Fear of the unknown, anxiety, and social isolation in Iranian patients with Covid-19, the grounded theory.

BACKGROUND: Coronavirus 2019 (COVID-19) pandemic has incurred a health challenge. Patients suffer from many physical and mental disorders. To accurately identify the experience of patients with Covid-19 in the Iranian society. MATERIALS AND METHODS: This qualitative research was conducted using the grounded theory. The data of this grounded theory study were collected using 32 semi-structured interviews with participants and field notes including the patients with Covid-19, nurses, physicians, and the patients' families. Data analysis was performed using Corbin and Strauss (2008) approach for concepts, context, process, and categories' integration. RESULTS: Qualitative analysis of data led to the extraction of 54 sub-categories and 7 final categories. "Isolation, fear of death, and fear of infection of relatives and family members" were identified as the main issue. The context to this concern was the "unfamiliarity with the virus due to its ambiguous nature that was obtained with a wide range of symptoms." Facing this issue, the patients used the strategy of "adherence to health protocol in the coronavirus infection process" that was recognized as the central variable. CONCLUSION: The ambiguous and complex nature of the emerging virus, the appearance of different symptoms in different people, and the fear of infecting others, death and anxiety due to unknown complications of the disease make patients go through the most difficult experience of their lives. That requires ongoing training on up-to-date prevention and treatment protocols, along with the emergence of mutated viruses and new symptoms.

Perception risk, preventive behaviors and assessing the relationship between their various dimensions: A cross-sectional study in the Covid-19 peak period.

The Covid-19 epidemic is known as "the deadliest plague of the century" that has overshadowed various aspects of human life. Despite mutations in SARS-CoV-2, the development of new strains, and the escape of immunity, preventive health behaviors continue to play a key role in controlling this epidemic. The purpose of this study was to determine the relationship between risk perception and the performance of preventive behaviors of people in the Covid-19 peak period in society. This anonymous online survey was conducted with 1950 people in 30 provinces of Iran. The results showed that by increasing the score of cognitive, social and emotional structures of people's perception of risk, their performance in following health recommendations increases.

Medical students' psychological and behavioral responses to the COVID-19 pandemic: A descriptive phenomenological study.

On February 19, 2020, the Iranian government officially confirmed the first deaths due to COVID-19 and within a week, all universities were closed. The purpose of this study is to explore Iranian medical students' psychological and behavioral responses to the COVID-19 pandemic. This descriptive phenomenological study was conducted on 52 medical students. Data were collected using a purposive sampling method by means of synchronous virtual focus group discussions which were conducted using the WhatsApp messaging application. Data were analyzed using the MAXQDA software version 2020. Data analysis resulted in the emergence of three categories consisting of psychological responses to the pandemic and the behavioral and psychological responses to the quarantine. Most of the extracted themes are related to students' psychological reactions to the pandemic. During the quarantine period, students suffered from uncertainty, experienced boredom, worried about delay in their graduation, and were concerned about losing employment opportunities. Medical students must be prepared for crisis situations like the present pandemic. We recommend that online courses and training programs be developed with the aim of offsetting the negative effects of university closure on students' education and skill training.

Designing a comprehensive clinical competency test for operating room technology student: Using Delphi technique and CIPP model evaluation.

BACKGROUND: The ultimate goal in educating medical students is to train skilled workforce who by obtaining the required knowledge of the discipline, personal and professional skills, and attitudes to enter the national health-care system. This study was conducted with the goal of designing a comprehensive clinical competency test of operating room technology student using the Delphi technique, and then, the clinical skills of the operating room technology students of the paramedical school were assessed using the CIPP evaluation model. MATERIALS AND METHODS: The present study was conducted in the University of Medical Sciences to evaluate clinical skills with Delphi technique and CIPP evaluation model. This was a mixed methods study. Purposive sampling method was employed in the qualitative stage, and a census was conducted in the quantitative part. A comprehensive clinical competency test was designed in this research using the Delphi technique and was conducted with 18 students. Then, clinical skills evaluation was performed by descriptive-analytical statistical tests and evaluator's observation using the CIPP model. RESULTS: The comprehensive clinical competencies test of the surgical technology students was designed in four sections: content, evaluation method, test conditions, and the criteria for passing the comprehensive test. The results in the implementation stage showed that the operating room technology students had a range of excellent to weak performances in exhibiting basic skills at different levels. CONCLUSIONS: The results of the present study showed that the comprehensive test, designed based on the Delphi technique of experts, and using the CIPP model can be a good criterion for the evaluation of the operating room technology students before entering the clerkship.

