠状病毒病大流行期间医本科生对电子学习的态度方法:本横断面研究采用人口普查抽样方法，选取伊朗马什哈德医学大学2020 - 21学年的医本科生，基于Ghanizadeh等人的量表评估其对电子学习的态度。分类变量用频率和百分比表示，定量变量用均值和标准差表示。采用独立样本t检验对假设进行研究。采用协方差分析(ANCOVA)比较临床前组和临床组在性别控制后对电子学习的态度。采用SPSS 23进行统计学分析。结果:本研究共纳入528名医学本科生。调查结果显示，85.4%的受访学生认同在医学教育中开展更有效的电子学习的必要性，95.5%的受访学生认为电子学习应在医学教育中发挥补充作用。临床生对网络学习的态度显著优于临床预科生(t = -2.04, df = 526, P = 0.041)。性别对照后，两组间差异无统计学意义(t = 2.87, P = 0.091)。结果显示，男性对网络学习的积极态度高于女性(t = 2.28, df = 526, P = 0.023)。结论:调查结果揭示了学生对网络学习的可接受态度。尽管许多学生宣称电子学习很有用，并肯定了它在医学教育中的补充作用，但一些学生宣布，它不能取代面对面的培训。
{"title":"Medical Students' Attitude Toward E-learning During the COVID-19 Pandemic","authors":"S. Niroumand, Haniye Mastour, AmirAli Moodi Ghalibaf, A. Shamshirian, M. Moghadasin","doi":"10.5812/semj-121340","DOIUrl":"https://doi.org/10.5812/semj-121340","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) crisis has greatly impressed medical education by shifting traditional educational methods to e-learning. Objectives: This study evaluated the undergraduate medical students' attitudes toward e-learning during the COVID-19 pandemic Methods: This cross-sectional study included undergraduate medical students of Mashhad University of Medical Sciences, Mashhad, Iran, in the academic year 2020 - 21 by census sampling method, whose attitude toward e-learning was evaluated based on the Ghanizadeh et al. scale. Categorical variables were demonstrated with frequency and percentage, and quantitative variables were described using the mean and standard deviation. An independent-sample t test was run to study the hypothesis. Analysis of covariance (ANCOVA) was performed to compare pre-clinical and clinical groups' attitudes toward e-learning after gender control. Statistical analyses were performed by SPSS 23. Results: The study enrolled 528 undergraduate medical students. The findings indicated that 85.4% of the students agreed with the necessity of more effective e-learning in medical education, and 95.5% believed that e-learning should play a complementary role in medical education. It was found that clinical students had a marginally statistically significantly better attitude toward e-learning than pre-clinical students (t = -2.04, df = 526, P = 0.041). Nevertheless, no significant difference was observed between the two groups after gender control (t = 2.87, P = 0.091). It was shown that males had more positive attitudes toward e-learning than females (t = 2.28, df = 526, P = 0.023). Conclusions: The results revealed acceptable attitudes toward e-learning. Although many students declared e-learning's usefulness and confirmed its complementary role in medical education, some announced that it could not replace in-person training.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86618129","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}
F. Asadi, M. AHMADI HOSSEINI, Tahere Gomar, A. Sabahi
Background: Coding errors lead to incorrect classification of diseases and thus severely affect health care planning and epidemiological research. Objectives: This study aimed to investigate the factors affecting clinical coding errors. Methods: This descriptive study was conducted in 2020 in 2 stages. In the first stage, a questionnaire was developed by examining relevant resources, documents, and articles. The questionnaire’s validity was examined by 5 health information management experts. Its reliability was determined using Cronbach α and correlation coefficient (r = 0.84%). In the second stage, the data were collected by visiting teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences, examining the medical records, and interviewing the coders. Data were analyzed using descriptive statistics. Results: Non-observance of diagnostic principles by physicians, illegibility of medical records, use of ambiguous and nonstandard abbreviations, and incomplete medical documentation were the most important causes of coding errors. Conclusions: Considering the importance of coding in presenting correct data as a powerful lever in health care, knowledge of the factors affecting the occurrence of coding errors will greatly contribute to the selection of effective strategies to reduce and eliminate errors.
