Physical, psychological, and social experiences of women recovered from COVID-19 in Iran: A qualitative study.

BACKGROUND: This paper aims to examine the impact of COVID-19 on various health aspects of women recovered from this disease in Ardabil province, Iran. MATERIALS AND METHODS: This qualitative study using a content analysis approach was carried out through in-depth individual and focus group discussion using semi-structured interviews schedule in 26 women during June and August 2021. Interviews were recorded, transcribed, and MAXQDA six-stage analysis framework. RESULTS: Negative consequences of COVID-19 were generally categorized into five main themes (including increased self-conscious excitement, perceived social stigma, depression, changes in behavioral patterns, and reduced level of quality of life) and 13 subthemes. The positive consequences were the following five themes (including the development of the spiritual attitude, increasing the importance of personal health, the rise of perceived support, increased sense of altruism, and increased financial management) and four subthemes. CONCLUSION: Based on the findings, it is concluded that effective support by the government, society, and the medical staff could help to relieve people's psychological and social stress through providing financial aid, the right information, and training.

Experiences of students on virtual education in Iranian medical science universities during the COVID-19 pandemic: A qualitative study.

BACKGROUND: Due to the changing environment and responding to the needs of the society, change in the traditional education system is inevitable. Also, the occurrence of events such as the COVID-19 pandemic showed that the existence of a virtual education system to prevent the cessation of education is the need of today's society. OBJECTIVE: This study aimed to investigate the students' experiences of virtual education in Iranian universities of medical sciences during the COVID-19 pandemic. METHODS: This qualitative study was conducted on 28 students studying in Iranian universities of medical sciences from October 2021 to January 2022 to investigate their experiences of virtual education during the COVID-19 pandemic. The participants were selected by purposive sampling. An interpretive phenomenological approach and semi-structured, face-to-face, in-depth interview were used to collect the data. The data were analyzed by Colizzi's seven-step method. RESULTS: Students' experiences of virtual education during the COVID-19 pandemic were categorized into three themes and seven sub-themes, including the strengths of virtual education (sub-themes: individual and educational dimensions), the weaknesses of virtual education (sub-themes: infrastructural, educational, tests and assignments fields), and suggestions to improve virtual education (sub-themes: infrastructural development and educational planning). CONCLUSION: According to the study results, the virtual education during the COVID-19 pandemic led to students staying away from the crowded centers. However, some weaknesses were also mentioned by the participants. Therefore, by anticipating requirements and needs, planning and policy making, and seriously reviewing human, financial, and support resources, virtual education can be developed and used as a supplement to face-to-face education in the future.

Assessment of virtual education during the covid-19 pandemic from the perspective of faculty members and students: a cross-sectional descriptive study in northwest Iran.

BACKGROUND: Since the coronavirus outbreak, many countries have replaced traditional education with virtual education in order to prevent the disease spread, and also avoid stopping education. The aim of the present study was to assess the virtual education status at Khalkhal University of Medical Sciences during the covid-19 pandemic from the perspective of students and faculty members. METHODS: This is a descriptive-cross-sectional study that was conducted between December 2021and February 2022. The study population included faculty members and students who were selected by consensus. Data collection instruments included demographic information form and a virtual education assessment questionnaire. Data analysis was carried out using independent T-test, one sample T-test, Pearson Correlation, and ANOVA test in SPSS software. RESULTS: A total of 231 students and 22 faculty members of Khalkhal University of Medical Sciences participated in the present study. The response rate was 66.57%. The mean and standard deviation of assessment scores of students (3.3 ± 0.72) were lower than those of faculty members (3.94 ± 0.64), which showed a statistically significant difference (p < 0.01). User access to the virtual education system (3.8 ± 0.85) and lesson presentation (4.28 ± 0.71) obtained the highest scores from the perspective of students and faculty members, respectively. There was a statistically significant association between employment status and the assessment score of faculty members (p = 0.01), and the field of study (p < 0.01), the year of university entrance (p = 0.01), and the assessment score of students. CONCLUSION: The results showed a higher than mean assessment score in both groups of faculty members and students. There was a difference between faculty members and students in terms of virtual education scores in the parts that require the creation of better processes and more complete capabilities in the systems, which seems that more detailed planning and reforms will improve the process of virtual education.

