Psychometric Properties of the Patient Self-Advocacy Scale: The Persian Version.

BACKGROUND: Advances in science and technology and the changes in lifestyle have changed the concept of health in terms of etiology and mortality. The aim of this study was to test the psychometric properties of the original Patient Self-Advocacy Scale for use with an Iranian population. METHODS: In the current study, 50 chronic patients between the ages of 25 and 75 were selected as samples. This study was conducted in May 2013 at Bou Ali Sina Hospital in Sari. The translation process and cultural adaptation of the Patient Self-Advocacy Scale were conducted. The face validity and content validity of the instrument were formally verified by analyzing the feedback of patients and health professionals. In order to evaluate questionnaire's reliability, the intraclass correlation coefficient (ICC) was calculated for each item and each domain; and the Cronbach's alpha was calculated for the entire instruments and each domain. RESULTS: Of the 50 patients participating in the study, 36% were male and 64% were female. The mean age of the patients was 42.5. To comply with the Iranian culture and the study target population, slight changes were applied to the process of translation and validation. In the present study, intraclass correlation coefficient for each item was 0.8-1, which demonstrates excellent reliability of the questionnaire. The Cronbach's alpha value was 0.75 for overall scale. CONCLUSION: The Persian version of Patient Self-Advocacy Scale was valid and reliable. Hence, it can be used by public health researchers and health system policy makers for programming and offering patient-oriented health services based on patients' comments, needs, and preferences.

Tuberculosis disease diagnosis using artificial immune recognition system.

BACKGROUND: There is a high risk of tuberculosis (TB) disease diagnosis among conventional methods. OBJECTIVES: This study is aimed at diagnosing TB using hybrid machine learning approaches. MATERIALS AND METHODS: Patient epicrisis reports obtained from the Pasteur Laboratory in the north of Iran were used. All 175 samples have twenty features. The features are classified based on incorporating a fuzzy logic controller and artificial immune recognition system. The features are normalized through a fuzzy rule based on a labeling system. The labeled features are categorized into normal and tuberculosis classes using the Artificial Immune Recognition Algorithm. RESULTS: Overall, the highest classification accuracy reached was for the 0.8 learning rate (α) values. The artificial immune recognition system (AIRS) classification approaches using fuzzy logic also yielded better diagnosis results in terms of detection accuracy compared to other empirical methods. Classification accuracy was 99.14%, sensitivity 87.00%, and specificity 86.12%.

Determining Core Components in Accreditation of Limited Surgery Facilities in Iran.

BACKGROUND: Limited surgery facilities, or day-care centers, have been expanding in recent years with the approach of reducing the number of patients referred to hospitals for treatment in relation to limited and ambulatory surgeries. This study was conducted to perform a comparative review of accreditation models for limited surgery facilities of selected countries and to obtain expert opinions in the field of policymaking and accreditation in Iran. MATERIALS AND METHODS: This applied and qualitative study was carried out by a comparative method in 2019. The accreditation standards of limited surgery facilities in nine selected countries/states were assessed. Semi-structured interviews were then held with 25 Iranian experts in policymaking as well as accreditation authorities. RESULTS: Evaluation of the core components of accreditation standards for limited surgery facilities in selected countries showed that the main concepts of care and treatment, human resource management, patient safety, drug management, patient education, health information management, quality improvement, service recipient rights, infection prevention and control, physical structure, management and leadership, and general facilities were among the key recurring concepts in all models. In the study of factors affecting the accreditation model of limited surgery facilities in Iran, 5 main topics and 43 subtopics were identified. CONCLUSION: Although the current assessment model of limited surgery facilities is an appropriate tool for evaluation, it still needs to be improved because of the uncertainty of evaluation model, training of accreditors and the content of standards.