{"title":"Factors Affecting Clinical Coding Errors","authors":"F. Asadi, M. AHMADI HOSSEINI, Tahere Gomar, A. Sabahi","doi":"10.5812/semj-122161","DOIUrl":"https://doi.org/10.5812/semj-122161","url":null,"abstract":"Background: Coding errors lead to incorrect classification of diseases and thus severely affect health care planning and epidemiological research. Objectives: This study aimed to investigate the factors affecting clinical coding errors. Methods: This descriptive study was conducted in 2020 in 2 stages. In the first stage, a questionnaire was developed by examining relevant resources, documents, and articles. The questionnaire’s validity was examined by 5 health information management experts. Its reliability was determined using Cronbach α and correlation coefficient (r = 0.84%). In the second stage, the data were collected by visiting teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences, examining the medical records, and interviewing the coders. Data were analyzed using descriptive statistics. Results: Non-observance of diagnostic principles by physicians, illegibility of medical records, use of ambiguous and nonstandard abbreviations, and incomplete medical documentation were the most important causes of coding errors. Conclusions: Considering the importance of coding in presenting correct data as a powerful lever in health care, knowledge of the factors affecting the occurrence of coding errors will greatly contribute to the selection of effective strategies to reduce and eliminate errors.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82241032","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}
Baharak Tasorian, Mohsen Tabatabaei, M. Shayganfard
Background: The prevalence of anxiety and depression is high in rheumatoid arthritis (RA) patients. As RA patients tend to be immunodeficient, they are at greater risk of coronavirus disease 2019 (COVID-19) infection due to their scheduled hospital appointments. Therefore, they have become more anxious and worried during COVID-19 pandemic, and some patients recently have canceled or postponed their treatment. Objectives: This study aimed to assess the effect of stress, anxiety, and depression due to COVID-19 outbreak on non-compliance to treatment among RA patients. Methods: In this cross-sectional study, we included 149 RA patients (male/female = 12: 137). Four questionnaires, including the 21-item Depression, Anxiety, and Stress Scale (DASS-21), 14-item Perceived Stress Scale (PSS-14), 18-item Health Anxiety Inventory (HAI-18), and 8-item Morisky Medication Adherence Scale (MMAS-8) were employed. The questionnaires were filled by the researchers on behalf of the participants using telephone interviews due to social distancing protocol. Results: There was a significant negative correlation between stress (P = 0.001), anxiety (P < 0.001), health anxiety (P = 0.014), and depression (P = 0.001) and compliance to treatment among RA patients. However, anxiety was the only predictor for non-compliance to treatment. Conclusions: Therapists should be aware of the symptoms of stress, anxiety, and depression among their RA patients, especially during stressful life events, and carefully monitor their compliance to treatment to prevent exacerbation of RA.
{"title":"Correlation Between Stress, Anxiety, and Depression Related to COVID-19 Pandemic among Patients with Rheumatoid Arthritis and Non-compliance to Treatment: A Cross-Sectional Study","authors":"Baharak Tasorian, Mohsen Tabatabaei, M. Shayganfard","doi":"10.5812/semj-117966","DOIUrl":"https://doi.org/10.5812/semj-117966","url":null,"abstract":"Background: The prevalence of anxiety and depression is high in rheumatoid arthritis (RA) patients. As RA patients tend to be immunodeficient, they are at greater risk of coronavirus disease 2019 (COVID-19) infection due to their scheduled hospital appointments. Therefore, they have become more anxious and worried during COVID-19 pandemic, and some patients recently have canceled or postponed their treatment. Objectives: This study aimed to assess the effect of stress, anxiety, and depression due to COVID-19 outbreak on non-compliance to treatment among RA patients. Methods: In this cross-sectional study, we included 149 RA patients (male/female = 12: 137). Four questionnaires, including the 21-item Depression, Anxiety, and Stress Scale (DASS-21), 14-item Perceived Stress Scale (PSS-14), 18-item Health Anxiety Inventory (HAI-18), and 8-item Morisky Medication Adherence Scale (MMAS-8) were employed. The questionnaires were filled by the researchers on behalf of the participants using telephone interviews due to social distancing protocol. Results: There was a significant negative correlation between stress (P = 0.001), anxiety (P < 0.001), health anxiety (P = 0.014), and depression (P = 0.001) and compliance to treatment among RA patients. However, anxiety was the only predictor for non-compliance to treatment. Conclusions: Therapists should be aware of the symptoms of stress, anxiety, and depression among their RA patients, especially during stressful life events, and carefully monitor their compliance to treatment to prevent exacerbation of RA.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79427266","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}
: The reduction of preventable deaths from non-communicable diseases, including cancers, is one of the main targets of universal health coverage. Not only there is a shortage of financial resources for universal health coverage for cancer patients in many countries, but also there are many challenges in the continuity and the quality of care. There are disparities rooted in both providers’ and patients’ behavior at the time of care. Unmet needs for information on treatment and prognosis, inadequate cost coverage of care, and inadequate support for other living costs are contributing factors to poor prognosis in cancer patients, especially in cases with advanced stages and those living in low-income countries. There is a need for a comprehensive, holistic approach to the care of cancer patients considering the patients’ socioeconomic and cultural status and the institutional status of the providers.