Students' perspectives on the virtual teaching challenges in the COVID-19 pandemic: A qualitative study.

BACKGROUND: The COVID-19 pandemic led to the closure of crowded places such as universities and replaced face-to-face learning with virtual education. The purpose of this qualitative study was to investigate the challenges of virtual learning from the students' perspectives. MATERIALS AND METHODS: This qualitative descriptive study was conducted on students of Sabzevar University of Medical Sciences. Purposeful sampling was performed by semi-structured group interviews on the Internet in the WhatsApp social network. Fifty-two nursing, midwifery, hygiene, and paramedical students were interviewed. Every interview was started by asking the question "what is your experience about virtual teaching?" The data were analyzed using MAXQDA software version 2020. According to the steps of qualitative content analysis, content analysis was performed and the themes were extracted. RESULTS: Fifty-two students were interviewed in eight group sessions. Qualitative data analysis leads to the extraction of 23 codes, 7 categories, and the 2 main themes; dissatisfaction with virtual education with 4 categories (lack of feedback, communication channel problems, the unpreparedness of the message receiver, and weakness in educational content) and solutions to the modification of virtual teaching with three categories (possibility of receiving feedback, channel improvement, and strengthening educational content) were extracted. The highest frequency of code was related to the dissatisfaction with the uploaded contents. CONCLUSIONS: Virtual education has created a negative experience among students for various reasons, including the lack of distance learning infrastructure and the lack of a standard for preparing quality content. Therefore, it is necessary for the officials of the Education Development Center to supervise the prepared contents and improve distance learning infrastructure.

The lived experiences of pregnant women during COVID-19 pandemic: a descriptive phenomenological study.

BACKGROUND: With the onset of the COVID-19 epidemic, pregnancy and childbirth for women are taking place in unusual circumstances. We explored the lived experiences of pregnant women during the COVID-19 pandemic to better understand their experience of pregnancy so that better support could be provided. METHODS: We used a descriptive phenomenological approach to understand the lived experience of pregnant women in COVID-19 pandemic. We collected data using a purposive sampling method through in-depth interviews in cyberspace with a semi-structured questionnaire. We used Colaizzi's seven-step content analysis method to analyze the research data with the help of MAXQDA software version 2020. RESULTS: We conducted this descriptive phenomenology study on 19 pregnant women in a period between the 10th to the 20th of May, 2020. The participating women were already pregnant when the first signs of the epidemic appeared in the country and at the time of the interview. We acquired four themes including disruption of the tranquility and regular routines of daily life, new challenges caused by the epidemic, resilience and strength in facing the crisis, and adaptation with new conditions. CONCLUSIONS: The pregnant women were under intense stress during the COVID-19 outbreak. The general mobilization the health system is necessary for alleviating pregnant women's difficulties in situations like the COVID-19 epidemic. Virtual training classes and virtual counseling may enhance the peace and tranquility of pregnant women.

Evaluation of Risk Perception of COVID-19 Disease: A Community-Based Participatory Study.

OBJECTIVE: How people behave in a crisis depends on their understanding and evaluation of risk and vulnerability. Therefore, this study was conducted to investigate the Iranians' risk perception of coronavirus disease (COVID-19). METHODS: An online survey was applied, which resulted in the collection of information on demographics, the 5 dimensions of risk perception (cognitive, political, social, cultural, and emotional), and trust in the government among the Iranian users of social networks. Data were analyzed by descriptive and analytical tests of SPSS (IBM Corp, Armonk, NY) software, and confirmatory factor analysis of Amos software. RESULTS: A total of 364 persons from 20 provinces completed the questionnaire during February 25 to March 2, 2020. More than 80% of the participants believed that negligence and lack of close supervision of the authorities have led to the spread of COVID-19. The mean (SD) risk perception was 58.77 (± 10.11), indicating the medium level of risk perception of people. The second-order confirmatory factor analysis also indicated that cultural dimension had the highest positive correlation (0.96), emotional dimension had the highest negative correlation (-0.65), and social dimension had the least correlation with the risk perception model (0.08). CONCLUSION: Iranians' risk perception of the COVID-19 outbreak is not optimal, and it seems necessary to improve it.

Prioritizing the health education needs based on community participation: AHP method.