Perceived stress, stress coping strategies, and post-traumatic-growth among healthcare professionals during COVID-19 pandemic.

AIM: The purpose of this research was to identify the perceived stress, stress coping strategies, and Post-Traumatic-Growth (PTG) among Iranian healthcare professionals. DESIGN: A cross-sectional study was applied. METHODS: This study was conducted among 402 healthcare professionals in northwestern Iran. Participants completed demographic, perceived stress, stress coping strategies, and PTG questionnaires. Multiple linear regression was employed to identify the predictors of perceived stress and PTG. RESULTS: The overall score of perceived stress was calculated 30.55 (6.18). The problem-oriented strategy was the most common stress coping by healthcare professionals (52.66 (8.72)). Also, the total score of PTG was calculated at 45.72 (30.42). Perceived stress, stress coping strategies (except problem-oriented), and PTG scores were significantly different between hospital and health centres participants (p-value < 0.05). Previous experience in critical situations, crisis-related course, degree, age, department, and stress coping strategies were related to the stress level. Moreover, workplace, department, work experiences, and employment status were the predictors of PTG.

Work-family conflict, burnout, and related factors among nurses during the COVID-19 pandemic in the Northwest of Iran.

BACKGROUND: Nurses, as the largest working group in the hospital, experience many problems, conflicts, and stressors in the workplace and family especially after the widespread distribution of coronavirus 2019 (COVID-19). OBJECTIVE: The perceived conflict and burnout among nurses, as well as the correlation between these two variables and the associated factors, were the main subjects of this study. METHODS: This cross-sectional study involved 256 nurses from three COVID-19 referral hospitals in northwest Iran. Participants completed demographic, work-family conflict (WFC), and burnout questionnaires. The nonparametric tests including Mann-Whitney U, Kruskal-Wallis, and Spearman correlation coefficient were applied to statistical analysis. RESULTS: The overall score of conflict was 55.3 (12.7). The time dimension received the highest score 11.4 (2.9). In terms of intensity 27.6 (8.7) and frequency 27.6(8.8), nurses had the most burnout in the lack of personal accomplishment dimension. All aspects of WFC, emotional exhaustion, and depersonalization characteristics of burnout had statistically significant positive correlations (p < 0.01). The ward, hospital and employment status variables were associated with WFC (p < 0.05). The association between taking the crisis management course and the severity of depersonalization, and the frequency of lack of personal accomplishment was confirmed (p < 0.01). Additionally, the frequency and severity of emotional exhaustion were associated with employment status and work experiences (p < 0.05). CONCLUSION: The findings showed that nurses had WFC and burnout rates that were above average. Regarding the negative effects of these two phenomena on health, and also nurse's clinical practices, rearranging work conditions and providing better organizational support seem necessary.

Hypochondriasis and self-medication among medical sciences students during the COVID-19 pandemic: A descriptive cross-sectional study in Northwestern Iran.

BACKGROUND: Increased fear and anxiety among the general public following the emergence of coronavirus 2019 (COVID-19) can lead to hypochondriasis as well as indiscriminate use of drugs, versus the disease. OBJECTIVE: The present study was conducted to identify the frequency and causes of self-medication and hypochondriasis among students. METHODS: This descriptive cross-sectional study was conducted among 241 students of different disciplines of Khalkhal University of Medical Sciences in northwestern Iran over a period of six months. SPSS 26 software, Chi-square and Fisher tests were used to analyze the data. RESULTS: The rate of self-medication was calculated 51%. The highest rate of self-medication was in the form of tablets (75.6%) and capsules (28.5%) and the highest type of medication was herbal medicine (59.3%) and multivitamins and complementary drugs (54.5%). The most common cause of self-medication was previous use and the effectiveness of the drug in the past (79.7%). The mean score of hypochondriasis was calculated at 21.52 (11.02) and the majority of students (49.8%) were in the healthy group. There was a statistically significant association between hypochondriasis and self-medication (p = 0.002). CONCLUSION: Based on the findings, more than half of the participants in the study had self-medication. About 20% of students also experienced mild to moderate hypochondriasis. Therefore, it is suggested that the necessary training and support be provided to deal with the side effects of these two phenomena.

Designing and conducting initial application of a performance assessment model for in-hospital trauma care.