{"title":"The Global Status of Universal Health Coverage and Oncology Care","authors":"K. Bagheri Lankarani","doi":"10.5812/semj-129053","DOIUrl":"https://doi.org/10.5812/semj-129053","url":null,"abstract":": The reduction of preventable deaths from non-communicable diseases, including cancers, is one of the main targets of universal health coverage. Not only there is a shortage of financial resources for universal health coverage for cancer patients in many countries, but also there are many challenges in the continuity and the quality of care. There are disparities rooted in both providers’ and patients’ behavior at the time of care. Unmet needs for information on treatment and prognosis, inadequate cost coverage of care, and inadequate support for other living costs are contributing factors to poor prognosis in cancer patients, especially in cases with advanced stages and those living in low-income countries. There is a need for a comprehensive, holistic approach to the care of cancer patients considering the patients’ socioeconomic and cultural status and the institutional status of the providers.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83259420","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}
A. Amanat, K. Bagheri Lankarani, B. Honarvar, Naeimehossadat Asmarian, M. Shokripour, F. Rafiee, M. Aghazadeh, Farahnaz Izadi, N. Omidifar, Seyed Abolfazl Dorraninejad
Background: SARS-CoV-2 is a novel virus that caused the recent global pandemic. Health care workers (HCWs), especially hospital staff, are at a higher risk of infection by this virus than the general population. In this study, anti-SARS-CoV-2 IgG antibodies were assessed in hospital workers. Methods: This prospective seroconversion-based cohort study assessed chronic immunity against covid-19 in the staff of two hospitals, the main referral hospital and a general hospital in Shiraz, south of Iran. A valid and reliable checklist was filled out for each available staff member willing to participate in this study through a face-to-face interview. Furthermore, the titer of anti-covid-19 IgG was measured by ELISA twice; in July 2020 after the second wave of COVID-19 and in February 2021 after the third wave in IRAN. Results: One hundred forty (65%) of the 214 members who participated in both stages of this consideration were from the COVID-19 referral healing center, and 74 (35%) were from the common clinic. Twelve (5.6%) of staff members had anti-SARS-CoV-2 IgG antibodies, including 10 (7.1%) from the referral healing center and 2 (2.7%) from the common healing center (P = 0.23). In the second measurement (second overview), 79 (36.9%) of members had IgG antibodies; 58 (41.4%) from the primary hospital and 21 (28.3%) from the second healing center (P = 0.039). Cruel of the IgG titer within the first study and the referral clinic was 0.8 ± 0.3 compared to 0.15 ± 0.42 within the common clinic (P = 0.001). These figures were 3.05 ± 4.58 and 1.74 ± 3.53 in both clinics and within the second overview separately (P = 0.003). IgG levels were significantly higher in the second overview compared to the first (P < 0.0001). Conclusions: During the third wave of COVID-19, a significant proportion of hospital staff developed COVID-19 IgG, especially in the referral hospitals for COVID-19. As a result of their higher and chronic exposure to COVID-19 patients than the general hospital staff, the titer of IgG in the referral hospital staff was also higher. However, the seroconversion rate between the two waves was 1.8 times in the general hospital staff compared to the referral hospital, possibly due to less conservative precautions against covid-19 among them. Even after receiving the anti-covid-19 vaccination, it is important to monitor the immunity of hospital staff to covid-19 and to adhere strictly to standard precautions.
{"title":"SARS-CoV-2 Antibodies in the Public Hospital Staff: The Second Report of a Seroprevalence Cohort Study from Iran","authors":"A. Amanat, K. Bagheri Lankarani, B. Honarvar, Naeimehossadat Asmarian, M. Shokripour, F. Rafiee, M. Aghazadeh, Farahnaz Izadi, N. Omidifar, Seyed Abolfazl Dorraninejad","doi":"10.5812/semj-121681","DOIUrl":"https://doi.org/10.5812/semj-121681","url":null,"abstract":"Background: SARS-CoV-2 is a novel virus that caused the recent global pandemic. Health care workers (HCWs), especially hospital staff, are at a higher risk of infection by this virus than the general population. In this study, anti-SARS-CoV-2 IgG antibodies were assessed in hospital workers. Methods: This prospective seroconversion-based cohort study assessed chronic immunity against covid-19 in the staff of two hospitals, the main referral hospital and a general hospital in Shiraz, south of Iran. A valid and reliable checklist was filled out for each available staff member willing to participate in this study through a face-to-face interview. Furthermore, the titer of anti-covid-19 IgG was measured by ELISA twice; in July 2020 after the second wave of COVID-19 and in February 2021 after the third wave in IRAN. Results: One hundred forty (65%) of the 214 members who participated in both stages of this consideration were from the COVID-19 referral healing center, and 74 (35%) were from the common clinic. Twelve (5.6%) of staff members had anti-SARS-CoV-2 IgG antibodies, including 10 (7.1%) from the referral healing center and 2 (2.7%) from the common healing center (P = 0.23). In the second measurement (second overview), 79 (36.9%) of members had IgG antibodies; 58 (41.4%) from the primary hospital and 21 (28.3%) from the second healing center (P = 0.039). Cruel of the IgG titer within the first study and the referral clinic was 0.8 ± 0.3 compared to 