INTRODUCTION: The identification of health education needs through the community results in targeted services and health promotion. Prioritizing these needs, in addition to identifying the desired health system based on the needs of the community, is required for the optimal allocation of resources. Therefore, this study was conducted with the aim prioritizing the health educational needs of Sabzevar-Iran community. MATERIALS AND METHODS: This study was a two-step mix study. In the first stage, the qualitative method of the main themes of health educational needs of Sabzevar society was determined. Then, the questionnaire was prepared by a paired scale (36 questions) and quantitative method was used to prioritize the main themes with Analytic Hierarchy Process (AHP) software. The random sampling method was used in this study and data analysis was performed using Expert Choice software using AHP method. RESULTS: Social problems with 0.206, contagious diseases with 0.205, nutrition with 0.161, and public health with 0.132 were in the first to fourth grades of health educational needs in Sabzevar city and environmental health, health management, noncontagion diseases, elderly, and occupational health were in the fifth to ninth grades. The consistency index in this study was 0.08, although the adjustment index is <0.1 good and acceptable. CONCLUSION: Social problems are the first priority of Sabzevar society, which require appropriate training.

Innovation capability in medical sciences universities: A qualitative study of Iran.

BACKGROUND: Innovation is a competitive advantage, with its preservation and continuity dependent on the organizational innovation capability. This study was conducted with the aim of determining the innovation capability dimensions and components in medical sciences universities of Iran. METHODS: The present study is a qualitative study with content analysis approach, undertaken in 2016-2017. The data processing included 10 deep interviews with the experts of the health innovation domain in top management of the three types of the medicine sciences universities of Iran with >5 years of experience. Targeted data sampling was performed using snowball method and continued until the saturation of the data. Data analysis was performed using conventional content analysis method using Maxqda 12 software. RESULTS: Data analysis resulted in the extraction of 28 categories and 8 main themes including communications and interactions, innovation climate, university setting, policy factors (policy-making, rules and regulations), organizational culture, organizational resources, management and leadership, and organizational learning in two university internal and external dimensions. CONCLUSION: To accelerate innovation in medical sciences universities, recognizing the potential of innovation capability is essential.

Pre-Hospital Emergency in Iran: A Systematic Review.

CONTEXT: Pre-hospital care plays a vital role in saving trauma patients. OBJECTIVES: This study aims to review studies conducted on the pre-hospital emergency status in Iran. DATA SOURCES: Data were sourced from Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, and non-Iranian electronic databases, such as Medline, Embase, Cochrane Library, Scopus, and Google Scholar. In addition, available data and statistics for the country were used. DATA SELECTION: All Persian-language articles published in Iranian scientific journals and related English-language articles published in Iranian and non-Iranian journals indexed on valid sites for September 2005 - 2014 were systematically reviewed. DATA EXTRACTION: To review the selected articles, a data extraction form developed by the researchers as per the study's objective was adopted. The articles were examined under two categories: structure and function of pre-hospital emergency. RESULTS: A total of 19 articles were selected, including six descriptive studies (42%), four descriptive-analytical studies (21%), five review articles (16%), two qualitative studies (10.5%), and two interventional (experimental) studies (10.5%). In addition, of these, 14 articles (73.5%) had been published in the English language. The focus of these selected articles were experts (31.5%), bases of emergency medical services (26%), injured (16%), data reviews (16%), and employees (10.5%). A majority of the studies (68%) investigated pre-hospital emergency functions and 32% reviewed the pre-hospital emergency structure. CONCLUSIONS: The number of studies conducted on pre-hospital emergency services in Iran is limited. To promote public health, consideration of prevention areas, processes to provide pre-hospital emergency services, policymaking, foresight, systemic view, comprehensive research programs and roadmaps, and assessments of research needs in pre-hospital emergency seem necessary.

The Evaluation of Hospital Performance in Iran: A Systematic Review Article.

BACKGROUND: This research aimed to systematically study and outline the methods of hospital performance evaluation used in Iran. METHODS: In this systematic review, all Persian and English-language articles published in the Iranian and non-Iranian scientific journals indexed from Sep 2004 to Sep 2014 were studied. For finding the related articles, the researchers searched the Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, as well as the non-Iranian electronic databases, including Medline, Embase, Scopus, and Google Scholar. For reviewing the selected articles, a data extraction form, developed by the researchers was used. RESULTS: The entire review process led to the selection of 51 articles. The publication of articles on the hospital performance evaluation in Iran has increased considerably in the recent years. Besides, among these 51 articles, 38 articles (74.51%) had been published in Persian language and 13 articles (25.49%) in English language. Eight models were recognized as evaluation model for Iranian hospitals. Totally, in 15 studies, the data envelopment analysis model had been used to evaluate the hospital performance. CONCLUSION: Using a combination of model to integrate indicators in the hospital evaluation process is inevitable. Therefore, the Ministry of Health and Medical Education should use a set of indicators such as the balanced scorecard in the process of hospital evaluation and accreditation and encourage the hospital managers to use them.