BACKGROUND: Trauma is a major cause of death worldwide, especially in Low and Middle-Income Countries (LMIC). The increase in health care costs and the differences in the quality of provided services indicates the need for trauma care evaluation. This study was done to develop and use a performance assessment model for in-hospital trauma care focusing on traffic injures. METHODS: This multi-method study was conducted in three main phases of determining indicators, model development, and model application. Trauma care performance indicators were extracted through literature review and confirmed using a two-round Delphi survey and experts' perspectives. Two focus group discussions and 16 semi-structured interviews were conducted to design the prototype. In the next step, components and the final form of the model were confirmed following pre-determined factors, including importance and necessity, simplicity, clarity, and relevance. Finally, the model was tested by applying it in a trauma center. RESULTS: A total of 50 trauma care indicators were approved after reviewing the literature and obtaining the experts' views. The final model consisted of six components of assessment level, teams, methods, scheduling, frequency, and data source. The model application revealed problems of a selected trauma center in terms of information recording, patient deposition, some clinical services, waiting time for deposit, recording medical errors and complications, patient follow-up, and patient satisfaction. CONCLUSION: Performance assessment with an appropriate model can identify deficiencies and failures of services provided in trauma centers. Understanding the current situation is one of the main requirements for designing any quality improvement programs.

Identifying indicators and evaluation steps with suggestions for improving trauma care in Iran: experts' perspective.

BACKGROUND: Trauma is one of the major causes of mortality across the world. Trauma patients have critical status and need timely, adequate, and organized care. The different consequences of trauma care among service centers around the world and even within a country revealed the need for careful evaluation. This study was designed and executed to collect experts' opinions on the evaluation steps, related indicators, and improvement strategies in trauma care. METHODS: This qualitative study was based on a conventional content analysis approach. 2 focus group discussions (FGD) with 6 participants per FGD and 16 face-to-face in-depth interviews were conducted to collect the required information (from September 2018 to early 2019). Participants were selected through the purposive sampling method. The experts' viewpoints were classified by the main and sub themes. RESULTS: Four basic themes extracted from the interviews and focus group discussions including, trauma care importance (sub-themes: the involved individuals' being young and productive and the effectiveness of trauma care); trauma care indicators (sub-themes: pre-hospital indicators, in-hospital indicators, and post-hospital indicators); stages of trauma care evaluation (sub-themes: evaluation prerequisites, finalization of indicators before the evaluation, determining evaluation time scope, determining evaluation dimensions, external and internal evaluation and use of evaluation results); trauma care improvement (sub-themes: balancing workload in trauma centers, enhancement of information system, considering extra-organizational dimensions in trauma care and empowerment of trauma care providers). CONCLUSIONS: According to experts' viewpoints, trauma is a very important issue, because it involves young people. They believed that having indicators covering all aspects of care assist health managers and policymakers to understand under-standard performance. These indicators should be used in the form of a specific evaluation program and related to Iran context. Besides, reforming macro policies, planning, development of infrastructures, and education was some recommendations of experts to improve trauma care.

Advantages and disadvantages of different methods of hospitals' downsizing: a narrative systematic review.

BACKGROUND: Hospitals as key actors in health systems face growing pres-sures especially cost cutting and search for costeffective ways to resources management. Downsizing is one of these ways. This study was conducted to identify advantages and disadvantages of different methods of hospital' downsizing. METHODS: The search was conducted in databases of Medlib, SID, Pub Med, Science Direct and Google Scholar Meta search engine by keywords of Downsizing, Hospital Downsizing, Hospital Rightsizing, Hospital Restructuring, Staff Downsizing, Hospital Merging, Hospital Reorganization and the Persian equivalents. Resulted 815 articles were studied and refined step by step. Finally, 27 articles were selected for analysis. RESULTS: Five hospital downsizing methods were identified during searching. These methods were reducing the number of employees and beds, outsourcing, integration of hospital units, and the combination of these methods. The most important benefits were cost reduction, increasing patient satisfaction, increasing home care and outpatient services. The most important disadvantage included reducing access, reducing the rate of hospital admissions and increasing employees' workload and dissatisfaction. CONCLUSION: Each downsizing method has strengths and weaknesses. Using different methods of downsizing, according to circumstances and applying appropriate interventions after implementation, is necessary for promotion.