ABSTRACT
Background: Assessing the performance of hospitals in waste management requires considering several criteria of different types. The multiplicity of the criteria and how they are weighed and, ultimately, the ranking of hospitals; are among the most complex challenges faced by the environmental health authorities. This research tried to assess the capability of four commonly used multi-criteria decision-making methods, as well as a hybrid technique for performance assessment of six hospitals in Tehran City, Iran, in 2018 regarding waste management. Methods: The effective criteria and sub-criteria were identified by reviewing the relevant literature. The data collection tool was a self-constructed checklist developed based upon the identified criteria and sub-criteria and analysis of the collected data was done in MATLAB software. The sample hospitals were ranked based on the scores given to the management performance of hospitals. Results: The final rankings by the different techniques did not differ significantly. According to the results of the hybrid method, among six studied hospitals, the top three hospitals were Hospital C, B, and A respectively, regarding hospital waste reduction criteria. These hospitals generally had an acceptable performance in terms of waste management, especially waste disinfection and separation at the origin. Conclusion: In assessing the performance and ranking of hospitals in terms of waste management, hybrid multi-criteria decision-making techniques can be used as a useful tool in waste management planning. By identifying the areas in need of corrective actions and choosing the appropriate strategy, they pave the way for improving the performance of hospitals in the field of waste management.
ABSTRACT
BACKGROUND: To control diabetes mellitus (DM) it is necessary to make overall changes in the life style of the patients. The aim of this study was to determine the effects of predisposing, reinforcing and enabling factors on self-care behaviors of the patients with DM in the Minoodasht city, Iran in 2012. METHODS: In this quasi-experimental study, 78 people with DM were selected by convenience sampling method. In the first stage of study, the educational program was compiled and executed on six information sessions. To present the informative content, a video projector and different lecturing methods including questions and answers, dynamic group discussion and different educational materials such as pamphlets and CDs were employed. After one month, the efficiency of the educational program was determined by using the same questioner. Data were analyzed using paired sample T-test and McNemar test. RESULTS: The mean age of participants was 49 (SD: 3.27.) years old, 87.2% were married, and 19.2% were illiterate. The results showed that the enabling factors like adopting to go on a diet and the educational classes facilitated by the staff had significant effects on health care behavior of the patients. Furthermore 69.2% of the participants adopted to go on a diet before the educational sessions; that figure increased to 94.9% after the educational sessions. According to the results the mean scores for the knowledge, attitude, and behavior, reinforcement factors and enabling factors increased significantly after of the educational intervention (p- value >0.001). CONCLUSION: Predisposing, enabling and reinforcement factors affected in taking self-care behavior in the patient with DM.
ABSTRACT
BACKGROUND: Diabetes is a chronic disease and its control requires essential change in patients' life style. The aim of this study was survey of effects of educational intervention based on PRECEDE Model on self care behaviors and control in patients with type 2 diabetes. METHODS: This was a quasi-experimental study carried out in 78 patients with type 2 diabetes who have referred to Minoodasht clinic of diabetes. The educational program has been designed according to the PRECEDE Model. Prior to perform the educational intervention, the patients filled a questionnaire which was designed according to the structure of PRECEDE Model for type 2 diabetes patients. The diabetes education program was performed on three target groups (patients, their families and Health care personnel). After four weeks, the effects of the educational program have been evaluated through the same questionnaire. The findings were analyzed by SPSS version 16 and p-value less than 0.05 was taken as statistically significant. RESULTS: The mean age of participants was 49 years, 87.2% were married and 19.2% was illiterate. The rate of income of 44.9% was low. 66% had a family history of diabetes and 64% had been afflicted with diabetes more than 5 years. The Chi-square test showed a significant relationship between formation of a file in diabetes clinic and on-time presence to receive services and participation in the educational classes with the marital status variable. The results also showed that there is a significant relationship between observing food diet and job. The mean scores of knowledge, attitude, practice, reinforcing factors and enabling factors has increased after educational intervention. The Chi-square test shows a significant difference before and after of education intervention in stages of the model. CONCLUSION: The obtained results based on PRECEDE Model would support the positive effect of the educational intervention and its major elements (predisposing, enabling and reinforcing factors) on diabetes self-care behaviors.