Status of Quality in Strategic Purchasing in the Health System: A Systematic Review / Estado de la calidad en las compras estratégicas en el sistema de salud: Una revisión sistemática

Introduction. Las compras estratégicas son un componente importante del financiamiento del sistema de salud. Puede mejorar la productividad, la justicia y la responsabilidad en la prestación de atención médica en caso de considerar la calidad. Este estudio, que se realizó como una revisión sistemática, tuvo como objetivo investigar el estado de la calidad en cinco dominios de compras estratégicas en el sistema de salud para responder qué, para quién, de quién, cómo comprar y cuánto comprar. Material y Métodos: Este estudio revisó sistemáticamente los artículos publicados en las bases de datos de Web of Sciences (WOS), Scopus, PubMed, Medline vía Ovid, Embase desde 2000 hasta octubre de 2019. Las palabras clave utilizadas para la búsqueda en las bases de datos incluyeron las siguientes: Sector Salud, Entrega de atención médica, garantía de calidad, mejora de la calidad y compras estratégicas. Un total de 182 artículos fueron seleccionados y revisados ​​por cuatro investigadores. Se excluyeron los artículos con contenido irrelevante. Los datos de los artículos seleccionados se analizaron mediante el método de análisis de contenido. Resultados: De los 182 artículos recopilados mediante la búsqueda en las bases de datos seleccionadas, se analizaron 16 artículos. Con base en los resultados de este estudio, las compras estratégicas en el sistema de salud resultan en la entrega de servicios con mayor calidad. Conclusión: Las compras estratégicas pueden mejorar el desempeño del sistema de salud al elegir el proveedor más apropiado y el método de pago más apropiado, junto con la equidad en la prestación de servicios de atención médica de calidad

Introducction. Strategic purchasing is an important component of financing in the health system. It can enhance productivity, justice, and accountability in the health care delivery in case of considering the quality. This study, which was conducted as a systematic review, was aimed at investigating the status of quality in five domains of strategic purchasing in the health system to answer what, for whom, from whom, how to buy, and how much to buy. Material and Methods: This study systematically reviewed the articles published in the databases of Web of Sciences (WOS), Scopus, PubMed, Medline via Ovid, Embase from 2000 to October 2019. The keywords used to search the databases included the following: Health Care Sector, Delivery of Health Care, Quality Assurance, Quality Improvement, and Strategic Purchasing. A total of 182 articles were selected and reviewed by four researchers. Articles with irrelevant content were excluded. Data of the selected articles were analyzed using the content analysis method. Results: Of the 182 articles collected through searching the selected databases, 16 articles were analyzed. Based on the results of this study, strategic purchasing in the health system results in the delivery of services with higher quality. Conclusion: Strategic purchasing can enhance the performance of the health system through choosing the most appropriate provider and the most appropriate payment method, along with equity in providing quality health care services

Patient involvement in health care decision making: a review.

BACKGROUND: Patient participation means involvement of the patient in decision making or expressing opinions about different treatment methods, which includes sharing information, feelings and signs and accepting health team instructions. OBJECTIVES: Given the importance of patient participation in healthcare decision making which empowers patients and improves services and health outcomes, this study was performed to review previous studies on patient participation in healthcare decision making. MATERIALS AND METHODS: To prepare this narrative review article, researchers used general and specific search engines, as well as textbooks addressing this subject for an in-depth study of patient involvement in healthcare decision-making. As a result, 35 (out of 100 relevant) articles and also two books were selected for writing this review article. RESULTS: BASED ON THE REVIEW OF ARTICLES AND BOOKS, TOPICS WERE DIVIDED INTO SIX GENERAL CATEGORIES: definition of participation, importance of patient participation, factors influencing participation of patients in healthcare decisions, method of patient participation, tools for evaluating participation, and benefits and consequences of patient participation in health care decision-making. CONCLUSIONS: IN MOST STUDIES, FACTORS INFLUENCING PATIENT PARTICIPATION CONSISTED OF: factors associated with health care professionals such as doctor-patient relationship, recognition of patient's knowledge, allocation of sufficient time for participation, and also factors related to patients such as having knowledge, physical and cognitive ability, and emotional connections, beliefs, values and their experiences in relation to health services.