0.15 ± 0.42 within the common clinic (P = 0.001). These figures were 3.05 ± 4.58 and 1.74 ± 3.53 in both clinics and within the second overview separately (P = 0.003). IgG levels were significantly higher in the second overview compared to the first (P < 0.0001). Conclusions: During the third wave of COVID-19, a significant proportion of hospital staff developed COVID-19 IgG, especially in the referral hospitals for COVID-19. As a result of their higher and chronic exposure to COVID-19 patients than the general hospital staff, the titer of IgG in the referral hospital staff was also higher. However, the seroconversion rate between the two waves was 1.8 times in the general hospital staff compared to the referral hospital, possibly due to less conservative precautions against covid-19 among them. Even after receiving the anti-covid-19 vaccination, it is important to monitor the immunity of hospital staff to covid-19 and to adhere strictly to standard precautions.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78569308","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}
A. Hosseini, N. Sharifi, F. Dehghanrad, E. Sharifipour
Background: Brain stroke is the main cause of death and disability worldwide. This disease can cause major complications in patients and place a great burden of care on caregivers. Therefore, this study was conducted to determine the effect of telenursing on the burden of care in caregivers and the rate of complications in patients with acute brain stroke discharged from neurological wards. Methods: This two-arm parallel-group single-blind randomized clinical trial study was carried out on 72 patients with acute brain stroke discharged from neurological wards in Qom, Iran, in 2019. The patients and their caregivers were divided to control and intervention groups using random block allocation. In addition to the usual training of the ward, the intervention group received training and counseling based on their needs through phone calls for 4 weeks. However, the control group received only the usual ward training. Immediately after discharge from the hospital and 1 month later, the average care load in caregivers and urinary problems, bedsores, and the number of falls in patients were measured. A demographic questionnaire, Caregiver Burden Inventory, Braden Scale, Morse Scale, and a urinary problem checklist were used for data collection. The data were analyzed using the chi-square test, Mann-Whitney U test, independent t-test, and paired t-test by SPSS software (version 24). Results: After the intervention, the mean scores of the caregiver’s burden of care in the control and counseling groups were 35.22 ± 17.215 and 8.00 ± 7.556, respectively (P < 0.001). In addition, the counseling group experienced remarkably fewer urinary problems (P < 0.001) and falling (P = 0.011). Conclusions: This study showed that telenursing reduced the burden of care in caregivers and decreased urinary tract infections and the number of falls in patients with acute stroke. Therefore, nurses and healthcare providers can use this program to improve the lifestyle of patients with acute brain stroke and their caregivers.
{"title":"Effect of Telenursing on Caregiver Burden of Care and Incidence of some Complications in Patients with Acute Stroke Discharged from Neurological Wards: A Randomized Control Trial","authors":"A. Hosseini, N. Sharifi, F. Dehghanrad, E. Sharifipour","doi":"10.5812/semj-123479","DOIUrl":"https://doi.org/10.5812/semj-123479","url":null,"abstract":"Background: Brain stroke is the main cause of death and disability worldwide. This disease can cause major complications in patients and place a great burden of care on caregivers. Therefore, this study was conducted to determine the effect of telenursing on the burden of care in caregivers and the rate of complications in patients with acute brain stroke discharged from neurological wards. Methods: This two-arm parallel-group single-blind randomized clinical trial study was carried out on 72 patients with acute brain stroke discharged from neurological wards in Qom, Iran, in 2019. The patients and their caregivers were divided to control and intervention groups using random block allocation. In addition to the usual training of the ward, the intervention group received training and counseling based on their needs through phone calls for 4 weeks. However, the control group received only the usual ward training. Immediately after discharge from the hospital and 1 month later, the average care load in caregivers and urinary problems, bedsores, and the number of falls in patients were measured. A demographic questionnaire, Caregiver Burden Inventory, Braden Scale, Morse Scale, and a urinary problem checklist were used for data collection. The data were analyzed using the chi-square test, Mann-Whitney U test, independent t-test, and paired t-test by SPSS software (version 24). Results: After the intervention, the mean scores of the caregiver’s burden of care in the control and counseling groups were 35.22 ± 17.215 and 8.00 ± 7.556, respectively (P < 0.001). In addition, the counseling group experienced remarkably fewer urinary problems (P < 0.001) and falling (P = 0.011). Conclusions: This study showed that telenursing reduced the burden of care in caregivers and decreased urinary tract infections and the number of falls in patients with acute stroke. Therefore, nurses and healthcare providers can use this program to improve the lifestyle of patients with acute brain stroke and their caregivers.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85447552","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}
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